What is the minimum dose of selegiline/imidopir?

As a MAO-B inhibitor, the dose design of Selegiline/imidopir(Selegiline) for the treatment of Parkinson's disease must not only ensure drug efficacy but also avoid side effects. According to the guidelines and labeling information, the recommended starting dose of selegiline is usually 5 mg once daily in the morning. This dose is considered the minimum effective dose, which can reduce the incidence of drug-related adverse reactions while maintaining selective inhibition of MAO-B. In clinical practice, if the patient tolerates the 5 mg dose well and has insufficient symptom control, the doctor may adjust the dose to 10 mg daily, and may choose to take it once in the morning or twice in the morning and noon to help maintain the stability of blood concentration and reduce the risk of nighttime insomnia.

It is important to note that dose is closely related to selectivity. In the range of 5 to 10 mg, selegiline mainly exhibits MAO-B inhibition, thereby improving the symptoms of Parkinson's disease. However, if it exceeds this range, the drug may inhibit MAO-A at the same time, leading to a higher risk of drug-food interactions, especially tyramine reactions, which may manifest as sudden increases in blood pressure or even hypertensive crisis. Therefore, regular doses exceeding 10 mg are rarely recommended clinically, but they are used in combination with levodopa or other anti-Parkinson drugs to achieve better efficacy at low doses.

Patients also need to pay attention to timing when taking selegiline. Since the drug may cause insomnia, it is usually recommended to take it in the morning and avoid using it in the evening. Sleep disturbances can be further reduced if a daily dosage of 10 mg is taken, divided into two doses in the morning and at noon. When formulating a dosage plan, doctors will also consider the patient's age, severity of illness, concomitant medications, and liver and kidney function to ensure that the therapeutic objectives can be achieved while adverse reactions can be minimized.

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