What Does Azilect Do
Men and women diagnosed with Parkinsons disease are likely to have much lower levels of the neurotransmitter Dopamine in the brain than normal. Scientists estimate that up to 80 percent of Dopamine could be lost by the time an individual is diagnosed with the disorder. A small Dopamine level is a far-reaching condition, as it is believed that Dopamine controls movement and coordination in the human body, including simple tasks such as walking and raising the arms. According to the producing company, Azilect may improve Dopamine levels in the brain, enabling the patient to regain some of his or her mobility lost as a result of the cognitive disorder.
The latest research has shown that increasing Dopamine levels in the brain may be a good way to treat some of the Alzheimers symptoms. However, the average individual looking to boost his or her cognitive function may be better off using select natural supplements, according to many industry watchers.
This drug should be taken once a day and is offered in a pill form. It can be taken alone or with food. The dose depends on the severity of the treatment necessary for the individual. Typically, the doctor will start out with a small dose and then adjust it to a higher dose if needed and if permitted.
Are There Any Contraindications To Using Azilect
Yes. A contraindication is a condition or factor that would prevent you from taking a medication. There are some contraindications to using Azilect.
You shouldnt take certain medications with Azilect. If youre using one of the drugs mentioned below, your doctor will typically recommend an alternative. This may be an alternative to Azilect or an alternative to the medication thats contraindicated .
Contraindications include taking any of the following drugs while using Azilect:
If your doctor advises you to stop taking Azilect, you shouldnt use the above medications until at least 14 days after your last dose of Azilect. For more information, talk with your doctor.
What Other Drugs Could Interact With This Medication
There may be an interaction between rasagiline and any of the following:
- alpha-adrenergic receptor blockers
- angiotensin converting enzyme inhibitors
- angiotensin receptor blockers
- beta-adrenergic blockers
- calcium channel blockers
- diabetes medications
- MAO inhibitors
- quinolone antibiotics
- selective serotonin reuptake inhibitors
- serotonin-norepinephrine reuptake inhibitors
- St. John’s wort
- sympathomimetic medications
- tricyclic and tetracyclic antidepressants
- “triptan” migraine medictions
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
What Drugs And Food Should I Avoid While Taking Rasagiline
Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
Avoid drinking alcohol, especially red wine, vermouth, and tap beers or ale.
Also avoid eating foods that are high in tyramine, such as aged cheeses, fava beans, soy sauce, herring, pickled or processed meats and fish, and meats that are aged, dried, smoked, or fermented. Eating tyramine while you are taking rasagiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects.
How Should I Take Azilect
Take Azilect exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
If you take Azilect alone, your dose may be different than if you take it with other Parkinson’s medications. Follow your doctor’s dosing instructions very carefully.
Azilect may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor.
Get familiar with the list of foods you should avoid to help prevent certain side effects of rasagiline.
Store at room temperature away from moisture and heat.
Do not stop using Azilect suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
Who Is It For
Rasagiline is indicated for treating the symptoms of Parkinson’s disease, either as monotherapy or as adjunctive therapy with levodopa. Participants in monotherapy trials had been diagnosed for approximately 4 months and 1 year and did not have severe symptoms. Participants in adjunctive therapy trials had been diagnosed for about 10 years on average and experienced more severe motor symptoms as well as off-time and dyskinesia.
Rasagiline is contraindicated for people with hepatic impairment . For further information on ChildPugh classification of liver disease see the NPS web extra on this topic or the Australian Prescriber article ‘Prescribing in liver disease’.
Rasagiline may not be suitable for people already taking antidepressants; some classes and specific drugs are contraindicated and specialist advice should always be obtained . Use of antidepressants in combination with dopamine agonists is less restricted. The suitability of rasagiline for people with severe depression, clinically significant or unstable vascular disease, congestive heart failure or cognitive impairment has not been investigated.
Rasagiline Adjunctive Therapy May Increase Dyskinesia
As with other levodopa adjunctive therapies, rasagiline may increase dyskinesia. There was a significant mean increase in dyskinesia compared with levodopa therapy alone in the PRESTO but not the LARGO trial ||.
The reason for the disparity between the two trials is not known, although combinations of rasagiline and entacapone were permitted in the PRESTO trial but not the LARGO trial. In both trials levodopa dose adjustment was precluded after the first 6 weeks. During this first 6 weeks a small decrease in required levodopa was reported.
Monotherapy: Adverse Events Similar To Those With Placebo
In rasagiline monotherapy trials, incidence of adverse events was not significantly increased with rasagiline compared with placebo. In the TEMPO trial , headache was reported as a very common adverse event with incidence increased with rasagiline over placebo .
Other common adverse events reported with increased incidence compared with placebo include those reported in Box 1.3,4,723
Safety data for the ADAGIO trial are limited to events reported in > 5% of trial participants. Of these only fatigue was increased in rasagiline-treated compared with placebo-treated subjects. However, incidence was not significantly increased compared with placebo.
Before Taking This Medicine
You should not take Azilect if you are allergic to rasagiline.
Do not use Azilect 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.
Many drugs can interact and cause dangerous effects. Some drugs should not be used together with Azilect. Your doctor may change your treatment plan if you also use:
if you take ciprofloxacin .
People with Parkinson’s disease may have a higher risk of skin cancer . Ask your doctor about skin symptoms to watch for.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
Dosage For Parkinsons Disease
If Azilect is the only Parkinsons disease medication that your doctor prescribes for you, youll likely take one 1-mg tablet once daily.
If Azilect is prescribed for you along with a medication that contains levodopa , youll likely take one 0.5-mg tablet daily to start. Your doctor will see whether you have any side effects and how well the drug is working for you. Based on these factors, they may increase your dosage of Azilect to one 1-mg tablet daily.
If you take certain medications that interact with Azilect, such as ciprofloxacin , or if you have mild liver disease, your doctor may adjust your dosage.
Make sure to take the dosage your doctor prescribes for you. They can determine the best dosage to fit your needs.
Impulsive And Compulsive Behaviours
Behaviours may involve gambling, becoming a shopaholic, binge eating or focusing on sexual feelings and thoughts. This can have a huge impact on peoples lives including family and friends.
Not everyone who takes Parkinsons medication will experience impulsive and compulsive behaviours, so these side effects should not put you off taking your medication to control your symptoms.
Find out more about impulsive and compulsive behaviours.
What Are The Important Side Effects Of Azilect
The most common adverse effects of rasagiline are:
- vomiting, and
- difficulty moving.
Rasagiline also may cause low or high blood pressure. A hypertensive crisis may occur if foods high in tyramine are consumed while taking rasagiline.
Tyramine in food usually is broken down in the intestine by MAO-A in the intestinal wall as the tyramine is absorbed into the body. There are no adequate studies in humans to determine whether rasagiline also inhibits MAO-A; however, if MAO-A is inhibited, tyramine ingested in food may enter the body in larger amounts and result in a hypertensive crisis.
Foods high in tyramine include those that are aged, fermented, pickled, or smoked. Examples include aged cheeses, air-dried meats, sauerkraut, sauce, tap/draft beers and red wines. As a precaution, foods high in tyramine should be avoided when taking rasagiline.
What Are The Side Effects Of Rasagiline
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
- severe headache, blurred vision, pounding in your neck or ears;
- extreme drowsiness or falling asleep suddenly, even after feeling alert;
- unusual changes in mood or behavior;
- a light-headed feeling, like you might pass out; or
- worsening symptoms of Parkinson’s disease .
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
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:
- depressed mood;
- cough or other flu symptoms;
- dry mouth; or
- swelling in your hands or feet.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How Should This Medicine Be Used
Rasagiline comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take rasagiline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rasagiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of rasagiline and may increase your dose based upon your body’s response to this medication.
Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased.
What Does Azilect Do For Parkinson’s
It acts by slowing down the breakdown of dopamine in the brain. Dopamine is a chemical that sends information to the parts of the brain that control movement and coordination. In early Parkinson’s disease, Azilect can be used as single drug therapy to slow progression of symptoms.
Likewise, what foods should be avoided when taking Azilect? Those taking monoamine oxidase B inhibitors such as Azilect or Eldepryl should avoid foods containing tyramine because they could lead to high blood
In this regard, what are the side effects of Azilect?
Common side effects may include:
- depressed mood;
- sleep problems , strange dreams;
- involuntary muscle movements;
- loss of appetite, weight loss;
- indigestion, stomach pain, nausea, vomiting, constipation;
- joint pain or stiffness;
- cough or other flu symptoms;
Does azilect cause dyskinesia?
Dyskinesia. When used as an adjunct to levodopa, AZILECT may cause dyskinesia or potentiate dopaminergic side effects and exacerbate pre-existing dyskinesia.
Precautions When Taking Azilect
It is always advised that before taking any drugs or medications that you inform your doctor or pharmacist if any other products you are using. It is no different with Azilect. Be sure to inform your doctor if you are taking other medications. Cautions to follow are;
- Inform your pharmacist or doctor if you are allergic to this drug
- Inform your doctor or pharmacist of your medical history
- Do not by any chance increase the dosage of Azilect more than the prescribed
- Do not reduce the dosage
- You should not stop taking this medication before consulting with your doctor
- Do not use other herbal products together with this medication unless advised by the doctor
- No machinery should be operated when taking this medication
- Do away with any alcoholic beverages or limit their intake
What Focus Have You Taken In The Field Of Pharmacology And What Interesting Results Have You Seen
Since joining the Faculty of Medicine at the Technion, Haifa, most of my research has been connected with catecholamines, mainly studies on the mechanism of the action of antidepressants, and on drugs for the treatment of Parkinson’s disease. My major interest has been on the pharmacology of MAO inhibitors. These are fascinating compounds, since they can be used to cause irreversible and highly selective inactivation of one of the isoforms, i.e., MAO-A or MAO-B. Because they cause “laser-like” selective enzyme inactivation, one can use them to study not only the pharmacological effects of the drugs, but also the physiological role of these important enzymes. Inhibitors of the A form of the enzyme are effective antidepressants, and I was interested to understand the way in which inhibition of this enzyme affects neuronal noradrenaline release. Remember that, like other neurotransmitters, noradrenaline is released physiologically by exocytosis, and cleared from the extracellular space mainly by reuptake, so the effects of MAO inhibition are not easily predictable. Using in vivo micro dialysis, I was able to show that long-term administration of MAO-A inhibitors does increase CNS extracellular noradrenaline levels , by reduction in net neuronal uptake, and a similar effect occurs in the periphery.
Rasagiline Might Slow Parkinson’s Progression Large Multicenter Study Finding
- The Mount Sinai Hospital / Mount Sinai School of Medicine
- Following one of the largest studies ever conducted in Parkinson’s disease , researchers report that rasagiline, a drug currently used to treat the symptoms of PD, may also slow the rate of disease progression.
Following one of the largest studies ever conducted in Parkinson’s disease , researchers at Mount Sinai School of Medicine report in The New England Journal of Medicine that rasagiline, a drug currently used to treat the symptoms of PD, may also slow the rate of disease progression.
Known as ADAGIO , the 18-month study used a novel design called the delayed start. In this type of study, patients are randomized to start active treatment early or late, and then researchers look to see if early treatment influences the outcome at final visit when patients in both groups are on the same treatment.
ADAGIO showed that previously untreated PD patients randomized to initiate therapy with rasagiline 1 mg per day had benefits at 18 months that were not achieved when the same drug was initiated at nine months. These results are consistent with the possibility that the drug has a disease-modifying effect which slows disease progression. The study examined both 1- and 2-mg doses of rasagiline using a rigorous design that included three primary endpoints. The 1-mg dose met all three primary endpoints. The 2-mg dose did not.
Dr. Olanow has served as a consultant to Teva, which sponsored the ADAGIO study.
Impulsive And Compulsive Behavior
Some people taking dopamine agonists may experience problems with impulsive or compulsive behaviours. For example an increased desire to gamble or engage in sexual activity. These behaviours often develop slowly so may not seem to be a problem immediately. It is important for both the person living with Parkinsons and their family to be aware of this side effect. If affected by this side effect, a reduction in dose or stopping the medication will stop the behaviour.
Parkinson’s Drug Doesn’t Slow Disease Progress Fda Staff Says
WASHINGTON — Azilect , which is already approved to treat symptoms of Parkinson’s disease, does not appear effective at slowing progression of the neurodegenerative disease, according to an FDA review.
Rasagiline was approved in 2006 to treat the signs and symptoms of Parkinson’s disease — such as tremors, difficulty walking, slowness of movement, and decreased facial expressions — either when used by itself or with levodopa.
Teva, which makes rasagiline, would like the drug’s indication expanded to include slowing disease progression.
The review document was released Thursday in advance of a Monday advisory panel meeting to discuss the issue.
If rasagiline were to be approved to slow development of Parkinson’s — which affects an estimated one million people in the U.S. — it would be a major advance in the field of brain and central nervous systems disorders, and a practice-changer for doctors who treat patients with Parkinson’s disease.
The FDA has never approved a treatment to slow progression of a neurodegenerative disease, Russell Katz, MD, director of the FDA’s division of neurology products, wrote in a memo to the advisory panel.
And if the negative FDA review released Thursday is any indication, it likely won’t any time soon.
Patients in the all-rasagiline 1 mg/day group showed a 2.82-point worsening of symptoms compared with a 4.52-point worsening among patients in the “delayed start” group who received the 1-mg dose .
How Much Does Azilect Cost
The cost of Azilect is moderate, but the fact that it has to be taken with other prescription medications can result in a higher overall medical cost per month. Aside from this, an Azilect generic alternative is available, at lower prices compared to the brand names that can offer this product. The generic can be found as Rasagiline, the key active substance of Azilect.
Getting The Most From Your Treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- As your condition improves and your body movements become easier, be careful not to overdo physical activities. You should increase your activity gradually to allow your body to adjust to any changes in balance, circulation and co-ordination.
- If you buy any medicines, check with a pharmacist that they are safe to take alongside this medicine. Rasagiline should not be taken with medicines containing sympathomimetics. These are present in some remedies for coughs and colds, and in decongestant nasal sprays and tablets.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking rasagiline.
- Stopping treatment suddenly can cause problems and your doctor will want you to reduce your dose gradually if this is necessary. Do not stop taking this medicine without speaking with your doctor first.
Azilect Withdrawal And Dependence
Its very important not to stop taking Azilect suddenly.
Some medications, including Azilect, cause your body to react when you suddenly stop using the drug. This reaction is known as withdrawal.
Serious withdrawal symptoms have been reported when people abruptly stopped taking Azilect. These symptoms can include:
- muscle stiffness
In addition, autonomic instability may occur. This condition, which may also be called autonomic dysfunction, can be the result of nerve damage. Symptoms can include sweating too much or little and orthostatic hypotension .
If you want to stop taking Azilect, you must talk with your doctor first. If your doctor agrees that its necessary to end your treatment, theyll guide you on how to gradually decrease your dosage before you stop using the drug.
You should take Azilect according to your doctors or healthcare providers instructions.
How To Take Rasagiline
- Before you start this treatment, read the manufacturer’s printed information leaflet from inside your pack. The leaflet will give you more information about rasagiline and a full list of side-effects which you may experience from taking it.
- Take rasagiline tablets exactly as your doctor has told you. Take one tablet a day. Try to take the tablets at the same time of day each day, as this will help you to remember to take them.
- You can take the tablets before or after meals.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Will I Be Able To Have Surgery If Im Taking Azilect
Yes, but its important to be aware that some medications used for surgery may interact with Azilect. These include:
- Certain anesthetics used for surgery. Some anesthetics used for surgery shouldnt be used with Azilect. This includes meperidine . Harmful serious side effects, such as serotonin syndrome, could occur. This syndrome occurs when you have high levels of a chemical called serotonin. For more information, see the Azilect side effects section above.
- Certain medications that reduce nausea and vomiting after anesthesia. Some drugs that ease nausea and vomiting after anesthesia could interact with Azilect. This includes metoclopramide , which could make Azilect less effective.
- Pain medications after surgery. Pain medications, including opioids, are often given after surgery to relieve pain. But certain opioids arent safe to take with Azilect. These include tramadol , and methadone.
Its crucial that the doctor and surgical team know you take Azilect. But if you have a medical emergency and need surgery, you may not be able to tell them which drugs youre taking. For this reason, its important to wear a medical alert bracelet or necklace that shows youre using Azilect, which is a monoamine oxidase inhibitor drug. If the staff is aware that youre taking an MAOI, theyll typically select alternatives that are safe to use with Azilect. If this isnt possible, theyll monitor you very closely after surgery.
Looking Out For Side Effects If You’re A Carer
If youre a carer of someone with Parkinsons, medication side effects can be difficult and tiring to cope with.
It may be that the person having side effects such as hallucinations and delusions or impulsive and compulsive behaviour does not realise they are experiencing them.
Its important to seek help from your specialist as soon as you can.
Side Effects Of Medication
All prescribed medication can have potential side effects, including those used to treat Parkinsons.
Many people find their Parkinsons medication works very well when they start taking it, but this may change over time and side effects can develop.
Some things you think are symptoms of Parkinsons may actually be side effects of medication.
Some peoples side effects will have a big impact on their lives and have to be kept under control along with the symptoms.
Does Rasagiline Have Neuroprotective Effects In Patients With Parkinson Disease
Rasagiline is also an MAO-B inhibitor that exhibits neuroprotective effects in cell culture and animal models. Possible disease-modifying effects of rasagiline were studied in 2 large, delayed-start studies. In such studies, subjects are randomized to treatment with active study medication or to placebo followed by active study medication. This creates 2 phases within the study. In phase I, one group is on placebo, and the other is on active study medication; in phase II, both groups are receiving active study medication. If phase II is long enough to allow full wash-in of symptomatic effects, any differences between the groups at the end of the study should be due to enduring benefits that accrue only to the group that received active study medication during phase I.
Stated another way, in a delayed-start design, half of the subjects in the study take the trial drug from day 1 and the other half take placebo. However, halfway through the study, the placebo group is switched from placebo to the trial drug. If the drug is truly beneficial in slowing progression of the disease, those that started the trial on placebo should never catch up, in terms of disease progression, to those who were given the trial drug from the beginning of the study.
ADAGIO and TEMPO studies
Hauser RA, Grosset DG. FP-CIT SPECT Brain Imaging in Patients with Suspected Parkinsonian Syndromes. J Neuroimaging. 2011 Mar 16. .