Rasagiline

(ra sa' ji leen)

Brand Name(s): Azilect^®

WHY is this medicine prescribed?

Rasagiline is used alone or in combination with another medication to treat the symptoms of Parkinson's disease (a slowly progressing disease of the nervous system causing a fixed face without expression, tremor at rest, slowing of movements, walking with shuffling steps, stooped posture and muscle weakness). Rasagiline is in a class of medications called monoamine oxidase (MAO) type B inhibitors. It works by increasing the amounts of certain natural substances in the brain.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Rasagiline comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take rasagiline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rasagiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of rasagiline and may increase your dose based upon your body's response to this medication.

Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased.

What SPECIAL PRECAUTIONS should I follow?

Before taking rasagiline,

• tell your doctor and pharmacist if you are allergic to rasagiline, any other medications, or any of the ingredients in rasagiline tablets. Ask your pharmacist for a list of the ingredients.

• tell your doctor if you are taking cough and cold products containing dextromethorphan (DM; Delsym, Hold, Robitussin CoughGels, Vicks 44 Cough Relief, in Robitussin DM, others), cyclobenzaprine (Flexeril), meperidine (Demerol), methadone (Dolophine, Methadose), propoxyphene (Darvon, in Darvocet-N, others), St. John's wort, or tramadol (Ultram, in Ultracet). Also tell your doctor if you are taking MAO inhibitors such as phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) or have stopped taking them within the past two weeks. Your doctor may tell you not to take rasagiline if you are taking one or more of these medications.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amphetamines (Adderall, Dexedrine, DextroStat); antidepressants; cimetidine (Tagamet); decongestants placed in the eye or nose; diet or weight-control products containing ephedrine; fluoroquinolone antibiotics including ciprofloxacin (Cipro), gatifloxacin (Tequin), levofloxacin (Levaquin), norfloxacin (Noroxin), and ofloxacin (Floxin); fluvoxamine (Luvox); medications to treat asthma; medications to treat high blood pressure; medications to treat mental illness; medications to treat pain; phenylpropanolamine (not available in the U.S.); pseudoephedrine (PediaCare, Sudafed, Suphedrine, others); and ticlopidine (Ticlid). Tell your doctor if you are taking fluoxetine (Prozac, Sarafem) or have stopped taking it within the past 5 weeks. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had high blood pressure, mental illness or psychosis;kidney, or liver disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking rasagiline, call your doctor.

• you should know that rasagiline may cause dizziness, lightheadedness, nausea, sweating, and fainting when you get up too quickly from a lying position. This is more common during the first 2 months of taking rasagiline. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

• you should know that rasagiline may cause serious, life-threatening high blood pressure when taken with certain medications or foods. Carefully follow your doctor's instructions about medications and foods to be avoided. Call your doctor right away if you have a severe headache, blurred vision, or any of the other symptoms listed below as serious side effects.

• you should know that people who have Parkinson's disease have a higher risk of melanoma (a type of skin cancer) than people who do not have Parkinson's disease. It is not known whether this increased risk is caused by Parkinson's disease, medications used for Parkinson's disease such as rasagiline, or other factors. You should have regular visits with a dermatologist to examine your skin for melanoma.

• you should know that some people who took rasagiline or similar medications to treat Parkinson's disease experienced intense urges to gamble, increased sexual urges, and other urges that they were unable to control. Tell your doctor if you experience new or increased gambling urges, increased sexual urges, or other intense urges while taking rasagiline.

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 (e.g., Stilton or blue cheese) 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 should I do IF I FORGET to take a dose?

Do not take a double dose to make up for a missed one. Skip the missed dose and take your next dose at the usual time the next day.

What SIDE EFFECTS can this medicine cause?

Rasagiline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• mild headache
• joint or neck pain
• heartburn
• nausea
• vomiting
• stomach pain
• constipation
• diarrhea
• loss of appetite
• weight loss
• flu-like symptoms
• fever
• sweating
• red, swollen, and/or itchy eyes
• dry mouth
• swollen gums
• unsteadiness, wobbliness, or lack of coordination
• involuntary, repeated body movements
• lack of energy
• sleepiness
• abnormal dreams
• depression
• pain, burning, numbness, or tingling in the hands or feet
• rash
• bruising or purple discoloration on skin

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• severe headache
• blurred vision
• seizures
• chest pain
• shortness of breath or difficulty breathing
• confusion
• unconsciousness
• slow or difficult speech
• dizziness or faintness
• weakness or numbness of an arm or leg
• hallucinating (seeing things or hearing voices that do not exist)
• 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.

What should I know about STORAGE and DISPOSAL of this medication?

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 (not in the bathroom).

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 (http://goo.gl/c4Rm4p) 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 (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) 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 – one that is up and away and out of their sight and reach. http://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of rasagiline overdose may occur as late as 1 to 2 days after the overdose. Symptoms of overdose may include the following:

• drowsiness
• dizziness
• faintness
• irritability
• hyperactivity
• agitation or restlessness
• severe headache
• hallucinating
• confusion
• loss of coordination
• difficulty opening the mouth
• rigid body spasm that may include an arched back
• twitching muscles
• seizures
• loss of consciousness
• fast or irregular heart beat
• pain in the area between the stomach and chest
• difficulty breathing or slowed breathing
• diarrhea
• fever
• sweating
• cool, clammy skin
• shivering
• increase in pupil size (black circle in middle of eye)

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: July 15, 2016.