Why Do Doctors Prescribe Rasagiline?
Doctors often prescribe rasagiline in the treatment of Parkinson’s disease. Usually it can be used as adjunctive therapy with levodopa, a precursor to dopamine that used to be the treatment of choice for Parkinson’s disease. However, doctors also prescribe it without levodopa.
Parkinson’s disease is a type of movement disorder that occurs when the neurons don’t produce enough of a chemical known as dopamine that is extremely important to the brain. Below we explain how rasagiline can help.
How rasagiline works
This drug is a selective inhibitor of MAO-B. The inhibition of MAO-B protects dopamine from extra-neuronal degradation. It increases its concentration in the brain. Initially, doctors prescribed it along with levodopa.
Today, doctors prescribe both drugs both rasagiline and levodopa in combination to patients who have motor fluctuations at the end of the dose.
Doctors Prescribe Rasagiline With Dosage And Administration
In general, the usual form of administration is oral, at a dose of 1 mg every 24 hours, on its own or in combination with levodopa. The patient can take it with or without food. Also, doctors do not need to adjust the dose in elderly patients.
Experts do not recommend rasagiline for minors. This is because there is insufficient data on safety and efficacy in children and adolescents.
Contraindications of rasagiline
Doctors do not prescribe rasagiline under the following conditions:
- First, if there is hypersensitivity to the active substance or to any of the excipients.
- Even if the patient is already being treated with monoamine oxidase (MAO). This also applies if the patient is taking non-prescription medicines and natural products, such as St. John’s wort. A patient should take a break of 14 days from the time he stops taking rasagiline to start treatment with MAO inhibitors or pethidine.
- Finally, in patients with acute or chronic liver failure. Patients with mild hepatic failure should also take special precautions when starting treatment with rasagiline. However, if the liver failure progresses from mild to acute, they should discontinue treatment.
Interactions with other medicinal products and other forms of interaction
As we mentioned above, the use of rasagiline along with other MAO inhibitors or antidepressants is contraindicated. These include:
- Natural antidepressants, such as St. John’s wort
- Selective Serotonin Reuptake Inhibitors
- SNRIs – Serotonin Norepinephrine Reuptake Inhibitors
- Tricyclic and Tetracyclic Antidepressants
Experts also advise against taking it along with sympathomimetics, such as those in nasal and oral decongestants, or in cold medicines containing ephedrine or pseudoephedrine.
In this regard, the enzyme cytochrome P450 (CYP450) plays a role in the metabolism of most drugs. In vitro metabolism studies even indicate that the isozyme of cytochrome P450 1A2 (CYP1A2) is the main enzyme responsible for the metabolism of rasagiline.
Therefore, co-administration of rasagiline and ciprofloxacin, a CYP1A2 inhibitor, may affect the plasma concentrations of rasagiline. Patients should therefore handle it with care.
In addition, there is a risk that plasma levels of rasagiline in smoking patients may be reduced due to the induction of the metabolizing enzyme CYP1A2.
Possible side effects
Here are the most common side effects of this drug:
- Flu or infections caused by the flu virus
- Skin carcinomas
- Leukopenia
- Allergy, rhinitis or conjunctivitis
- Decreased appetite
- Depression and hallucinations
- Headache
- Dizziness
- angina pectoris
- Dermatitis
- Flatulence
- Urge to urinate
- Fever or malaise
- Musculoskeletal Pain, Cervical Pain and Arthritis
Can doctors prescribe rasagiline to pregnant women?
Currently, there are no clinical data on exposure to rasagiline during pregnancy. However, animal studies do not indicate direct or indirect harmful effects on pregnancy. This also includes embryo-fetal development, birth and postnatal development.
nevertheless, pregnant women using it should be careful. rasagiline may also interfere with breastfeeding. According to experimental data, this drug inhibits prolactin secretion.
However, it is not known whether rasagiline is excreted in human milk. Medical professionals should therefore take precautions when prescribing it to women who are breastfeeding.
