Patients should be advised of the possible need to reduce levodopa dosage after the initiation of ZELAPARÃ? therapy.

Patients (or their families if the patient is incompetent) should be advised not to exceed the daily recommended dose of 2.5 mg. The risk of using higher daily doses of ZELAPARÃ? should be explained, and a brief description of the hypertensive/cheese reaction provided. Rare hypertensive reactions with oral selegiline at recommended doses associated with dietary influences have been reported.

Consequently, it may be useful to inform patients (or their families) about the signs and symptoms associated with MAOI induced hypertensive reactions. In particular, patients should be urged to report, immediately, any severe headache or other atypical or unusual symptoms not previously experienced.

Patients should be informed that hallucinations can occur.

Patients should be instructed not to remove the blister from the outer pouch until just prior to dosing. The blister pack should then be peeled open with dry hands and the orally disintegrating tablet placed on the tongue, where it will disintegrate. Patients should also avoid drinking liquids or eating food five minutes before and after taking ZELAPARÃ?.

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