What Is Rasagiline? Some Essential Information

Do you know what rasagiline is? Doctors prescribe this drug to treat Parkinson’s disease. In general, rasagiline can be used in adjuvant therapies with levodopa, a dopamine precursor that has been the main treatment for this disorder in the past. But doctors often prescribe rasagiline on their own.

Parkinson’s disease is a movement disorder that occurs when neurons do not produce enough dopamine, a very important chemical for the brain. In the following, we will explain why rasagiline is so useful.

What is rasagiline and how does it work?

Rasagiline is a selective inhibitor of monoamine oxidase B. Inhibition of monoamine oxidase B protects dopamine against extraneuronal degradation. Therefore, its level in the brain will increase. Initially, doctors prescribed rasagiline together with levodopa, but nowadays the two drugs are only associated in patients with high-dose motor fluctuations.

Doses and method of administration

In general, the drug is administered orally at a dose of 1 mg every 24 hours, on their own or in combination with levodopa. Patients can take rasagiline whether they have eaten or not, and doctors do not have to adjust the dose for the elderly.

Specialists do not recommend the administration of rasagiline to patients under 18 years of age. At present, there are not enough data on the effect of this drug on children and adolescents.

Contraindications

Doctors will not prescribe rasagiline in the following situations:

• If there is hypersensitivity to any of the excipients of the drug.
• If the patient is already undergoing treatment with monoamine oxidase inhibitors. This category also includes medicines or natural products released without a prescription, such as St. John’s wort. The patient should take a 14-day break from stopping rasagiline treatment before taking other selective monoamine oxidase or pethidine inhibitors.
• If the patient suffers from acute or chronic liver failure. Patients with milder forms of hepatic impairment should also be careful when taking resagiline. If the disease progresses negatively, treatment should be discontinued.

Interactions with other drugs and substances

As mentioned above, it is contraindicated to take rasagiline concomitantly with other monoamine oxidase inhibitors. This medicine should not be combined with antidepressants, including:

• Natural antidepressants, such as St. John’s wort
• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic or tetracyclic antidepressants

At the same time, experts recommend that patients taking rasagiline avoid sympathomimetic substances, such as nasal decongestants and ephedrine or pseudoephedrine-containing medicines or cold medicines.

The cytochrome P450 enzyme plays an important role in the metabolism of several drugs. Regarding rasagiline, in vitro metabolic studies suggest that the cytochrome P450 1A2 isoenzyme is the major enzyme responsible for the metabolism of this drug.

Therefore, concomitant administration of rasagiline and ciprofloxacin, a cytochrome P450 1A2 inhibitor, may affect plasma levels of rasagiline. Patients must be very careful if they want to combine these two drugs.

Last but not least, there is a risk that plasma levels of rasagiline may decrease in smoking patients due to induction of cytochrome P450 1A2 metabolism.

Possible side effects

The most common side effects with rasagiline are:

• Influenza and infections caused by the flu virus
• Skin cancer
• Allergies, rhinitis or conjunctivitis
• Loss of appetite
• Depression and hallucinations
• Headache
• vertigo
• Angina pectoris
• Dermatitis
• flatulence
• Urgent need to urinate
• Fever or malaise

• Musculoskeletal and cervical pain
• Arthritis

Is it advisable for pregnant women to take rasagiline?

There are currently no clinical data on exposure to this drug during pregnancy. However, animal studies do not indicate that rasagiline may affect embryo and fetal development, birth or postnatal development.

However, pregnant women should be careful when taking rasagiline. This could affect breastfeeding. According to experimental data, rasagiline inhibits the secretion of prolactin, but it is not known whether it can be excreted in human milk.

Therefore, doctors should be careful when prescribing rasagiline to breastfeeding women.