Drug interactions between Azilect and carbidopa/levodopa
| Results for the following 2 drugs: |
|---|
| Azilect (rasagiline) |
| carbidopa/levodopa |
Interactions between your selected drugs
levodopa ↔ rasagiline
Applies to:carbidopa/levodopa and Azilect (rasagiline)
MONITOR: Rasagiline may potentiate the dopaminergic side effects of levodopa and exacerbate preexisting dyskinesia. The mechanism is rasagiline inhibition of the breakdown of dopamine via monoamine oxidase. In clinical trials, treatment-emergent dyskinesia occurred in about 18% of patients treated with rasagiline 0.5 or 1 mg/day as adjunct to levodopa, compared to 10% of patients who received levodopa with placebo. The incidence of postural hypotension and hallucinations was also increased with the combination. Postural hypotension was reported in approximately 6% and 9% of patients receiving levodopa in combination with rasagiline 0.5 and 1 mg/day, respectively, compared to 3% of patients receiving rasagiline 1 mg/day or levodopa alone. Similarly, hallucinations were reported in approximately 5% of patients receiving levodopa with rasagiline, compared to 3% of patients receiving levodopa alone and 1.3% of patients receiving rasagiline 1 mg/day alone. In the two controlled trials of rasagiline as adjunct therapy to levodopa, levodopa dosage was reduced in some patients within the first 6 weeks due to treatment-emergent dopaminergic side effects including dyskinesia and hallucinations. In the first study, levodopa dosage reduction occurred in 8% of patients in the placebo group and 16% and 17% of patients in the 0.5 mg/day and 1 mg/day rasagiline groups, respectively. Average dosage reductions in these patients were 7% in the placebo group and 9% and 13% in the 0.5 mg/day and 1 mg/day rasagiline groups, respectively. In the second study, levodopa dosage reduction occurred in 6% of patients in the placebo group and 9% of patients in the rasagiline 1 mg/day group, with average dosage reductions of 13% and 11%, respectively.
MANAGEMENT: Patients receiving rasagiline as an adjunct to levodopa may have increased dyskinesia, postural hypotension, and hallucinations. A reduction of the levodopa dosage may be considered based upon individual response. Patients should be cautioned to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia. Postural hypotension occurs most frequently in the first two months of rasagiline treatment or after a dose increase at any time and tends to decrease over time.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2012 Multum Information Services, Inc. The information in 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.
