Rasagiline tablet

What is this medicine?

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 (stiffness, tremors, spasms, poor muscle control). Rasagiline is sometimes used with another drug called levodopa. Rasagiline may also be used for purposes not listed in this medication guide.

What should I tell my health care providers before I take this medicine?

You should not take rasagiline if you are allergic to it. Many medicines can interact with rasagiline and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

• cyclobenzaprine (a muscle relaxer);

• dextromethorphan (contained in many over-the-counter cough medicines);

• meperidine (Demerol);

• methadone;

• St. John's wort; or

• tramadol (Ultram, Ultracet).

Do not use rasagiline if you have used any other MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others. To make sure rasagiline is safe for you, tell your doctor if you have:

• high or low blood pressure;

• liver disease;

• if you take an antidepressant; or

• if you take ciprofloxacin (an antibiotic).

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for. It is not known whether rasagiline will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. It is not known whether rasagiline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use this medicine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. Your dose may be different if you take rasagiline alone than if you take rasagiline with other Parkinson's medications. Follow your doctor's dosing instructions very carefully.

Rasagiline is only part of a complete program of treatment that may include a diet plan created for you by your doctor or nutrition counselor. Call your doctor if your Parkinson's symptoms do not improve, or if they get worse while using rasagiline. Do not stop using rasagiline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using rasagiline.

What if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What may interact with this medicine?

Taking rasagiline while you are also taking an antidepressant can cause high levels of serotonin in your body. Symptoms of this condition include agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, and fainting. Tell your doctor if you have taken an antidepressant during the 2-week period before you start taking rasagiline.

Taking rasagiline with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking rasagiline with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or seizures.

Many drugs can interact with rasagiline, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with rasagiline. Give a list of all your medicines to any healthcare provider who treats you.

What side effects may I notice from this medicine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using rasagiline and call your doctor at once if you have:

• extreme drowsiness, falling asleep suddenly, even after feeling alert;

• unusual changes in mood or behavior;

• a light-headed feeling, like you might pass out;

• worsening symptoms of Parkinson's disease (especially uncontrolled muscle movements); or

• dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats, seizure.

Some people taking rasagiline with levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

Common side effects may include:

• dizziness, drowsiness;

• sleep problems (insomnia), strange dreams;

• depressed mood;

• upset stomach, nausea, vomiting, stomach pain;

• loss of appetite, weight loss;

• constipation;

• joint pain or stiffness;

• swelling in your hands or feet;

• dry mouth, cough; or

• flu symptoms (fever, chills, body aches).

This is not a complete list of side effects and others may occur.

What should I watch for while using this medicine?

Rasagiline may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can increase certain side effects of rasagiline.

Also avoid eating foods that are high in tyramine, such as aged cheeses, sour cream, yogurt, avocados, bananas, soy sauce, and pepperoni or other dried meats. Eating tyramine while you are taking rasagiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Where should I keep this medicine?

Store at room temperature away from moisture and heat.