Monograph Details
|
|
Central Nervous System
> Parkinsonism
|
|
AZILECT |
| Manufacturer |
|
Teva Neuroscience |
| Legal Classification |
|
Rx
|
| Pharmacological Class |
|
MAO-B inhibitor. |
| Generic Name |
|
Rasagiline 0.5mg, 1mg; tabs. |
| Indications |
|
Idiopathic Parkinson's disease, as initial monotherapy and as an adjunct to levodopa. |
| Children |
Not recommended.
|
| Adults |
|
Monotherapy: 1mg once daily. Adjunctive therapy: initially 0.5mg once daily; may increase to 1mg once daily (consider reducing levodopa dose if side effects increase). Mild hepatic impairment (Child-Pugh score 5–6) or concomitant CYP1A2 inhibitors: 0.5mg once daily. |
| Contraindications |
|
During or within 2 weeks of meperidine, tramadol, propoxyphene, methadone, MAOIs. Concomitant dextromethorphan, St. John's wort, mirtazapine, sympathomimetic amines, amphetamines, cyclobenzaprine, local anesthetics w. vasoconstrictors (cocaine). Elective surgery w. general anesthesia. Pheochromocytoma. |
| Precautions |
|
Avoid tyramine-rich foods (see literature). Mild hepatic impairment: reduce dose; moderate to severe hepatic impairment (Child-Pugh score ≥7): not recommended. Monitor for melanoma. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
|
See Contraindications. Possible hypertensive crisis with excess dietary tyramine (see literature). Potentiated by CYP1A2 inhibitors (eg, ciprofloxacin). Severe CNS toxicity (hyperpyrexia, death) with tricyclics, SSRIs, SNRIs, and MAOIs (both nonselective and type B selective); allow at least 14 days after discontinuing rasagiline before starting SSRI, tricyclic, or SNRI; allow 5 weeks after discontinuing fluoxetine before starting rasagiline. |
| Adverse Reactions |
|
As monotherapy: postural hypotension, flu syndrome, arthralgia, depression, GI upset, falls. With levodopa: also dyskinesia, accidental injury, weight loss, abdominal pain, dry mouth, rash, bruising, somnolence, numbness, tingling. |
| How Supplied |
|
Tabs—30 |
| Additional Resources |
|
• Related Prescribing Note |
|
|
|
|
