This medication is used alone or with other medications (e.g., levodopa, carbidopa) to treat movement disorders caused by Parkinson's disease. It does not cure Parkinson's disease, but it may improve shakiness (tremor), muscle stiffness, and sudden switching between normal movement and stiffness ("on-off" problems). It may improve your range of motion and ability to walk, dress, and exercise.
Rasagiline is an enzyme blocker (MAO inhibitor) that works by slowing the breakdown of certain natural substances in the brain (neurotransmitters such as dopamine, norepinephrine, and serotonin).
Take this medication by mouth with or without food as directed by your doctor, usually once daily.
The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Do not increase your dose or take it more often than directed.
It may take a few weeks for the full benefits of the drug to be noticed. Do not stop taking this drug without first consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.
Talk with your doctor if the medication stops working well or if your condition worsens.
Dizziness, drowsiness, joint pain, heartburn, nausea, fever, muscle pain, dry mouth, and stomach/abdominal pain may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
To minimize dizziness and the risk of fainting, get up slowly when rising from a sitting or lying position. This is especially important if you are also taking levodopa and when you first start taking rasagiline.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
If you are also taking levodopa, you may experience more side effects from the levodopa when taking rasagiline. Tell your doctor immediately if any of these side effects occur: nausea, shakiness, muscle stiffness, mental/mood changes such as hallucinations/abnormal dreams. Your doctor may need to change your medication or dose. Do not stop or change the dose of your levodopa without talking with your doctor first.
Tell your doctor right away if you have any serious side effects, including: fainting, loss of balance, mental/mood changes (e.g., agitation, confusion, depression, hallucinations, compulsive behavior including urge to gamble), worsening muscle stiffness/twitching, changes in sexual ability/interest, increased shaking (tremor), swollen ankles/legs, change in amount of urine, unusual weight gain/loss, easy bleeding/bruising, black/tarry stools, vomit that looks like coffee grounds.
Some people using this medication have reported falling asleep suddenly during their usual daily activities (such as talking on the phone, driving). In some cases, sleep occurred without any feelings of drowsiness beforehand. Therefore, you should not drive or take part in other possibly dangerous activities until you are certain that this medication will not cause drowsiness or sudden sleep. If you experience increased sleepiness or fall asleep during the day, do not drive or take part in other possibly dangerous activities until you have discussed this effect with your doctor. Your risk is increased with use of alcohol or other medications that can make you drowsy.
This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: hallucinations, unusual restlessness, loss of coordination, fast heartbeat, severe dizziness, unexplained fever, severe nausea/vomiting/diarrhea, twitching muscles.
This drug may rarely cause an attack of extremely high blood pressure (hypertensive crisis), which may be fatal. Drug and food interactions can increase this risk. (See also Drug Interactions section.) Get medical help right away if any of these serious side effects occur: frequent/severe headache, fast/slow/irregular/pounding heartbeat, chest pain, neck stiffness/soreness, severe nausea/vomiting, sweating/clammy skin (sometimes with fever), widened pupils, vision changes (e.g., double/blurred vision), sudden sensitivity to light (photophobia).
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before taking rasagiline, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: cerebrovascular disease (e.g., stroke), heart disease (e.g., coronary artery disease, heart attack, history of chest pain, congestive heart failure), personal/family history of high blood pressure, history of severe/frequent headaches, liver disease, sore in the stomach/intestine/esophagus (peptic ulcer), bleeding problems, diabetes, personal/family history of mental/mood disorders (e.g., schizophrenia, bipolar disorder), overactive thyroid (hyperthyroidism), a certain kind of adrenal gland tumor (pheochromocytoma), sleep disorders.
This drug may make you drowsy or dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.
Before having surgery, tell your doctor or dentist you are taking this medication. You may need to stop taking this drug beforehand. Follow your doctor's instructions carefully.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
It is not known if this drug passes into breast milk. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with rasagiline include: appetite suppressants (such as diethylpropion), drugs for attention deficit disorder (such as atomoxetine, methylphenidate), apraclonidine, bupropion, buspirone, cyclobenzaprine, dextromethorphan, certain herbal products (such as ephedra/ma huang), methyldopa, cold medications/nasal decongestants (such as phenylephrine, phenylpropanolamine, pseudoephedrine), street drugs (such as LSD, mescaline), stimulants (such as amphetamines, ephedrine), supplements (such as tryptophan, tyramine), tetrabenazine, certain "triptans" used to treat migraine headaches (such as rizatriptan, sumatriptan, zolmitriptan).
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, tramadol, certain narcotic medications (such as fentanyl, meperidine, methadone, propoxyphene, tapentadol), certain antidepressants (including maprotiline, mirtazapine, SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine, TCAs such as amitriptyline/doxepin), other MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Tell your doctor or pharmacist if you are using any of the medications listed above within the 2 weeks before, during, or after treatment with rasagiline. Tell your doctor or pharmacist if you have taken fluoxetine within 5 weeks before starting rasagiline. Discuss with your doctor how much time to wait between starting or stopping any of these drugs and taking rasagiline.
Other medications can affect the removal of rasagiline from your body, which may affect how rasagiline works. Examples include cimetidine, fluvoxamine, rifampin, quinolone antibiotics (such as ciprofloxacin), anticonvulsants (such as carbamazepine, oxcarbazepine), among others.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants (such as carisoprodol), and narcotic pain relievers (such as codeine, hydrocodone ).
Check the labels on all your medicines (such as allergy, cough-and-cold products, diet pills) because they may contain dextromethorphan, decongestants, stimulants, or ingredients that cause drowsiness . Ask your pharmacist about the safe use of those products.
A very serious high blood pressure reaction may rarely occur if you eat a large amount of tyramine while taking rasagiline and for 2 weeks after you stop it. Avoid foods that are high in tyramine, like aged cheeses (such as Stilton). Consult your doctor or dietician about which foods you should avoid or if you do not feel well after eating or drinking certain foods while taking this medication. Get medical help right away if you notice symptoms of very high blood pressure such as unusually fast/slow heartbeat, vomiting, unexplained sweating, headache, chest pain, sudden vision changes, weakness on one side of the body, difficulty thinking, slurred speech.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may not appear for up to 12 hours and may include: excitement, irritability, restlessness, dizziness, weakness, drowsiness, flushing, sweating, fast heartbeat, headache, confusion, seizures.
Do not share this medication with others.
Laboratory and/or medical tests (such as blood pressure) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
People with Parkinson's disease may have an increased risk for developing skin cancer (melanoma). Tell your doctor promptly if you notice a change in the appearance or size of moles or other unusual skin changes. Ask your doctor if you should have regular skin exams.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised June 2014. Copyright(c) 2014 First Databank, Inc.
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