Rasagiline Dosage

Usual Adult Dose for Parkinson's Disease

Monotherapy: 1 mg orally once daily

Adjunctive therapy (in combination with levodopa): 0.5 mg orally once daily. If a sufficient clinical response is not achieved, the dose may be increased to 1 mg orally daily.

Renal Dose Adjustments

Rasagiline can be given at usual doses in patients with mild renal impairment (greater than or equal to 60 mL/min). A reduced dose (0.5 mg) should be used in patients with creatinine clearance less than 60 mL/min.

Conclusive data are not available for renally impaired patients.

Liver Dose Adjustments

Mild hepatic impairment: 0.5 mg orally once daily.

Moderate or severe hepatic impairment: rasagiline should not be used.

Precautions

Rasagiline administered as an adjunct to levodopa may potentiate dopaminergic side effects and exacerbate preexisting dyskinesia. Decreasing the dose of levodopa may ameliorate this side effect.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Rasagiline may be taken with or without food.

Rasagiline is a selective inhibitor of monoamine oxidase (MAO)-B at recommended doses of 0.5 or 1 mg daily. Dietary tyramine restriction is not ordinarily required with recommended doses of rasagiline. However, certain foods (e.g., aged cheeses, such as Stilton cheese) may contain very high amounts (i.e., greater than 150 mg) of tyramine and could potentially cause a hypertensive "cheese" reaction in patients taking rasagiline even at the recommended dose due to mild increased sensitivity to tyramine. The selectivity for inhibiting MAO-B diminishes in a dose-related manner as the dose is progressively increased above the recommended daily dose.

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