Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Rasagiline is an oral drug that is used for
treating Parkinson's disease. It belongs to a class of drugs called monoamine
oxidase inhibitors (MAO) that also includes selegiline and tranylcypromine.
Monoamine oxidase is an enzyme that breaks down serotonin, norepinephrine,
dopamine, tyramine and similar chemicals that serve as neurotransmitters,
chemicals that nerves use to communicate with one another. There are two types
of monoamine oxidase enzymes, MAO-A and MAO-B. Monoamine oxidase inhibitors
inhibit one or both enzymes resulting in increased levels of the chemicals
normally broken down by MAO-A or MAO-B. Rasagiline inhibits MAO-B, but it is not
clear whether rasagiline also inhibits MAO-A. Rasagiline's exact mechanism of
action is not known; however, by inhibiting MAO-B rasagiline reduces the
breakdown of dopamine resulting in increased levels of dopamine in the brain.
Increased dopamine levels alleviate the symptoms of
Parkinson's disease.
Rasagiline was approved by the FDA in May, 2006.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets, 0.5 and 1 mg.
STORAGE: Tablets should be stored at 15-30°C (59-86°F).
PRESCRIBED FOR: Rasagiline is used alone or in combination with levodopa to
treat signs and symptoms of Parkinson's disease.
DOSING: The recommended dose of rasagiline is 1 mg once daily. When combined
with levodopa the recommended starting dose is 0.5 mg once daily. The dose may
be increased to 1 mg once daily if the response is not adequate.
Tyramine rich food, beverages and supplements should be avoided while taking
rasagiline.
DRUG INTERACTIONS: Rasagiline is eliminated by enzymes in the liver.
Ciprofloxacin inhibits the enzymes in the liver that eliminate rasagiline,
thereby increasing blood levels and possibly side effects of rasagiline.
Rasagiline should not be administered with antidepressants that increase
serotonin levels. Combining rasagiline with such antidepressants may lead to
excessive levels of serotonin and a fatal condition called the serotonin
syndrome. Examples of antidepressants to be avoided include selective serotonin
uptake inhibitors (e.g., fluoxetine, sertraline), tricyclic antidepressants
(e.g., amitriptyline), serotonin-norepinephrine uptake inhibitors (e.g.,
venlafaxine) and other MAO inhibitors (e.g., selegiline, tranylcypromine).
Rasagiline should be discontinued at least 14 days before initiating treatment
with antidepressants that increase serotonin levels. Due to its long half-life,
fluoxetine should be discontinued at least 5 weeks before initiating rasagiline.
Rasagiline should not be used with meperidine, propoxyphene, tramadol,
methadone, mirtazapine, cyclobenzaprine, dextromethorphan and St. John's Wort.
Serious reactions, including the serotonin syndrome, have occurred when other
MAO inhibitors were combined with some of these drugs, and there is concern that
rasagiline may cause similar serious reactions.
Rasagiline should not be used with sympathomimetic amine drugs such as
amphetamines and products containing vasoconstrictors (blood vessel narrowing
drugs, e.g., pseudoephedrine, ephedrine, phenylpropanolamine, phenylephrine).
Severe hypertensive reactions have occurred when such drugs were combined with
other MAO inhibitors.
Patients taking rasagiline should not be given cocaine or local anesthetics
containing sympathomimetic vasoconstrictor drugs. They also should not undergo
elective surgery requiring general anesthesia. Rasagiline should be discontinued
at least 14 days before surgery.
Parkinson's disease is a slowly progressive neurologic disease characterized by a fixed inexpressive face, a tremor at rest, slowing of voluntary movements, a gait with short accelerating steps, peculiar posture and muscle weakness, caused by degeneration of an area of the brain called the basal ganglia, and by low production of the neurotransmitter dopamine. Most patients are over 50, but at least 10 percent are under 40.
Eating a well-balanced and nutritional diet is very beneficial to people with Parkinson's disease. With a proper diet, our bodies work more efficiently and it is especially helpful because Parkinson's disease medications will work properly.
Before participating in a clinical trial for Parkinson's disease consider the risks and the benefits. You should know about who is eligible and what the necessary precautions are. Find out more in this article all about Parkinson's disease clinical trials.
Introduction to eating right with Parkinson's disease
While there is no special diet required for people with
Parkinson's disease, eating a well-balanced, nutritious diet is extremely beneficial. With the proper diet, our bodies work more efficiently, we have more energy, and Parkinson's disease medications will work properly.
This article addresses the basics of good nutrition. Please consult your doctor or dietitian before making any dietary changes. A registered dietitian can provide in-depth nutrition education, tailor these general guidelines to meet your needs, and help you create and follow a personal meal plan.
The Basics of Eating Well
Eat a variety of foods from each food category. Ask your doctor if you should take a daily vitamin supplement.
Maintain your weight through a proper balance of exercise and food. Ask your doctor what your "goal" weight should be and how many calories you should consume ...
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