Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Selegiline

Antiparkinsonian (MAO-B inhibitor)

Brand names: Eldepryl, Zelapar

Oral health effects

  • Xerostomia (dry mouth)

    Reduced salivary flow with elevated caries and discomfort risk.

    Clinical management: Hydration, salivary substitutes, high-fluoride caries prevention.

  • Hypertensive/local anesthetic interaction caution

    MAO inhibition warrants caution with vasoconstrictors and certain analgesics (e.g., meperidine).

    Clinical management: Review interactions before prescribing; consult physician as needed.

  • Dizziness on standing (orthostatic hypotension)

    Orthostatic hypotension is listed among cardiovascular adverse reactions and as a reason for discontinuation; most patients also take levodopa, which adds to the effect.

    Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. Selegiline prescribing information (FDA label) Chartwell RX, LLC / DailyMed, 2024.