Wednesday, March 20, 2024

What Does Rasagiline Do For Parkinson’s

Rasagiline 1 Mg Tablets

Parkinson’s Disease & Medication: Whats new?

This information is intended for use by health professionals

Rasagiline 1 mg tablets

Each tablet contains 1 mg rasagiline .

For the full list of excipients, see section 6.1.

Tablet

White to off-white, circular, flat tablets with “771” debossed on one side and “G” on other side, approximately 8 mm in diameter.

Rasagiline is indicated in adults for the treatment of idiopathic Parkinson’s disease as monotherapy or as adjunct therapy in patients with end of dose fluctuations.

Posology

The recommended dose of rasagiline is 1 mg once daily, to be taken with or without levodopa.

Elderly

No change in dose is required for elderly patients .

Hepatic impairment

Rasagiline is contraindicated in patients with severe hepatic impairment . Rasagiline use in patients with moderate hepatic impairment should be avoided. Caution should be used when initiating treatment with rasagiline in patients with mild hepatic impairment. In case patients progress from mild to moderate hepatic impairment rasagiline should be stopped .

Renal impairment

No special precautions are required in patients with renal impairment.

Paediatric population

The safety and efficacy of rasagiline in children and adolescents have not been established. There is no relevant use of rasagiline in the paediatric population in the indication Parkinson’s disease.

Method of administration

Rasagiline may be taken with or without food.

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

What Special Dietary Instructions Should I Follow

You will need to avoid eating foods that contain very high amounts of tyramine, such as aged cheeses during your treatment with rasagiline. Talk to your doctor or dietitian about which foods you should avoid during your treatment or if you do not feel well after eating or drinking certain foods while taking rasagiline.

What Other Drugs Could Interact With This Medication

There may be an interaction between rasagiline and any of the following:

  • alpha-adrenergic receptor blockers
  • angiotensin converting enzyme inhibitors
  • angiotensin receptor blockers
  • anti-psychotics
  • beta-adrenergic blockers
  • calcium channel blockers
  • diabetes medications
  • quinolone antibiotics
  • selective serotonin reuptake inhibitors
  • serotonin-norepinephrine reuptake inhibitors
  • St. John’s wort
  • sympathomimetic medications
  • tricyclic and tetracyclic antidepressants
  • “triptan” migraine medictions

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter , and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Read Also: Idiopathic Parkinson’s Disease Life Expectancy

Evidence For Potential Neuroprotection

Rasagiline has shown evidence of neuroprotective properties in multiple in vitro and in vivo models with various mechanisms of neurotoxicity. The mechanism cannot be solely accounted for by MAO-B inhibition.

Rasagiline has shown protection against various neuronal insults in cell cultures. These include protection against glutamate-induced toxicity in rat hippocampal neuronal cultures17 and against apoptotic cell death from deprivation of oxygen and glucose, or from serum and nerve growth factor in pheochromocytoma cells.15,16 Rasagiline also demonstrated antiapoptotic activity against peroxynitrite from SIN-1-induced DNA damage in human dopaminergic neuroblastoma SH-SY5Y cells.28

In vivo evidence of neuroprotection also exists. Rat models of PD using 6-OHDA striatal lesioning revealed increased survival of dopaminergic neurons subsequently treated with rasagiline relative to controls.29 Rodent models have also demonstrated improvements in motor function after drug-induced dopaminergic dysfunction, and in motor and cognitive function post-hypoxia.30 Furthermore, rasagiline-treated mice had faster recovery of motor function and spatial memory, and less cerebral edema, after closed head injury. Stroke models in the rat demonstrated decreased infarct sized after MCA occlusion and improved neurological severity scores in multiple models.2,31,32

People With Parkinson’s Disease Should Undergo Periodic Skin Examinations

Pin on Parkinsons

People with Parkinson’s disease are at increased risk of melanoma and possibly other skin cancers and should undergo periodic skin examinations.3,21,28,29 It is unclear whether this risk is increased by any specific Parkinson’s disease therapies, including rasagiline. Rasagiline-treated patients will be monitored by the drug sponsor in Australia and the USA to investigate this potential link.21

Don’t Miss: Brain Games For Parkinson Patients

Rasagiline May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:

  • red, swollen, and/or itchy eyes
  • unsteadiness, wobbliness, or lack of coordination
  • involuntary, repeated body movements
  • weakness or numbness of an arm or leg
  • extreme restlessness
  • difficulty thinking clearly or understanding reality

Rasagiline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Impulsive And Compulsive Behaviours

Behaviours may involve gambling, becoming a shopaholic, binge eating or focusing on sexual feelings and thoughts. This can have a huge impact on peoples lives including family and friends.

Not everyone who takes Parkinsons medication will experience impulsive and compulsive behaviours, so these side effects should not put you off taking your medication to control your symptoms.

Dont Miss: Does Vitamin B12 Help Parkinsons

You May Like: Traveling With Parkinson’s Disease

How Should I Use This Medication

The recommended dose of rasagiline is 1 mg once daily. The recommended starting dose of rasagiline for someone already taking levodopa is 0.5 mg, which may then be increased to 1 mg once daily if necessary. The recommended starting dose for someone taking a dopamine agonist is 1 mg taken once daily.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

This medication may be taken with or without food.

If you feel you need to stop this medication, contact your doctor for advice on how to discontinue it without causing problems.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Where Does Rasagiline Fit Into The Current Scope Of Parkinson’s Disease Therapy

Azilect is used to treat symptoms of Parkinson’s disease.

Rasagiline is effective in monotherapy in the early stage of the disease, and can be used instead of dopaminergic agonists. In the more advanced stages of the disease, it is given together with L-DOPA, when it produces a significant increase in the “on-time” per day, and reduces response fluctuations. However, there is great interest in the neuroprotective potential of rasagiline, which is currently the objective of a large clinical study . Rasagiline may cause neuroprotection by reducing the metabolism of dopamine, but it also possesses its own intrinsic neuroprotective properties.

Read Also: What Benefits Am I Entitled To If I Have Parkinson’s

How Long Does It Take To Work

In a clinical study, people reported that their Parkinsons symptoms eased after 1 week of taking Azilect daily.

If youve been using Azilect for more than a couple of weeks and havent noticed any symptoms relief, talk with your doctor. They may suggest making adjustments to your treatment plan.

Here are answers to some frequently asked questions about Azilect.

Before Taking Rasagiline For Parkinson’s Disease

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rasagiline it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breastfeeding.
  • If you have a problem with the way your liver works.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

Don’t Miss: How Many Stages Of Parkinson’s Is There

How Does This Medication Work What Will It Do For Me

Rasagiline belongs to the family of medications known as monoamine oxidase inhibitors . It is used to treat Parkinson’s disease. It acts on the nervous system to increase the levels of a chemical called dopamine. Low dopamine levels in the brain are responsible for many of the symptoms of Parkinson’s disease, so this medication works by rebalancing the levels of dopamine.

This medication may be taken alone or in combination with levodopa or a dopamine agonist to treat the symptoms of Parkinson’s disease.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. Do not stop taking this medication without consulting your doctor.

Research Involving Human Participants

Rasagiline

This study was conducted with the highest respect for the study participants according to the protocol and the ethical principles that have their origin in the Declaration of Helsinki. The study was reviewed and approved by the Institutional Review Board at each of the participating study centers, and was conducted in full compliance with the International Conference on Harmonization unified guidelines and the regulatory requirements of the region.

Read Also: Parkinson’s Disease Continuing Education Physical Therapy

Adjunctive Therapy To Levodopa In Pd

In patients with advanced PD on levodopa, motor fluctuations and dyskinesias result in significant morbidity and disability. The following two large phase 3 trials were conducted to determine the benefit of rasagiline in this subset of patients.

Parkinsons rasagiline: efficacy and safety in the treatment of Off trial

The PRESTO trial is a 26-week, multicenter, randomized, double-blind, placebo-controlled study of parallel groups of subjects with PD on optimized levodopa therapy, with motor fluctuations. Efficacy, safety, and tolerability of rasagiline as a levodopa adjunct were evaluated in 472 subjects enrolled at 57 centers. Inclusion criteria were idiopathic PD with modified Hoehn and Yahr stage < 5 in the off state, and presence of 2.5 hours of off time daily. Those with atypical or secondary parkinsonism, pronounced cognitive impairment , depression , and unstable neurological and medical disorders were excluded. There was no tyramine restriction required for subjects diets. Subjects were on optimized, stable doses of levodopa for at least 2 weeks prior to starting the study, and could receive concomitant treatment with dopamine agonists, amantadine, anticholinergics, and catechol-O-methyltransferase inhibitors. The levodopa dose could be decreased in the first 6 weeks, but not thereafter.

Lasting effect in adjunct therapy with rasagiline given once daily

Effect Of Rasagiline On Cognitive And Behavioral Symptoms In Pd

PD treatment has largely involved strategies to correct the underlying dopamine deficit. However, management of patients with long standing disease is often complicated by development of cognitive and behavioral symptoms, resulting from medication side effects and/or development of extranigral disease, which may involve other neurotransmitter systems than dopamine . Neuropsychiatric symptoms that have been associated with PD therapy include hallucinations, depression, confusion, impulse control disorders, sleep disorders, daytime somnolence, and sleep attacks. Adverse events reported with administration of selegiline include confusion, hallucinations, and insomnia .

You May Like: Parkinson’s Staring Into Space

Are There Any Other Precautions Or Warnings For This Medication

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Antidepressant medication: Severe reactions are possible when rasagiline is combined with medications and natural products used to treat depression. Avoid combining rasagiline and antidepressants. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are also possible.

If you have taken antidepressants recently, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Behaviour changes: People taking rasagiline have experienced abnormal behaviour such as compulsive gambling, compulsive shopping, hypersexuality, and binge eating. If you experience these symptoms or any other behaviour change while taking this medication, contact your doctor immediately.

Skin cancer: People taking this medication have a higher risk of developing skin cancer. It is unclear whether this increased risk is due to Parkinson’s disease or to rasagiline. You and your doctor should check your skin regularly for signs of skin cancer .

What Should I Know About Storage And Disposal Of This Medication

Azilect Profile for Teva

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

You May Like: Does Caffeine Make Parkinson’s Tremors Worse

No Differences In Primary Outcome

In all, 90 participants were included in the final analysis. Of this group, 11 did not return to complete the 1-year follow-up visit.

In the placebo group, 29% of the participants were women, compared with 36% of the rasagiline group. The baseline age was 63 years and 65 years, respectively. These differences were not statistically significant. Baseline free-water measurements were also similar between the groups.

Absolute change in free-water accumulation in the pSN at 1 year, which was the study’s primary outcome, did not differ significantly between the groups. The estimated mean group difference was 0.0015 on short TR scans and -0.0015 on long TR scans .

There were also no significant between-group differences in change in the secondary endpoints of anxiety, depression, cognition, and motor function at 1 year.

A significant increase in free-water measurements during the study period was observed on long TR scans but not on short TR scans.

There was also a positive correlation between long TR baseline free-water pSN values and the 1-year change in Movement Disorder SocietyUnified Parkinson’s Disease Rating Scale part III total score and change in bradykinesia score .

The current study differed from the earlier ADAGIO study in several ways, Vaillancourt noted.

Vaillancourt said that although there are currently “a lot” of medications for symptoms of PD, “the field needs a DMT.

What Other Drugs Will Affect Rasagiline

Using rasagiline with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor if you have taken an antidepressant during the 2-week period before you start taking rasagiline.

Many drugs can affect rasagiline, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Read Also: Fatigue In Parkinson’s Disease

Controlled Release Madopar And Sinemet

Controlled release preparations have the letters CR or HBS after the drug name.

These let the levodopa enter your body slowly instead of all at once. They can increase the time between doses.

They may be used when the dose of standard levodopa starts to wear off and the person taking it no longer feels the treatment is effective.

Controlled release options can sometimes reduce involuntary movements .

How Should I Take Rasagiline

(S)

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

If you take rasagiline alone, your dose may be different than if you take rasagiline with other Parkinson’s medications. Follow your doctor’s dosing instructions very carefully.

Rasagiline may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor.

Get familiar with the list of foods you should avoid to help prevent certain side effects of rasagiline.

Store at room temperature away from moisture and heat.

Do not stop using rasagiline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using rasagiline.

Don’t Miss: Parkinson’s And Muscle Cramps

Popular Articles
Related news