## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Treatment](/living-with-parkinsons/treatment) - [Prescription Medications](/living-with-parkinsons/treatment/prescription-medications) ## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Treatment](/living-with-parkinsons/treatment) - [Prescription Medications](/living-with-parkinsons/treatment/prescription-medications) # MAO-B Inhibitors ## 💡 Quick Summary - MAO-B inhibitors block the enzyme that breaks down [dopamine](/living-with-parkinsons/treatment/prescription-medications/dopamine-antagonists "Dopamine Agonists"), helping modestly improve Parkinson’s movement symptoms. - They can be used alone early in the disease or added to other medications like levodopa to reduce [“off” time](/library/fact-sheets/managing-off-time "Managing "Off" Time in Parkinson's") and extend “on” time. - Common side effects include [nausea](/understanding-parkinsons/non-movement-symptoms/constipation "Constipation & Nausea"), dry mouth, lightheadedness and confusion or hallucinations in older adults. - Medication interactions should be reviewed with a doctor or pharmacist. ![Doctor writing prescription](/sites/default/files/styles/no_sizing/public/images/maobinhibitors.jpg?itok=KWEwYSsX) Monoamine oxidase-B (MAO-B) is an enzyme in the body that breaks down several chemicals in the brain, including dopamine. An MAO-B inhibitor makes more dopamine available to the brain. This can modestly improve many PD [movement symptoms](/understanding-parkinsons/movement-symptoms "Movement Symptoms"). MAO-B inhibitors may be useful as early monotherapy (a medication used alone) or as an add-on to other medications, including [levodopa](/living-with-parkinsons/treatment/prescription-medications/levodopa "Levodopa"). When used with other medications, MAO-B inhibitors may reduce [motor fluctuations](/library/fact-sheets/managing-off-time "Managing "Off" Time in Parkinson's") *—* periods of diminished symptom control as a levodopa dose wanes *—* minimizing “off” time and extending “on” time. ## Quick Facts - MAO-B inhibitors block an enzyme that breaks down dopamine in the brain. This helps keep more dopamine available for longer. - These drugs can provide modest benefits for Parkinson’s movement symptoms. - These medications can be used early in the disease as monotherapy or as an adjunct (add-on) to other medications. - When used together with other medications, MAO-B inhibitors may reduce “off” time and extend “on” time. [Read more in our blog article](/blog/science-news/dopamine-medication "Dopamine Medication May Help with Sleep, Depression and Pain") ## Forms of MAO-B Inhibitors - ### Selegiline (L-deprenyl, Eldepryl) **Available Doses:** 5 mg **Typical Treatment Regimen**: 5 mg twice daily with breakfast and lunch **Side Effects**: Nausea, dry mouth, lightheadedness, constipation; may worsen dyskinesia; insomnia **Indications for Usage**: Monotherapy for slowness, stiffness and tremor; adjunct therapy for motor fluctuations - ### Selegiline HCL Orally Disintegrating (Zelapar) **Available Doses:** 1.25 mg, 2.5 mg **Typical Treatment Regimen**: 1.25 to 2.5 mg once per day **Side Effects**: Nausea, dry mouth, lightheadedness, constipation; may worsen dyskinesia; insomnia **Indications**: Adjunctive therapy for motor fluctuation, plus need for dissolvable medication in mouth especially if swallowing is impaired - ### Rasagiline (Azilect®) **Available Doses:** 0.5 mg, 1 mg doses **Typical Treatment Regimen**: 1 mg once per day **Side Effects**: Nausea, dry mouth, lightheadedness, constipation; may worsen dyskinesia **Indications for Usage**: Monotherapy for slowness, stiffness and tremor; adjunct therapy for motor fluctuations - ### Safinamide (Xadago) **Available Doses:** 50 mg, 100 mg **Typical Treatment Regimen**: Once daily at the same time every day **Side Effects**: Nausea, dry mouth, lightheadedness, constipation; may worsen dyskinesia; insomnia **Indications for Usage**: Adjunctive therapy to carbidopa/levodopa for “off” episodes ## Common Side Effects of MAO-B Inhibitors - Mild nausea - Dry mouth - Lightheadedness - Constipation - Confusion (can occur in elderly people with PD) - Hallucinations (can occur in elderly people with PD) ### Potential for Neuroprotection Animal studies have historically suggested that MAO-B inhibitors might slow the progression of Parkinson’s, offering neuroprotection. When tested in humans true disease modification remains unproven. - ### Disclaimers Please note that the side effects listed in the tables that accompany each class of medication are the most *commonly experienced*. Not all individuals will experience such side effects. Careful adjustments to dosage or the timing of individual doses can often effectively limit or eliminate side effects for many people. Speak to your doctor immediately if you experience any side effects. For a complete description of each drug and its possible side effects, please request a “package insert” from your pharmacist for each drug used. **It is recommended that all prescriptions be filled at the same pharmacy to avoid interactions between medications.** Interactions can be dangerous and even life-threatening, so make sure the pharmacist knows of all medications and supplements being taken, including over-the-counter medications and supplements. **Caution:** Parkinson’s medications may have interactions with certain foods, other medications, vitamins, herbal supplements, over-the-counter cold pills and other remedies. Anyone taking a PD medication should talk to their doctor and pharmacist about potential drug interactions. *Page reviewed by Dr. Chauncey Spears, Clinical Assistant Professor and Dr. Amelia Heston, Movement Disorders Fellow at the University of Michigan.* ## Related Materials Books ### [ Medications: A Treatment Guide to Parkinson’s Disease ](/library/books/medications) [Read Now](/library/books/medications) Podcasts ### [ Episode 115: Repurposing Medications to Slow Progression of PD ](/library/podcast/115) [Listen Now](/library/podcast/115) Podcasts ### [ Episode 96: PD Medications and Side Effects ](/library/podcast/96) [Listen Now](/library/podcast/96) ## Related Blog Posts ![Couple buying medication in a store](/sites/default/files/styles/500x360/public/images/pdmednew-bloghero.png?h=ed9ce7df&itok=xE6j_DbB) Raise Awareness ### [ PD and Medication: What's New? ](/blog/tips/2019-medication-update) READ NOW ![Couple looking at papers](/sites/default/files/styles/500x360/public/images/medicationtherapy-blog.jpg?h=ed9ce7df&itok=4L9hOKes) Advancing Research ### [ What's Hot in PD? When should you start medication therapy for Parkinson’s disease? ](/blog/research/starting-medications) READ NOW ![giving medications to older man](/sites/default/files/styles/500x360/public/images/medicationadvancingtreatment-blog.jpg?h=f2fcf546&itok=_oFS4UXr) Advancing Research ### [ PD and Medication: Advancing Treatment ](/blog/research/medication-treatment) READ NOW ### Order a Parkinson’s Hospital Safety Guide The Hospital Safety Guide is a resource for people with Parkinson's and their care partners filled with useful tools and information to prepare for and navigate a hospital stay. [ORDER NOW](/resources-support/pd-library/order-publications) [LEARN MORE](/resources-support/hospital-safety-guide) - Share on Facebook - Share on X - Share on LinkedIn