Rasagiline

Rasagiline is used to help with symptoms of Parkinson's disease (such as stiffness, tremors, spasms, and poor muscle control). Rasagiline is sometimes used together with another medicine called levodopa.

Rasagiline may also be used for reasons not mentioned in this medication guide.

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 treatment program 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.

Call your doctor if your Parkinson's symptoms do not improve, or if they get worse while using 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.

Tell your doctor about all medicines you have used in the 2-week period before you start taking rasagiline. Many drugs can interact with rasagiline, and some drugs should not be used together.

You should not take rasagiline if you are allergic to it.

Do not use rasagiline if you have taken any other MAO inhibitor in the last 14 days. A dangerous drug interaction could happen. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others.

Many drugs can interact and lead to dangerous effects. Some drugs should not be used with rasagiline. Your doctor may change your treatment plan if you are also taking:

• cyclobenzaprine (a muscle relaxer);
• dextromethorphan (found in many over-the-counter cough medicines);
• meperidine (Demerol);
• methadone;
• St. John's wort; or
• tramadol (Ultram, Ultracet).

Make sure your doctor knows if you are also taking stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, migraine headaches, serious infections, or to prevent nausea and vomiting. These medicines may interact with rasagiline and cause a serious condition called serotonin syndrome.

Tell your doctor if you have ever had:

• high or low blood pressure;
• liver or kidney disease; or
• if you take ciprofloxacin (an antibiotic).

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Ask your doctor about skin symptoms to look out for.

Tell your doctor if you are pregnant or breastfeeding.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Rasagiline may cause serious side effects. Call your doctor right away if you have:

• severe headache, blurred vision, pounding in your neck or ears;
• extreme drowsiness or suddenly falling asleep, even after feeling alert;
• unusual changes in mood or behavior;
• hallucinations;
• feeling light-headed, as if you might pass out; or
• worsening symptoms of Parkinson's disease (especially uncontrolled muscle movements).

Seek medical attention immediately if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, rapid heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Some people taking rasagiline with levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any issues with daytime sleepiness or drowsiness.

You may experience increased sexual urges, unusual urges to gamble, or other strong urges while taking rasagiline. Discuss this with your doctor if it happens.

Common side effects of rasagiline may include:

• depressed mood;
• sleep problems (insomnia), strange dreams;
• involuntary muscle movements;
• loss of appetite, weight loss;
• indigestion, stomach pain, nausea, vomiting, constipation;
• joint pain or stiffness;
• rash;
• cough or other flu symptoms;
• dry mouth; or
• swelling in your hands or feet.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Parkinson's Disease:

Monotherapy: Recommended dose: 1 mg orally once a dayAdjunct therapy: Initial dose (in patients on concomitant levodopa): 0.5 mg orally once a dayInitial dose (in patients not on concomitant levodopa): 1 mg orally once a dayMaintenance dose: 0.5 mg to 1 mg orally once a dayMaximum dose: 1 mg orally once a dayComments: May be used as adjunct therapy in patients on levodopa therapy, with or without other drugs used in the treatment of Parkinson's disease.

Skip the missed dose and take your next dose at the usual time. Do not take two doses at the same time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of rasagiline can be fatal.

Overdose symptoms may include drowsiness, dizziness, severe headache, rapid pulse, feeling agitated or irritable, muscle spasms in your neck or jaw, sweating, cold or clammy skin, shallow breathing, fainting, or seizure (convulsions). These symptoms may be delayed for 12 to 24 hours after an overdose.

Avoid driving or doing anything dangerous until you know how rasagiline will affect you. Dizziness or drowsiness can lead to falls, accidents, or serious injuries. Be careful not to get up too quickly from a sitting or lying position, or you may feel dizzy.

Avoid drinking alcohol, especially red wine, vermouth, and tap beers or ale.

Also avoid eating foods that are high in tyramine, such as aged cheeses, fava beans, soy sauce, herring, pickled or processed meats and fish, and meats that are aged, dried, smoked, or fermented. Eating tyramine while you are taking rasagiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Using rasagiline with other drugs that cause drowsiness can make you feel even more tired. Check with your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Inform your doctor if you have taken an antidepressant in the 2 weeks before starting rasagiline.

Many drugs can influence how rasagiline works, and some should not be taken together. Tell your doctor about all the medicines you are currently taking and any new medicine you start or stop. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are mentioned here.