Generic Name: rasagiline (ras AJ il een)
Brand Names: Azilect

What is Azilect?

Azilect (rasagiline) is a monoamine oxidase-B (MAO-B) inhibitor. It works by increasing the levels of certain chemicals in the brain.

Azilect is used to treat the symptoms of Parkinson's disease (stiffness, tremors, spasms, poor muscle control).

Azilect is sometimes used with another drug called levodopa.

Important information

Many medicines can interact with Azilect and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs: cyclobenzaprine (a muscle relaxer), dextromethorphan (a cough medicine), meperidine (Demerol), methadone, St. John's wort, or tramadol.

Do not use Azilect if you have used any other MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others.

Slideshow: Parkinson’s Disease - 10 Clinical Fast Facts

Before you take Azilect, tell your doctor if you have liver disease.

There are many other drugs that can cause serious medical problems if you take them together with Azilect. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you. While you are taking this medicine and for 2 weeks after you stop taking it, you may not be able to eat certain types of cheese. Follow your doctor's instructions. Rasagiline may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Before taking Azilect

You should not take Azilect if you are allergic to rasagiline.

Many medicines can interact with rasagiline and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • cyclobenzaprine (a muscle relaxer);

  • dextromethorphan (contained in many over-the-counter cough medicines);

  • meperidine (Demerol);

  • methadone;

  • St. John's wort; or

  • tramadol (Ultram, Ultracet).

Do not use Azilect if you have used any other MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others.

To make sure rasagiline is safe for you, tell your doctor if you have:

  • high or low blood pressure;

  • liver disease;

  • if you take an antidepressant; or

  • if you take ciprofloxacin (an antibiotic).

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether Azilect will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether rasagiline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take Azilect?

Take Azilect exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your dose may be different if you take Azilect alone than if you take this medicine with other Parkinson's medications. Follow your doctor's dosing instructions very carefully.

Azilect is only part of a complete program of treatment that may include a diet plan created for you by your doctor or nutrition counselor.

Call your doctor if your Parkinson's symptoms do not improve, or if they get worse while using Azilect.

Do not stop using this medicine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Azilect dosing information

Usual Adult Dose for Parkinson's Disease:

Monotherapy:
Recommended dose: 1 mg orally once a day

Adjunct therapy:
Initial dose (in patients on concomitant levodopa): 0.5 mg orally once a day
Initial dose (in patients not on concomitant levodopa): 1 mg orally once a day
Maintenance dose: 0.5 mg to 1 mg orally once a day

Maximum dose: 1 mg orally once a day

Comments: May be used as adjunct therapy in patients on levodopa therapy, with or without other drugs used in the treatment of Parkinson's disease.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, dizziness, severe headache, hallucinations, feeling agitated or irritable, fast and uneven heart rate, muscle spasms, sweating, cold or clammy skin, shallow breathing, fainting, or seizure (convulsions).

What should I avoid while taking Azilect?

Azilect may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can increase certain side effects of rasagiline.

Also avoid eating foods that are high in tyramine, such as aged cheeses, sour cream, yogurt, avocados, bananas, soy sauce, and pepperoni or other dried meats. Eating tyramine while you are taking Azilect can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Azilect side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Azilect : hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Azilect and call your doctor at once if you have:

  • extreme drowsiness, falling asleep suddenly, even after feeling alert;

  • unusual changes in mood or behavior;

  • a light-headed feeling, like you might pass out;

  • worsening symptoms of Parkinson's disease (especially uncontrolled muscle movements); or

  • dangerously high blood pressure - severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats, seizure.

Some people taking Azilect with levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

Common Azilect side effects may include:

  • dizziness, drowsiness;

  • sleep problems (insomnia), strange dreams;

  • depressed mood;

  • upset stomach, nausea, vomiting, stomach pain;

  • loss of appetite, weight loss;

  • constipation;

  • joint pain or stiffness;

  • swelling in your hands or feet;

  • dry mouth, cough; or

  • flu symptoms (fever, chills, body aches).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Azilect?

Taking Azilect while you are also taking an antidepressant can cause high levels of serotonin in your body. Symptoms of this condition include agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, and fainting. Tell your doctor if you have taken an antidepressant during the 2-week period before you start taking Azilect.

Taking Azilect with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking this medicine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or seizures.

Many drugs can interact with rasagiline, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Azilect. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your doctor or pharmacist has more information about Azilect.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Azilect only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2015 Cerner Multum, Inc. Version: 4.01. Revision Date: 2014-12-19, 3:16:43 PM.

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