Azilect (rasagiline) Alcohol, Food & Lifestyle Interactions

There are 2 food and lifestyle interactions with Azilect (rasagiline) which include:

ADJUST DOSE: Coadministration with drugs that are inhibitors of CYP450 1A2 may increase the plasma concentrations of rasagiline, which is a substrate of the isoenzyme. In 12 healthy volunteers, coadministration with ciprofloxacin (500 mg twice a day) increased the systemic exposure (AUC) of rasagiline (2 mg once a day) by 83%, with no change in elimination half-life.

MANAGEMENT: Patients treated concomitantly with potent inhibitors of CYP450 1A2 such as ciprofloxacin or fluvoxamine should use rasagiline 0.5 mg/day. Patients receiving other CYP450 1A2 inhibitors should initiate therapy at the lower dosage, then increase gradually as necessary.

GENERALLY AVOID: Foods that contain large amounts of tyramine may precipitate a hypertensive crisis in patients treated with monoamine oxidase inhibitors (MAOIs). The mechanism is inhibition of MAO-A, the enzyme responsible for metabolizing exogenous amines such as tyramine in the gut and preventing them from being absorbed intact. Once absorbed, tyramine is metabolized to octopamine, a substance that is believed to displace norepinephrine from storage granules. Although rasagiline is considered a selective inhibitor of MAO-B, the selectivity has not been established in humans and may not be absolute even at recommended dosages. Rare cases of hypertensive reactions associated with ingestion of tyramine-containing foods have been reported in patients taking the recommended daily dose of selegiline, another MAO-B inhibitor.

MANAGEMENT: Patients treated with rasagiline should preferably avoid consumption of products that contain large amounts of amines and protein foods in which aging or breakdown of protein is used to increase flavor. These foods include cheese (particularly strong, aged or processed cheeses), sour cream, wine (particularly red wine), champagne, beer, pickled herring, anchovies, caviar, shrimp paste, liver (particularly chicken liver), dry sausage, salamis, figs, raisins, bananas, avocados, chocolate, soy sauce, bean curd, sauerkraut, yogurt, papaya products, meat tenderizers, fava bean pods, protein extracts, yeast extracts, and dietary supplements. Caffeine may also precipitate hypertensive crisis so its intake should be minimized as well. At least 14 days should elapse following discontinuation of rasagiline therapy before these foods may be consumed. Specially designed reference materials and dietary consultation are recommended so that an appropriate and safe diet can be planned. Patients should also be advised to promptly seek medical attention if they experience potential signs and symptoms of a hypertensive crisis such as severe headache, visual disturbances, difficulty thinking, stupor or coma, seizures, chest pain, unexplained nausea or vomiting, and stroke-like symptoms. The recommended dosages of rasagiline should not be exceeded, as it can increase the risk of nonselective MAO inhibition and a hypertensive crisis.

You should also know about...

Azilect (rasagiline) drug Interactions

There are 625 drug interactions with Azilect (rasagiline)

See also...

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 2000-2009 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.