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 should not be used with sympathomimetic amine drugs such as amphetamines and products containing vasoconstrictors (blood vessel narrowing drugs, for example, 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. Rasagiline should not be used with other MAO inhibitors because of the risk of a hypertensive crisis. Rasagiline should be discontinued at least 14 days before starting other MAO inhibitors.
PREGNANCY: There are no adequate studies of rasagiline in pregnant women. Rasagiline should only be used in pregnant women if the benefit is felt to justify the unknown risk.
NURSING MOTHERS: It is not known whether rasagiline is secreted in human milk.
SIDE EFFECTS: The most common adverse effects of rasagiline are flu like symptoms, headache, nausea, joint pain, upset stomach, depression, falls, constipation, postural hypotension (a drop in blood pressure when moving from a lying or sitting position to a sitting or standing position, respectively), dry mouth, rash, hallucinations, vomiting and difficulty moving. 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.
Reference: FDA Prescribing Information
Last Editorial Review: 4/2/2012
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