Rasagiline

By Medically reviewed by hellodoktor

Generic Name: Rasagiline Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: C

Uses

What is Rasagiline used for?

Rasagiline is used alone or with other medications (such as levodopa/carbidopa) to treat symptoms of Parkinson’s disease. It can help improve symptoms such as shakiness, stiffness, and difficulty moving. It can also help reduce the amount of “off” time (periods of slow movement or stiffness).

Rasagiline belongs to a class of drugs known as MAO inhibitors. It works by increasing the levels of certain natural substances in the brain (such as dopamine, norepinephrine, serotonin). Parkinson’s disease is thought to be caused by too little dopamine in the brain.

How should I take Rasagiline?

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Do not increase your dose or take it more often than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.

Tell your doctor if this medication stops working well or if your condition gets worse.

How do I store Rasagiline?

Rasagiline is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Rasagiline in the bathroom or the freezer. There may be different brands of Rasagiline that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Rasagiline down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Rasagiline?

Before taking rasagiline, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (such as coronary artery disease, heart attack, chest pain, heart failure), stroke, high blood pressure, severe/frequent headaches, liver disease, mental/mood disorders (such as schizophrenia, bipolar disorder, depression), diabetes, overactive thyroid, a certain kind of adrenal gland tumor (pheochromocytoma), sleep disorders.

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Rasagiline during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Rasagiline. Rasagiline is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Rasagiline?

Dizziness, drowsiness, joint pain, heartburn, nausea, dry mouth, weight loss, or stomach/abdominal pain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position, especially when you first start taking rasagiline.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting, loss of balance, mental/mood changes (such as confusion, depression, hallucinations), worsening muscle stiffness/twitching/uncontrollable movements, swollen ankles/legs, easy bleeding/bruising, unusual strong urges (such as increased gambling, increased sexual urges).

Some people taking rasagiline have fallen asleep suddenly during their usual daily activities (such as talking on the phone, driving). In some cases, sleep occurred without any feelings of drowsiness beforehand. This sleep effect may occur anytime during treatment with rasagiline even if you have used this medication for a long time. If you experience increased sleepiness or fall asleep during the day, do not drive or take part in other possibly dangerous activities until you have discussed this effect with your doctor. Your risk of this sleep effect is increased by using alcohol or other medications that can make you drowsy. See also Precautions section.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

This drug may rarely cause an attack of extremely high blood pressure (hypertensive crisis), which may be fatal. Many drug and food interactions can increase this risk. Get medical help right away if any of these serious side effects occur: severe headache, fast/slow/irregular/pounding heartbeat, chest pain, neck stiffness/soreness, severe nausea/vomiting, sweating/clammy skin (sometimes with fever), widened pupils, vision changes (such as double/blurred vision), sudden sensitivity to light (photophobia).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Rasagiline?

Dizziness, drowsiness, joint pain, heartburn, nausea, dry mouth, weight loss, or stomach/abdominal pain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position, especially when you first start taking rasagiline.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting, loss of balance, mental/mood changes (such as confusion, depression, hallucinations), worsening muscle stiffness/twitching/uncontrollable movements, swollen ankles/legs, easy bleeding/bruising, unusual strong urges (such as increased gambling, increased sexual urges).

Some people taking rasagiline have fallen asleep suddenly during their usual daily activities (such as talking on the phone, driving). In some cases, sleep occurred without any feelings of drowsiness beforehand. This sleep effect may occur anytime during treatment with rasagiline even if you have used this medication for a long time. If you experience increased sleepiness or fall asleep during the day, do not drive or take part in other possibly dangerous activities until you have discussed this effect with your doctor. Your risk of this sleep effect is increased by using alcohol or other medications that can make you drowsy. See also Precautions section.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

This drug may rarely cause an attack of extremely high blood pressure (hypertensive crisis), which may be fatal. Many drug and food interactions can increase this risk (see How to Use and Drug Interactions sections). Get medical help right away if any of these serious side effects occur: severe headache, fast/slow/irregular/pounding heartbeat, chest pain, neck stiffness/soreness, severe nausea/vomiting, sweating/clammy skin (sometimes with fever), widened pupils, vision changes (such as double/blurred vision), sudden sensitivity to light (photophobia).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Rasagiline may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Rasagiline?

Rasagiline may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

A very serious high blood pressure reaction may rarely occur if you eat a large amount of tyramine while taking rasagiline and for 2 weeks after you stop it. Avoid foods that are high in tyramine, like aged cheeses (such as Stilton cheese). Consult your doctor or dietician about which foods you should avoid and if you do not feel well after eating or drinking certain foods while taking this medication.

What health conditions may interact with Rasagiline?

Rasagiline may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Rasagiline.

What is the dose of Rasagiline for an adult?

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.

Renal Dose Adjustments

Mild to Moderate Renal Dysfunction: No adjustment recommended

Liver Dose Adjustments

Mild Liver Dysfunction (Child-Pugh 5 to 6): 0.5 mg orally once a day

Moderate to Severe Liver Dysfunction (Child-Pugh 7 to 15): Use is not recommended

Dose Adjustments

Concomitant CYP450 1A2 inhibitors (e.g., ciprofloxacin): A dose of 0.5 mg orally once a day should not be exceeded.

When this drug is used in combination with levodopa, the levodopa dose may need to be reduced, according to clinical response.

Other Comments

Administration advice:

-This drug may be taken with or without food

Monitoring:

-Cardiovascular: Hypertension, postural/orthostatic hypotension

-Dermatologic: Melanoma

-Hepatic: Liver function

-Musculoskeletal: Exacerbation of dyskinesia (if used concomitantly with levodopa)

-Nervous system: Falling asleep during activities of daily living and somnolence, serotonin syndrome

-Psychiatric: Suicidal ideation and behavior, falling asleep during activities of daily living and somnolence, re-emergence or worsening of symptoms of depression, impulse control disorders

General:

-Rasagiline interacts with other drugs such as MAO inhibitors, meperidine (pethidine), potent CYP450 1A2 inhibitors, tramadol, St John’s Wort, dextromethorphan, and methadone. Prescribers should be aware for the potential for interactions with rasagiline. A wash-out period may be required between ceasing rasagiline and commencing other medicines and vice versa.

Patient advice:

-If you, your family member, or caregiver notice symptoms such as agitation, hostility, depression, thoughts about suicide or dying, or changes in thinking or behavior that are out of character, contact your health provider immediately.

-Inform your health provider is you experience new or increased gambling urges, sexual urges, or other urges while taking this drug.

-There is a potential for sedating effects associated with this drug, including somnolence and the possibility of falling asleep while engaged in activities of daily living. Avoid driving or operating heavy machinery until you know how this drug affects you.

-Avoid foods containing a very large amount of tyramine (e.g., aged cheese) while taking recommended doses of this drug due to the potential to significantly increase blood pressure.

What is the dose of Rasagiline for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Rasagiline available?

Rasagiline is available in the following dosage forms and strengths:

  • Oral tablet.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Rasagiline, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 10, 2018 | Last Modified: September 12, 2019

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