Should selegiline/midopid be taken before or after meals?

In drug treatment, the time of taking the drug and the relationship with food often directly affect the efficacy and safety. For selegiline/midopyr(Selegiline), the way you take it is particularly important. According to pharmacological studies and instructions, selegiline should be taken with meals when treating Parkinson's disease, and it is best to take it during breakfast and lunch time. It is not recommended to use it in the evening.

The reason for this is that food can significantly affect the pharmacokinetics of selegiline. Studies have found that when taken after meals, the absorption and bioavailability of the drug will be significantly improved, and the amount of exposure in the body will increase by approximately 3 to 4 times. This means that compared with the fasting state, the drug effect is more stable and the patient's symptom control may be better. Therefore, in practical applications, doctors often recommend that patients take it with meals to obtain a more consistent therapeutic effect.

On the other hand, the choice of medication time is also closely related to side effect management. Since the metabolites of selegiline contain amphetamines, which can easily cause central nervous system excitement, insomnia or mental stress, taking the medicine at night may interfere with sleep. Arranging doses during breakfast and lunch can not only take advantage of meal conditions to enhance drug absorption, but also reduce the risk of nighttime insomnia. This is also a medication precaution that clinical guidelines and pharmaceutical experts have repeatedly emphasized.

It is worth noting that patients also need to pay attention to the interaction between diet and drugs while taking selegiline. Although MAO-B inhibitors at low doses usually do not cause severe "cheese reactions," it is still recommended to avoid ingesting large amounts of tyramine-rich foods at one time to reduce the possibility of abnormal blood pressure. In addition, if you use other central nervous system drugs together, especially antidepressants, you need to strictly follow the doctor's instructions to avoid serious consequences due to drug interactions.

Reference: https://www.drugs.com/mtm/selegiline.html