Why Do Doctors Prescribe Rasagiline?

Doctors prescribe rasagiline to treat Parkinson’s disease. It can be used as an adjunct to levodopa, or on its own. In this article you can find out how it is administered and what contraindications it may have.
Why do doctors prescribe rasagiline?

Doctors prescribe rasagiline to treat Parkinson’s disease. It can usually be used as an adjunct to Levodopa, a precursor to dopamine that used to be the treatment of choice for Parkinson’s disease. However, doctors also prescribe it for themselves, without levodopa.

Parkinson’s disease is a type of movement disorder that occurs when the neurons do not produce enough of a chemical that is extremely important for the brain, known as dopamine. Below we explain how rasagiline can help.

How rasagiline works

This drug is a selective inhibitor of MAO-B. Inhibition of MAO-B protects dopamine from extranevronal degradation. Therefore, it increases the concentration in the brain. Originally, doctors wrote it out with levodopa. Today, they prescribe both drugs in combination in cases of patients with motor fluctuations at the end of the dose.

Why do doctors prescribe rasagiline?

Dosage and administration

Overall, it is most commonly administered orally, in a dose of 1 mg every 24 hours, alone or in combination with levodopa. The patient can take it with or without food. Doctors also do not need to change the dose among elderly patients.

Contraindications to rasagiline

Physicians should not prescribe rasagiline under the following circumstances:

  • First of all if hypersensitivity to the active substance or to any of the excipients occurs.
  • If the patient is already being treated with monoamino oxidase (MAO). This includes if the patient is taking medicines and natural products that are not prescription, such as St. John’s wort. A patient must take a 14-day break from the moment they stop using rasagiline to start treatment with MAO inhibitors or pethidine.
  • Finally in patients with acute or chronic liver failure. Patients with mild hepatic impairment must also take special precautions when starting treatment with rasagiline. However, if the liver failure develops from mild to acute, they must discontinue treatment.

Interaction with other medicines and other forms of interaction

As we mentioned above, the use of rasagiline with other MAO inhibitors or antidepressants is contraindicated. These include:

  • Natural antidepressants, such as St. John’s wort
  • SSRIs – selective serotonin reuptake inhibitors
  • SNRIs – selective serotonin and norepinephrine reuptake inhibitors
  • Tricyclic and tetracyclic antidepressants

Experts advise against taking it with sympathomimetic drugs, such as those found in nasal and oral decongestants, or in cold medicines containing ephedrine or pseudoephedrine.

Why do doctors prescribe rasagiline?

In this regard, the enzyme cytochrome P450 (CYP450) plays a role in the metabolism of most drugs. In fact, in vitro metabolism studies indicate that the isozyme of cytochrome P450 1A2 (CYP1A2) is the major enzyme responsible for the metabolism of rasagiline. Therefore, co-administration of rasagiline and ciprofloxacin, a CYP1A2 inhibitor, may affect the plasma concentrations of rasagiline. Thus, patients should take it with caution.

Furthermore , there is a risk that plasma levels of rasagiline in patients who smoke may be reduced due to the induction of the metabolizing enzyme CYP1A2.

Possible side effects

These are the most common side effects of this drug:

  • Influenza or infections caused by influenza virus
  • Skin cancer
  • Leukopenia
  • Allergy, rhinitis or conjunctivitis
  • Decreased appetite
  • Depression and hallucinations
  • Headache
  • Dizziness
  • Angina pectoris
  • Dermatitis
  • Flatulence
  • Needy urination
  • Fever or discomfort
  • Pain in the muscles and scales, neck pain and arthritis

Can doctors prescribe rasagiline for pregnant women?

There are currently no clinical data on exposed pregnancies during rasagiline. However, animal studies do not indicate direct or indirect harmful effects with respect to pregnancy. This also includes embryo-fetal development, birth and postpartum development.

Nevertheless, pregnant women who take it should be careful. Rasagiline may also interfere with breast-feeding. According to experimental data, this drug inhibits prolactin secretion. However, it is unknown whether rasagiline is excreted in human milk. Therefore , medical professionals should take precautions when prescribing it to breastfeeding women.

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