rasagiline, Azilect (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
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.
Medical and Pharmacy Editor:
Rasagiline also may cause low or high blood pressure. A hypertensive crisis may occur if foods high in tyramine are consumed while taking rasagiline. Tyramine in food usually is broken down in the intestine by MAO-A in the intestinal wall as the tyramine is absorbed into the body. There are no adequate studies in humans to determine whether rasagiline also inhibits MAO-A; however, if MAO-A is inhibited, tyramine ingested in food may enter the body in larger amounts and result in a hypertensive crisis. Foods high in tyramine include those that are aged, fermented, pickled, or smoked. Examples include aged cheeses, air-dried meats, sauerkraut, soy sauce, tap/draft beers and red wines. As a precaution, foods high in tyramine should be avoided when taking rasagiline.
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 0.5 and 1 mg.
STORAGE: Tablets should be stored at 15 C - 30 C (59 F - 86 F).
DOSING: The recommended dose of rasagiline is 1 mg once daily when used alone (monotherapy). 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. Patients with mild liver disease should not use more than 0.5 mg daily. It should not be used by patients with moderate or severe liver disease. Tyramine rich food, beverages and supplements should be avoided while taking rasagiline.
DRUG INTERACTIONS: Rasagiline is eliminated by enzymes in the liver. Ciprofloxacin (Cipro, Cipro XR, Proquin XR) inhibits the enzymes in the liver that eliminate rasagiline, thereby increasing blood levels and possibly side effects of rasagiline. Patients taking ciprofloxacin should not exceed 0.5 mg daily 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 avoid include selective serotonin uptake inhibitors (for example, fluoxetine [Prozac, Sarafem], sertraline [Zoloft]), tricyclic antidepressants (for example, amitriptyline [Elavil, Endep]), serotonin-norepinephrine uptake inhibitors (for example, venlafaxine [Effexor]) and other MAO inhibitors (for example, selegiline, tranylcypromine). Rasagiline should be discontinued at least 14 days before initiating treatment with antidepressants that increase serotonin levels.
Medically Reviewed by a Doctor on 3/30/2015
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