Adult Dosing
Treatment of Parkinson's disease
- Monotherapy: 1 mg PO qd
- Adjunctive therapy
- Start with 0.5 mg PO qd; if adequate clinical response does not occur, may increase the dose to 1 mg PO qd
- A reduction of the levodopa dose should be considered based upon individual response when used in combination with levodopa
Note:
- Patients taking concomitant ciprofloxacin or other CYP1A2 inhibitors should receive 0.5 mg/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Concomitant treatment of an antidepressant and a non-selective MAOI or selective MAO-B inhibitors may cause severe CNS toxicity associated with hyperpyrexia; these reactions are described as serotonin syndrome, which could be fatal. Serotonin syndrome symptoms include behavioral and cognitive/mental status changes, autonomic effects, and somatic effects
- Increase in rasagiline plasma concentrations up to 2 fold may occur when ciprofloxacin and other CYP1A2 inhibitors are administered concomitantly with rasagiline
- Plasma concentrations of rasagiline may increase in patients with mild, moderate, and severe hepatic impairment. Administer a dose of 0.5 mg/day in patients with mild hepatic impairment; avoid use in patients with moderate or severe hepatic impairment
- Risk for hypertensive crisis and non-selective monoamine oxidase inhibition may increase when daily doses exceed 1 mg/day (or 0.5 mg/day for patients with mild hepatic impairment or in patients using concomitant ciprofloxacin or another CYP1A2 inhibitor)
- Advise patients to avoid consuming foods containing a very large amount of tyramine while taking recommended doses of rasagiline because of the potential for large increases in blood pressure
- Increased risk of melanoma has been reported in patients with Parkinson's disease. Advise patients and providers to monitor for melanomas frequently and on a regular basis. Dermatologists should perform periodic skin examinations during therapy
- Adjunctive therapy with levodopa may cause dyskinesia or potentiate dopaminergic side effects and worsen pre-existing dyskinesia; reduction in levodopa dose may reduce this side effect
- When co-administered with levodopa, the incidence of postural hypotension consisting of a decreased systolic blood pressure (
30 mm Hg) or a decreased diastolic blood pressure (20 mm Hg) has been reported - Postural hypotension occurs frequently in the first two months of treatment and decreases over time. Certain patients treated with rasagiline experienced a mildly increased risk for significant decreases in blood pressure; discontinue therapy if postural hypotension occurs
- Increased incidence of high blood pressure has been reported when given in combination with levodopa
- Hallucinations have been reported when given as monotherapy or in combination with levodopa. Inform patients about the possibility of developing hallucinations and instruct them to report these to their physicians
- Rasagiline may cause or worsen psychotic-like behavior; avoid therapy in patients with major psychotic disorder
- A symptom complex resembling neuroleptic malignant syndrome, with no other etiology, has been reported in association with rapid dose reduction, withdrawal of, or changes in drugs that increase central dopaminergic tone
Cautions: Use cautiously in
- Cardiovascular disease
- Hypertension
- Diabetes mellitus
- Bipolar disorder
- History of mania
- Schizophrenia
- Smoking habit changes
- Seizure disorder
- Cerebrovascular disease
Pregnancy Category:C
Breastfeeding: Safety unknown. In animal studies, rasagiline was shown to inhibit prolactin secretion. It is unknown whether rasagiline is excreted in human milk. Manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Azilect 1 MG TABS [Bottle] (TEVA NEUROSCIENCE)
30 mg = $407.01
90 mg = $1154.92 - Azilect 0.5 MG TABS [Bottle] (TEVA NEUROSCIENCE)
30 mg = $420
90 mg = $1156.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
Drug Name: Azilect 0.5 MG Oral Tablet
Ingredient(s): Rasagiline
Imprint: GIL;0;5
Color(s): White
Shape: Round
Size (mm): 7.00
Score: 1
Inactive Ingredient(s): mannitol / silicon dioxide / stearic acid / talc
Drug Label Author:
Teva Neuroscience, Inc.
DEA Schedule:
Non-Scheduled
Drug Name: Azilect 1 MG Oral Tablet
Ingredient(s): Rasagiline
Imprint: GIL;1
Color(s): White
Shape: Round
Size (mm): 8.00
Score: 1
Inactive Ingredient(s): mannitol / silicon dioxide / stearic acid / talc
Drug Label Author:
Teva Neuroscience, Inc.
DEA Schedule:
Non-Scheduled
