Generic name: rasagiline (ras AJ il een)
Brand name: Azilect
Drug class: Dopaminergic antiparkinsonism agents
Azilect (rasagiline) works by increasing the levels of certain chemicals in the brain.
Azilect is used to treat symptoms of Parkinson's disease (stiffness, tremors, spasms, poor muscle control).
Azilect is sometimes used with another medicine called levodopa.
Warnings
Do not Azilect if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, or tranylcypromine.
Tell your doctor about all medicines you have used in the 2-week period before you start taking Azilect. Many drugs can interact with rasagiline, and some drugs should not be used together.
Before you take this medicine, tell your doctor if you have liver disease.
There are many other drugs that can cause serious medical problems if you take them together with Azilect. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
While you are taking this medicine and for 2 weeks after you stop taking it, you may not be able to eat certain types of cheese. Follow your doctor's instructions. Rasagiline may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Before taking this medicine
You should not take Azilect if you are allergic to rasagiline.
Do not use Azilect if you have used any other MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others.
Many drugs can interact and cause dangerous effects. Some drugs should not be used together with Azilect. Your doctor may change your treatment plan if you also use:
- cyclobenzaprine (a muscle relaxer);
- dextromethorphan (contained in many over-the-counter cough medicines);
- meperidine (Demerol);
- methadone;
- St. John's wort; or
- tramadol (Ultram, Ultracet).
Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with rasagiline and cause a serious condition called serotonin syndrome.
To make sure Azilect is safe for you, 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 watch for.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
How should I take Azilect?
Take Azilect exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
If you take Azilect alone, your dose may be different than if you take it with other Parkinson's medications. Follow your doctor's dosing instructions very carefully.
Azilect 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.
Call your doctor if your Parkinson's symptoms do not improve, or if they get worse while using Azilect.
Store at room temperature away from moisture and heat.
Do not stop using Azilect suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
Dosing information
Usual Adult Dose for Parkinson's Disease:
Monotherapy:
Recommended dose: 1 mg orally once a day
Adjunct therapy:
Initial dose (in patients on concomitant levodopa): 0.5 mg orally once a day
Initial dose (in patients not on concomitant levodopa): 1 mg orally once a day
Maintenance dose: 0.5 mg to 1 mg orally once a day
Maximum dose: 1 mg orally once a day
Comments: May be used as adjunct therapy in patients on levodopa therapy, with or without other drugs used in the treatment of Parkinson's disease.
What happens if I miss a dose?
Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.
What happens if I overdose?
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.
What to avoid
Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Avoid getting up too fast 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 Azilect can raise your blood pressure to dangerous levels which could cause life-threatening side effects.
Azilect side effects
Get emergency medical help if you have signs of an allergic reaction to Azilect: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- severe headache, blurred vision, pounding in your neck or ears;
- extreme drowsiness or falling asleep suddenly, even after feeling alert;
- unusual changes in mood or behavior;
- hallucinations;
- a light-headed feeling, like you might pass out; or
- worsening symptoms of Parkinson's disease (especially uncontrolled muscle movements).
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Some people taking Azilect with levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.
You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.
Common Azilect side effects 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.
What other drugs will affect Azilect?
Using Azilect 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 Azilect.
Many drugs can interact with 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.