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All about: Azilect

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Generic Name: rasagiline (ras AJ il een)
Brand Names: Azilect

What is rasagiline?

Rasagiline is a monoamine oxidase-B (MAO-B) inhibitor. It works by increasing the levels of certain chemicals in the brain.

Rasagiline is used to treat the symptoms of Parkinson's disease. Rasagiline is sometimes used with another drug called levodopa.

Rasagiline may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about rasagiline?

Do not take rasagiline if you have liver disease or an adrenal gland tumor (also called pheochromocytoma). Do not take rasagiline within 14 days before having surgery.

There are many other medicines that should not be taken together with rasagiline or serious medical problems could result. Tell your doctor about all the prescription and over-the-counter medications you use, including vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

While you are taking rasagiline and for 2 weeks after you stop taking it, you must not eat or drink certain foods and beverages that are high in tyramine, listed in the "What should I avoid while taking rasagiline?" section of this leaflet. Eating these foods while you are taking rasagiline can raise your blood pressure to dangerous levels. This may cause life-threatening symptoms such as sudden and severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), and sudden numbness or weakness (especially on one side of the body). Call your doctor at once if you have any of these symptoms.

You should become very familiar with the list of foods you must avoid while taking rasagiline. Continue avoiding these foods for a full 14 days after you stop taking the medication.

Rasagiline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my health care provider before taking rasagiline?

Do not take rasagiline if you have liver disease or an adrenal gland tumor (also called pheochromocytoma). Do not take rasagiline within 14 days before having surgery. Do not take rasagiline if you have taken any of the following drugs within the past 14 days:
  • meperidine (Demerol);

  • tramadol (Ultram);

  • propoxyphene (Darvon, Darvocet);

  • methadone (Methadose, Dolophine);

  • over-the-counter cough, cold, or allergy medicines containing dextromethorphan, pseudoephedrine, or phenylephrine;

  • St. John's wort;

  • mirtazapine (Remeron);

  • cyclobenzaprine (Flexeril);

  • amphetamines (such as ADHD medication), stimulants, diet pills; or

  • other MAO inhibitors such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam).

Some people taking rasagiline have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk than most people for developing melanoma. Talk to your doctor about your specific risk and what skin symptoms to watch for.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether rasagiline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take rasagiline?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Rasagiline is usually taken once daily. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take this medication with a full glass of water. Rasagiline is only part of a complete program of treatment that also includes a diet plan created for you by your doctor or nutrition counselor. While you are taking rasagiline and for 2 weeks after you stop taking it, you must not eat foods that are high in tyramine, listed in the "What should I avoid while taking rasagiline?" section of this leaflet. Eating these foods while you are taking rasagiline can raise your blood pressure to dangerous levels. This may cause life-threatening side effects such as sudden and severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), and sudden numbness or weakness (especially on one side of the body). Call your doctor at once if you have any of these symptoms.

Foods that you may eat include:

  • fresh meat, poultry, or fish (including lunch meat, hot dogs, breakfast sausage, and cooked sliced ham);

  • any vegetables except broad bean pods (fava beans);

  • canned or bottled beer, white wine;

  • processed cheese, mozzarella, ricotta, cottage cheese;

  • pizza made with cheeses low in tyramine;

  • soy milk, yogurt; or

  • Brewer's or baker's yeast.

It is important to use rasagiline regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking rasagiline. You will need to stop using the medicine for at least 14 days before your surgery.

Store rasagiline at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a rasagiline overdose may include drowsiness, severe headache, feeling agitated or irritable, vision problems, fast and uneven heartbeats, sweating, cold or clammy skin, shallow breathing, fainting, or seizure (convulsions).

What should I avoid while taking rasagiline?

While you are taking rasagiline and for 2 weeks after you stop taking it, you must not eat foods that are high in tyramine, including:
  • air dried meats, aged or fermented meats, sausage or salami (including cacciatore and mortadella), pickled herring, and any spoiled or improperly stored beef, poultry, fish, or liver;

  • beer from a tap, beer that has not been pasteurized, or red wine;

  • aged cheeses, including blue, boursault, brick, brie, camembert, cheddar, emmenthaler, gruyere, parmesan, romano, roquefort, stilton, and swiss;

  • sauerkraut;

  • over-the-counter supplements or cough and cold medicines that contain tyramine;

  • soy beans, soy sauce, tofu, miso soup, bean curd, fava beans; or

  • yeast extracts (such as Marmite).

Eating tyramine while you are taking rasagiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

You should become very familiar with the list of foods you must avoid while you are taking rasagiline. Continue avoiding these foods for a full 14 days after you stop taking the medication.

Rasagiline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Rasagiline side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using rasagiline and call your doctor at once if you have any of these serious side effects:
  • increased blood pressure (sudden and severe headache, confusion, blurred vision, chest pain, nausea, vomiting, seizure);

  • sudden numbness or weakness (especially on one side of the body), problems with speech or balance;

  • unusual thoughts or behavior, confusion, extreme agitation;

  • fever, sweating, muscle stiffness;

  • feeling light-headed, fainting;

  • blistering skin rash;

  • twitching muscle movements; or

  • hallucinations (seeing things that are not there).

Continue using rasagiline and talk with your doctor if you have any of these less serious side effects:

  • joint pain;

  • mild headache, dizziness, or depressed mood;

  • hair loss;

  • numbness or tingly feeling;

  • dry mouth, loss of appetite;

  • constipation, diarrhea, upset stomach, vomiting, weight loss;

  • decreased sex drive, impotence, or difficulty having an orgasm; or

  • flu symptoms.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect rasagiline?

Before taking rasagiline, tell your doctor if you are using any of the following drugs:

  • ciprofloxacin (Cipro);

  • theophylline (Theo-Dur, Respbid, Uniphyl); or

  • antidepressants such as amitriptyline (Elavil), amoxapine (Ascendin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft).

If you are using any of these drugs, you may not be able to use rasagiline, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect rasagiline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has more information about rasagiline written for health professionals that you may read.

What does my medication look like?

Rasagiline is available with a prescription under the brand name Azilect. Other brand or generic forms may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Azilect 0.5 mg--white round tablet

  • Azilect 1 mg--white round tablet

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.03. Revision Date: 9/26/06 9:37:42 AM.

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