Key takeaways
Selegiline (Zelapar) and Rasagiline (Azilect) are both used to treat Parkinson's disease (PD) and belong to the same drug class, MAO-B inhibitors. Selegiline is typically used as an add-on treatment for those already taking carbidopa/levodopa, while Rasagiline can be used as a first-choice option for PD, even in early stages. Selegiline is available in tablets, capsules, and orally disintegrating tablets (ODTs), whereas Rasagiline is only available in tablet form. Selegiline is taken twice a day for tablets and capsules, but once a day for ODTs, while Rasagiline is taken once a day. Both medications can cause high blood pressure if you eat foods high in tyramine. Rasagiline may make you very sleep, but Selegiline can cause trouble sleeping if taken later in the day. Rasagiline is available in a lower-cost generic form, while the ODT form of Selegiline is only available as a brand name, making it potentially more expensive. Both medications can cause serious side effects like serotonin syndrome and neuroleptic malignant syndrome (NMS) if taken with certain other medications.
