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Azilect Side Effects

Generic name: rasagiline

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 18, 2023.

Note: This document contains side effect information about rasagiline. Some dosage forms listed on this page may not apply to the brand name Azilect.

Applies to rasagiline: oral tablet.

Serious side effects of Azilect

Along with its needed effects, rasagiline (the active ingredient contained in Azilect) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking rasagiline:

Less common

Other side effects of Azilect

Some side effects of rasagiline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

For Healthcare Professionals

Applies to rasagiline: oral tablet.

Cardiovascular

Very common (10% or more): Orthostatic/postural hypotension

Common (1% to 10%): Angina pectoris, first degree AV block, hypertension, peripheral edema, peripheral vascular disorder

Uncommon (0.1% to 1%): Myocardial infarction

Postmarketing reports: Hypertensive crisis (after ingestion of unknown amounts of tyramine-rich foods)

Frequency not reported: Arrhythmia, blood pressure fluctuations, bradycardia, bundle branch block, cardiovascular disorder, complete AV block, heart arrest, pallor, palpitation, second degree AV block, thrombosis, vasodilatation, vascular disorder, ventricular arrhythmia, ventricular extrasystoles[Ref]

When used as an adjunct to levodopa, the risk for developing posttreatment high blood pressure, combined with a significant increase from baseline was higher for rasagiline (2%) compared to placebo (1%).

Clinical trial data suggest that orthostatic hypotension occurs more frequently during the first 2 months of rasagiline treatment and tends to decrease over time.

Postmarketing reports of elevated blood pressure, including rare incidents of hypertensive crisis associated with the ingestion of unknown amounts of tyramine-rich foods, have been reported in patients taking recommended doses of rasagiline.[Ref]

Nervous system

Dyskinesia or exacerbation of dyskinesia has been reported when rasagiline (the active ingredient contained in Azilect) is used as an adjunct to levodopa. A dose reduction of levodopa may mitigate this effect.

Cases of patients treated with rasagiline and other dopaminergic medications falling asleep while engaged in activities of daily living including the operations of motor vehicles, have been reported and sometimes resulted in accidents. Some of these cases of somnolence have been reported more than 1 year after initiation of treatment.

The postmarketing reports of serotonin syndrome, associated with agitation, confusion, rigidity, pyrexia, and myoclonus have been reported by patients treated with antidepressants/SNRI concomitantly with rasagiline.

The symptom complex resembling neuroleptic malignant syndrome, with symptoms included elevated temperature, muscular rigidity, altered consciousness, and autonomic instability, has been reported with rapid dose reduction, and withdrawal of, or changes in, drugs that increase central dopaminergic tone.[Ref]

Very common (10% or more): Dizziness, dyskinesia, headache

Common (1% to 10%): Ataxia, balance disorder, carpal tunnel syndrome, dystonia, paresthesia

Uncommon (0.1% to 1%): Cerebrovascular accident, somnolence

Frequency not reported: Hyperkinesias, myoclonus, nystagmus, speech disorder, withdrawal-emergent hyperpyrexia and confusion resembling neuroleptic malignant syndrome

Postmarketing reports: Serotonin syndrome[Ref]

Psychiatric

Common (1% to 10%): Abnormal dreams, depression, hallucinations, insomnia, sleep disorder

Uncommon (0.1% to 1%): Confusion

Frequency not reported: Paranoid reactions, personality disorder

Postmarketing reports: Impulse control disorders, new or worsening mental status and behavioral changes including psychotic-like behavior[Ref]

When studied as an adjunct to levodopa, the incidence of hallucinations was approximately 5% at a rasagiline dose of 0.5 mg per day, 4% at 1 mg per day, and 3% with placebo. Dose reduction or treatment discontinuation should be considered if hallucinations or psychotic-like behaviors develop.

Reduced impulse control or increased compulsive behaviors include intense urges to gamble, increased sexual urges, intense urges to spend money, and binge eating. Patients may not recognize these behaviors as abnormal. Dose reduction or treatment discontinuation should be considered if such urges develop.[Ref]

Other

Very common (10% or more): Accidental injury, fall

Common (1% to 10%): Fever, hernia, infection, malaise, otitis media, pain, sweating, vertigo

Frequency not reported: Chills, dysautonomia, prolonged immobilization[Ref]

Dermatologic

Common (1% to 10%): Alopecia, cellulitis, contact dermatitis, dermatitis, ecchymosis, rash

Uncommon (0.1% to 1%): Vesiculobullous rash

Frequency not reported: Abscesses, dry skin, gangrene, nail disorder, pruritus, psoriasis, skin ulcer, urticaria[Ref]

Oncologic

Common (1% to 10%): Benign skin neoplasm, melanoma, skin carcinoma

Frequency not reported: Bladder carcinoma, breast neoplasm, cyst, Kaposi's sarcoma[Ref]

Endocrine

Frequency not reported: Goiter, inappropriate antidiuretic hormone secretion[Ref]

Gastrointestinal

Very common (10% or more): Nausea

Common (1% to 10%): Abdominal pain, constipation, diarrhea, dry mouth, dyspepsia, flatulence, gastroenteritis, gingivitis, tooth disorder, vomiting

Frequency not reported: Colitis, dysphagia, eructation, esophagitis, fecal impaction, gastritis, gastrointestinal disorder, gastrointestinal hemorrhage, halitosis, intestinal obstruction, megacolon, mouth ulceration, periodontitis[Ref]

Genitourinary

Common (1% to 10%): Albuminuria, decreased libido, impotence, urinary urgency

Frequency not reported: Anuria, breast pain, dysmenorrhea, dysuria, nocturia, prostate-specific antigen increase, testis disorder, urogenital anomaly, vaginal hemorrhage[Ref]

Hematologic

Common (1% to 10%): Hemorrhage, leucopenia

Uncommon (0.1% to 1%): Anemia

Frequency not reported: Eosinophilia, leukocytosis, megaloblastic anemia, thrombocytopenia[Ref]

Hepatic

Frequency not reported: Abnormal liver function tests[Ref]

Hypersensitivity

Common (1% to 10%): Allergy[Ref]

Immunologic

Common (1% to 10%): Flu syndrome, influenza, fungal infection

Frequency not reported: Sepsis, herpes simplex[Ref]

Metabolic

Common (1% to 10%): Anorexia, decreased appetite, weight loss

Frequency not reported: Gout, hyperphosphatemia, hypokalemia, hypolipemia, increased lactic dehydrogenase, weight gain[Ref]

Musculoskeletal

Common (1% to 10%): Arthralgia, arthritis, back pain, joint disorder, musculoskeletal pain, myasthenia, neck pain, tendon disorder, tenosynovitis

Frequency not reported: Bursitis, leg cramps, myositis, rhabdomyolysis following fall, spinal stenosis, tendinous contracture[Ref]

Ocular

Common (1% to 10%): Abnormal vision, conjunctivitis

Frequency not reported: Blindness, diplopia, eye disorder, eye hemorrhage, glaucoma, vitreous disorder[Ref]

Renal

Frequency not reported: Increased blood urea nitrogen, kidney pain[Ref]

Respiratory

Common (1% to 10%): Asthma, cough, dyspnea, pharyngitis, rhinitis, upper respiratory infection

Frequency not reported: Allergic rhinitis, epistaxis, pneumothorax, pulmonary embolus[Ref]

References

1. Product Information. Azilect (rasagiline). Teva Pharmaceuticals USA. 2006.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.