Exservan Disease Interactions

Alcohol consumption may intensify the hepatotoxic potential of riluzole. Therefore, patients should be warned to limit alcohol intake while receiving riluzole therapy.

The use of riluzole has been frequently associated with an increase in liver enzymes between 3 and 5 times the upper limit of normal (ULN). Therapy with riluzole should be administered cautiously in patients with a history of liver dysfunction. Baseline liver function tests (LFTs) should be obtained in all patients. Monitor patients for signs and symptoms of hepatic injury, every month for the first 3 months of treatment, and periodically thereafter. The use of riluzole is not recommended if patients develop hepatic transaminases levels greater than 5 times the ULN. Discontinue riluzole if there is evidence of liver dysfunction (e.g., elevated bilirubin). Patients with mild or moderate [Child-Pugh score A and B] hepatic impairment had increases in AUC compared to patients with normal hepatic function, and may be at increased risk of adverse reactions. The impact of severe hepatic impairment on riluzole exposure is unknown.

The use of riluzole has rarely been associated with neutropenia with an absolute neutrophil count (ANC) less than 500/mm3. The neutropenia developed within the first 2 months of treatment. Therapy with riluzole should be administered cautiously in patients predisposed to neutropenia. Patients should be warned to report any febrile illness.

Riluzole and its metabolites are eliminated via the kidney. Therapy with riluzole should be administered cautiously in patients with renal dysfunction. Reduced clearance and higher plasma levels may occur in these patients. Women, native Japanese patients, and the elderly may metabolize or excrete riluzole at a slower rate. The need for dosage adjustment is not known.