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Compare Zelapar vs. Duopa

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Selegiline (Zelapar) and carbidopa/levodopa (Duopa) are both prescription medications used to treat movement problems associted with Parkinson's disease (PD). However, they belong to different medication classes and have some important differences. Selegiline is a monoamine oxidase type B (MAO-B) inhibitor that helps keep dopamine in the brain longer, while carbidopa/levodopa is a combination of a dopa decarboxylase inhibitor and a dopamine replacement that directly increases dopamine levels. Selegiline is available in oral tablets, capsules, and orally disintegrating tablets (ODT), whereas Duopa is administered through a PEG-J tube using an infusion pump. Selegiline is typically taken once or twice a day, while Duopa is given over 16 hours, beginning in the morning. Common side effects of selegiline include nausea and dizziness, while Duopa can cause nausea, constipation, and issues related to tube placement. Selegiline has many drug interactions, including with other medications that affect serotonin, while Duopa shoud be taken at a different time than any iron-containing products to ensure proper absorption.

  • Selegiline
    Duopa (carbidopa / levodopa)
  • Selegiline
    Duopa (carbidopa / levodopa)

  • Summary of Zelapar vs. Duopa

    Summary for MAO-B inhibitor
    Prescription only

    Selegiline helps relieve symptoms of Parkinson's disease in people who have "off" episodes as their carbidopa/levodopa medication starts to wear off. Selegiline is a type of monoamine oxidase inhibitor (MAOI), which is a drug class that has many drug interactions. Generic selegiline tablets and capsules are taken twice per day; the brand name for the pills, Eldepryl, is no longer available. Selegiline also comes as orally disintegrating tablets (ODTs) under the brand name Zelapar that are dissolved on the tongue once per day. Side effects include changes in blood pressure, nausea, and dizziness.

    Summary for Dopa decarboxylase inhibitor / Dopamine replacement
    Prescription only

    Duopa is a combination medication that contains carbidopa (a decarboxylase inhibitor) and levodopa (a dopamine replacement). It treats symptoms of advanced Parkinson's disease (PD), particularly movement problems. Duopa (carbidopa / levodopa) comes as a cassette that gets attached to an infusion pump. The infusion pump then sends the medication into the intestines through a feeding tube called a PEG-J tube. Duopa (carbidopa / levodopa) is given over 16 hours out of the day as a morning dose, a continuous dose, and any extra doses. Side effects include nausea, constipation, and involuntary muscle movements.

  • Indications of Zelapar vs. Duopa

    Indications for
    •Relief of "off" episodes in people with Parkinson's disease (PD) who are taking a carbidopa/levodopa medication
    Indications for
    •Movement problems related to advanced Parkinson's disease (PD)

  • Pros and Cons of Zelapar vs. Duopa

    Pros and Const for MAO-B inhibitor
    Pros
    •Extends the actions of carbidopa/levodopa to relieve PD symptoms
    •Comes as tablets, capsules, and ODTs
    •Taken once or twice a day, depending on the form of the medication
    Cons
    •Doesn't work well when you take it by itself; must take in addition to a carbidopa/levodopa medication
    •Commonly causes nausea and dizziness
    Pros and Const for Dopa decarboxylase inhibitor / Dopamine replacement
    Pros
    •Given into your body continuously for 16 hours, so you don't need to remember to take pills
    •Comes with extra doses in case you feel like the medication is wearing off
    Cons
    •Must have a minor procedure done to place the PEG-J tube in your intestines
    •Risk of serious stomach problems since the infusion pump sends the medication directly into your gut
    •Can cause sleepiness and changes in behavior

  • Common Side Effects of Zelapar vs. Duopa

    Common Side Effects for

    Selegiline tablets and capsules:

    •Nausea (20%)
    •Dizziness (14%)
    •Stomach pain (8%)
    •Confusion (6%)
    •Hallucinations (6%)
    •Dry mouth (6%)

    Zelapar (selegiline) ODTs:

    •Nausea (11%)
    •Dizziness (11%)
    •General body pain (8%)
    •Headache (7%)
    •Trouble sleeping (7%)
    •Runny nose (7%)
    •Involuntary movements (dyskinesia; 6%)
    •Skin irritation (6%)
    •Back pain (5%)
    •Indigestion (5%)
    •Inflamed or sore mouth (5%)
    •Other irritation in the mouth (e.g., pain when swallowing, pain in mouth, mouth sores)
    Common Side Effects for
    •Issues related to tube placement (57%)
    •Nausea (30%)
    •Constipation (22%)
    •Redness around the area where the tube is placed (19%)
    •Involuntary movements (dyskinesia, 14%)
    •Depression (11%)
    •Discharge after the procedure where the tube is placed (11%)
    •Swelling in the legs or feet (8%)
    •High blood pressure (8%)
    •Upper respiratory tract infection (8%)
    •Mouth or throat pain (8%)
    •Collapsed lung (8%)

  • Warnings of Zelapar vs. Duopa

    Common Side Effects for
    •High blood pressure
    •Serotonin syndrome
    •Extreme sleepiness and falling asleep during activities
    •Low blood pressure and risk of falls
    •Difficulty controlling body movements
    •Hallucinations and behavior changes
    •Intense urges
    •Caution in people with phenylketonuria (PKU) - Zelapar ODTs only
    Common Side Effects for
    •Stomach problems
    •Sleepiness or falling asleep during activities
    •A drop in blood pressure when standing
    •Hallucinations, changes in behavior and thoughts, and confusion
    •Difficulty controlling impulsive behavior
    •Depression and suicidal thoughts
    •High fevers and confusion with treatment changes
    •Nerve problems
    •Heart problems
    •Rise in eye pressure in people with glaucoma

  • Prices with our coupons for Zelapar vs. Duopa

    Learn more about Selegiline
    Learn more about Duopa

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