Generic Name and Formulations:
Rasagiline 0.5mg, 1mg; tabs.
Parkinson's disease (PD).
Monotherapy or adjunct without levodopa: 1mg once daily. Concomitant levodopa with/without other PD drugs (eg, dopamine agonist, amantadine, anticholinergics): initially 0.5mg once daily; may increase to 1mg once daily (consider reducing levodopa dose based on response). Mild hepatic impairment (Child-Pugh score 5–6) or concomitant CYP1A2 inhibitors: 0.5mg once daily.
During or within 2 weeks of meperidine, tramadol, methadone, propoxyphene, MAOIs including other selective MAO-B inhibitors. Concomitant dextromethorphan, St. John's wort, cyclobenzaprine.
Monitor for new onset hypertension or hypertension that is not adequately controlled after starting therapy. Avoid tyramine-rich foods (see full labeling). Monitor for drowsiness or sleepiness. Mild hepatic impairment: reduce dose; moderate to severe hepatic impairment (Child-Pugh score ≥7): not recommended. Monitor for hallucinations, psychotic or compulsive behaviors; consider reduce dose or discontinue if develops. Monitor for melanoma. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Possible hypertensive crisis with excess dietary tyramine (see full labeling). Potentiated by CYP1A2 inhibitors (eg, ciprofloxacin). Concomitant antidepressants (eg, SSRIs, SNRIs, triazolopyridines, tricyclics, tetracyclics): not recommended; increased risk of serotonin syndrome. Allow at least 14 days after discontinuing rasagiline before starting SSRIs, SNRIs, triazolpyridines, tricyclics, tetracyclics; allow 5 weeks after discontinuing fluoxetine before starting rasagiline. Caution with sympathomimetics (eg, nasal, oral, ophthalmic decongestants or cold remedies).
As monotherapy: flu syndrome, arthralgia, depression, dyspepsia. With levodopa: also dyskinesia, accidental injury, weight loss, postural hypotension, GI upset, anorexia, abdominal pain, constipation, dry mouth, rash, abnormal dreams, fall.
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