Uses of Rasalet: - Parkinson's disease Parkinson Disease Severe hepatic impairment. Concomitant use w/ other MAOIs and pethidine w/in 14 days after discontinuation of therapy; St John's wort.

Antiparkinson drugs

Rasagiline is a potent, irreversible, selective MAO-B inhibitor that effectively crosses the blood brain barrier after oral administration. The precise mechanisms of action of Rasagiline are unknown. One mechanism is believed to be related to its MAO-B inhibitory activity, which causes an increase in extracellular levels of dopamine in the brain. The elevated dopamine level and subsequent increased dopaminergic activity are likely to mediate Rasagiline's beneficial effects.

How to use Rasagiline: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Rasagiline may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Avoid tyramine-rich foods, beverages or dietary supplements & amines (from cough/cold prep). Adult Dose: Parkinson Disease Monotherapy: 1 mg PO qDay Adjunct without levodopa: 1 mg PO qDay Adjunct to levodopa: 0.5 mg PO qDay initially, may increase to 1 mg/day if needed and tolerated; consider reducing levodopa dose Hepatic impairment Mild (Child-Pugh A): Not to exceed 0.5 mg/day Moderate-to-severe (Child-Pugh B/C): Do not use Child Dose: <18 years: Safety and efficacy not established Renal Dose: Renal impairment: No dosage adjustment required for mild-to-moderate; not studied in severe

Increased plasma levels w/ potent CYP1A2 inhibitors (e.g. ciprofloxacin). Increased clearance w/ entacapone. Potentially Fatal: Increased risk of non-selective MAO inhibition w/ other MAOIs and pethidine that may lead to hypertensive crises.

Severe hepatic impairment. Concomitant use w/ other MAOIs and pethidine w/in 14 days after discontinuation of therapy; St John's wort.

Common - Joint pain - Insomnia (difficulty in sleeping) - Indigestion - Flu-like symptoms - Depression - Cough - Peripheral edema >10% EPS (dyskinesia/dystonia) (18%) Headache (14%) Nausea (10-12%) 1-10% Postural hypotension (6-9%) Constipation (4-9%) Weight loss (2-9%) Arthralgia (7%) Dyspepsia (7%) Xerostomia (2-6%) Depression (5%) Fall (5%) Flu-like syndrome (5%) Hallucination (4-5%) Conjunctivitis (3%) Fever (3%) Gastroenteritis (3%) Rhinitis (3%) Arthritis (2%) Bruising (2%) Malaise (2%) Neck pain (2%) Parasthesia (2%) Vertigo (2%) <1% CV MI Bundle branch block Gastrointestinal hemorrhage

Pregnancy Category C. Rasagiline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. So, caution should be exercised when administered to a nursing woman.

Precaution: May cause hypertension (including severe hypertensive syndromes) at recommended doses May exacerbate hypertension; antihypertensive drugs may require dosage adjustment May cause hypotension, especially orthostatic May cause serotonin syndrome when used with antidepressants Daytime drowsiness and somnolence reported during activities of daily living May cause or exacerbate dyskinesia; decreasing the levodopa dose may lessen or eliminate this side effect Hallucinations and psychotic-like behavior reported Impulse control/compulsive behaviors reported; case reports describe patients with intense urges to gamble, increased sexual urges, intense urges to spend money, or binge eat Withdrawal-emergent hyperpyrexia and confusion reported with rapid dose reduction of drugs that increase central dopaminergic tone; this is characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability Lactation There are no data on presence of drug in human milk or effects on breastfed infant; in rats, rasagiline was shown to inhibit prolactin secretion; the clinical relevance in humans is unknown, and there are no data on effects of rasagiline on prolactin secretion in humans The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and potential adverse effects on breastfed infant from drug or from underlying maternal condition

Store below 30° c, protected from light and moisture. Keep all the medicines out of reach of children.

Antiparkinson drugs

Rasagiline is a potent, irreversible monoamine oxidase (MAO)-B selective inhibitor which may cause an increase in extracellular levels of dopamine in the striatum, leading to reduced symptomatic motor deficits of Parkinson's disease.

Pregnancy Category C. Rasagiline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. So, caution should be exercised when administered to a nursing woman.