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rasagiline

Generic Name: rasagiline (ras AJ il een)
Brand Name: Azilect

What is rasagiline?

Rasagiline works by increasing the levels of certain chemicals in the brain.

Rasagiline is used to treat symptoms of Parkinson's disease (stiffness, tremors, spasms, poor muscle control). Rasagiline is sometimes used with another medicine called levodopa.

Rasagiline may also be used for purposes not listed in this medication guide.

What is the most important information I should know about rasagiline?

Tell your doctor about all medicines you have used in the 2-week period before you start taking rasagiline. Many drugs can interact with rasagiline, and some drugs should not be used together.

Do not rasagiline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, or tranylcypromine.

What should I discuss with my healthcare provider before taking rasagiline?

You should not take rasagiline if you are allergic to it.

Do not use rasagiline if you have used any other MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others.

Many medicines can interact with rasagiline and cause unwanted or dangerous effects. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • cyclobenzaprine (a muscle relaxer);

  • dextromethorphan (contained in many over-the-counter cough medicines);

  • meperidine (Demerol);

  • methadone;

  • St. John's wort; or

  • tramadol (Ultram, Ultracet).

Some medicines can interact with rasagiline and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure rasagiline is safe for you, tell your doctor if you have ever had:

  • high or low blood pressure;

  • liver or kidney disease; or

  • if you take ciprofloxacin (an antibiotic).

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether rasagiline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take rasagiline?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you take rasagiline alone, your dose may be different than if you take rasagiline with other Parkinson's medications. Follow your doctor's dosing instructions very carefully.

Rasagiline may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor.

Get familiar with the list of foods you should avoid to help prevent certain side effects of rasagiline.

Call your doctor if your Parkinson's symptoms do not improve, or if they get worse while using rasagiline.

Do not stop using rasagiline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using rasagiline.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, dizziness, severe headache, hallucinations, feeling agitated or irritable, muscle spasms in your neck or jaw, sweating, cold or clammy skin, shallow breathing, fainting, or seizure (convulsions).

What should I avoid while taking rasagiline?

Rasagiline may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can increase certain side effects of rasagiline. Especially avoid red wine, vermouth, and tap beers or ale.

Also avoid eating foods that are high in tyramine, such as aged cheeses, fava beans, soy sauce, herring, pickled or processed meats and fish, and meats that are aged, dried, smoked, or fermented. Eating tyramine while you are taking rasagiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Rasagiline side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • extreme drowsiness or falling asleep suddenly, even after feeling alert;

  • unusual changes in mood or behavior;

  • a light-headed feeling, like you might pass out;

  • worsening symptoms of Parkinson's disease (especially uncontrolled muscle movements); or

  • dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, anxiety, confusion, severe chest pain, shortness of breath, severe weakness, seizure.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Some people taking rasagiline with levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

Common side effects may include:

  • dizziness, drowsiness;

  • sleep problems (insomnia), strange dreams;

  • involuntary muscle movements;

  • loss of appetite, weight loss;

  • indigestion, stomach pain, nausea, vomiting, constipation;

  • joint pain or stiffness;

  • swelling in your hands or feet;

  • dry mouth, cough; or

  • flu symptoms (fever, chills, body aches).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side effects (in more detail)

Rasagiline dosing information

Usual Adult Dose for Parkinson's Disease:

Monotherapy:
Recommended dose: 1 mg orally once a day

Adjunct therapy:
Initial dose (in patients on concomitant levodopa): 0.5 mg orally once a day
Initial dose (in patients not on concomitant levodopa): 1 mg orally once a day
Maintenance dose: 0.5 mg to 1 mg orally once a day

Maximum dose: 1 mg orally once a day

Comments: May be used as adjunct therapy in patients on levodopa therapy, with or without other drugs used in the treatment of Parkinson's disease.

What other drugs will affect rasagiline?

Taking rasagiline with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic medication, muscle relaxer, or medicine for anxiety, depression, or seizures. Tell your doctor if you have taken an antidepressant during the 2-week period before you start taking rasagiline.

Many drugs can interact with rasagiline, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist has more information about rasagiline.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information 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.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01.

Date modified: November 15, 2017
Last reviewed: September 20, 2017

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