My doctor suggested to me that Zelapar (selegiline) could be substituted for Azilect (resagiline). They are both MAO inhibitors, but I was under the impression that Azilect had additional symptomatic benefits. Does anyone have experience changing from azilect to zelapar? Does it work as well for you? Perry

I do know that NICE (UK's National Institute for Clinical Excellence) believes there are no clear advantages to Azilect over Selegiline and in most cases they won't fund it over Selegiline.

I discussed this with my Neuro 3 weeks ago.

Neil.

However I understand that rezagiline is more specific at inhibiting MAO B, with little effect on MAO A, at least at the recommended doses (1-2 mg per day for the new, expensive reza-, compared with 10-20 mg for the old standby sele-).
At one time there was some claim that Azilect had significant neuroprotective properties, but I think that has not been pushed more recently. Professor Youdim's group in Israel, the originators of rezagiline, built into it the chemical propargyl- group. This group was thought to be critical for its putative neuroprotective activity. Interstingly, the same group is also part of the selegiline structure. One might conclude, therefore that selegiline should also be neuroprotective, and I am not aware of any data to support that.

Anyone on Azilect can recommend safe over the counter meds for fever and colds?? not sure if i have to avoid certain meds. placed call into dr....still waiting for reply.


thanks eric aka kman

there was orginally controversy about selegiline metabolizing to amphetamine-like substances, and the question whether these products were helpful or harmful in PD. Am unsure if a consensus has ever been achieved. One neurologist we consulted maintained these products may help with fatigue in PD, the other neurologist wanted to avoid selegiline because of the amphetamine like metabolites....As in many other treatment areas in PD, the reasons for using one specific MAO-B inhibitor over the other appears to be partially dependent upon the physician one consults.....

From my reading of the replies and the other information available there seems to be little solid evidence to base a choice between these two. One big difference is the price of Azilect is as much as $8-$9 per day, while Zelapar is available in generic (selegiline) at a small fraction of the cost, a consideration for someone who pays out of pocket. The irony is my Neuro has been reluctant to prescribe ritalin which I have been taking for 8 years, but he does recommend the Zelapar which metabolizes into amphetimines. I am reluctant to switch because I have done pretty well with azilect (cutting my sinemet by 1/3), but I guess its worth a try.
Perry