Rasagiline

Rasagiline is a drug known for its ability to inhibit monoamine oxidase B (MAO B). This remarkable medication is primarily used to help manage the symptoms of Parkinsons' Disease.

The FDA has approved rasagiline for the treatment of Parkinsons' Disease, either as a therapy or in combination with other medications such, as levodopa.

The introduction of rasagiline has brought about a change in the way Parkinsons' Disease is managed. It has improved motor control. Helped reduce fluctuations in the condition of patients.

This detailed article explores the facets of rasagiline, including its applications, potential side effects, recommended dosages, and contraindications.

Rasagiline is a monoamine oxidase type B (MAO-B) inhibitor that can be used as monotherapy or adjuvant therapy to levodopa in Parkinson’s disease (PD) ¹. According to a retrospective case-control study, long-term use of MAO-B inhibitors resulted in a significant reduction in levodopa requirements and a lower frequency of dyskinesias in patients with PD. Selegiline and rasagiline had equal efficacy in controlling motor symptoms in PD patients on optimized therapy ¹.

¹: Cereda, E., Cilia, R., Canesi, M., Tesei, S., Mariani, C. B., Zecchinelli, A. L., & Pezzoli, G. (2017). Efficacy of rasagiline and selegiline in Parkinson’s disease: a head-to-head 3-year retrospective case–control study. Journal of Neurology, 264(6), 1254-1263. Link

Rasagiline is a monoamine oxidase type B (MAO-B) inhibitor ¹ that can be used as monotherapy or adjuvant therapy to levodopa in Parkinson’s disease (PD) ². According to a retrospective case-control study, long-term use of MAO-B inhibitors resulted in a significant reduction in levodopa requirements and a lower frequency of dyskinesias in patients with PD. Selegiline and rasagiline had equal efficacy in controlling motor symptoms in PD patients on optimized therapy ².

MAO-B is an enzyme that breaks down several chemicals in the brain, including dopamine. An MAO-B inhibitor makes more dopamine available to the brain, which can modestly improve many PD movement symptoms ¹. Rasagiline’s MAO-B inhibitory activity causes an increase in extracellular levels of dopamine in the striatum. The elevated dopamine level and subsequent increased dopaminergic activity are likely to mediate rasagiline’s beneficial effects seen in models of dopaminergic motor dysfunction ³.

²: Cereda, E., Cilia, R., Canesi, M., Tesei, S., Mariani, C. B., Zecchinelli, A. L., & Pezzoli, G. (2017). Efficacy of rasagiline and selegiline in Parkinson’s disease: a head-to-head 3-year retrospective case–control study. Journal of Neurology, 264(6), 1254-1263. Link ¹: Parkinson’s Foundation. (n.d.). MAO-B Inhibitors. 

According to some doctors, rasagiline can be used as an additional treatment option for patients struggling with resistant depression, although it is not officially approved by the FDA for this purpose¹.

¹: For more information, please refer to this article on JAMA Network.

Research is being conducted to investigate the effectiveness of rasagiline in treating neurological conditions such as restless legs syndrome and multiple system atrophy ¹².

¹: Thin film hydration versus modified spraying technique to fabricate intranasal spanlastic nanovesicles for rasagiline mesylate brain delivery: Characterization, statistical optimization, and in vivo pharmacokinetic evaluation. Springer. Link ²: In a randomized trial, rasagiline did not alter clinical disease progression in multiple system atrophy. Rasagiline is one of several monoamine oxidase inhibitors that have been proposed as possible disease-modifying therapies for Parkinson disease (PD). NEJM Journal Watch. Link

The primary way that Rasagiline works is by blocking the MAO B enzyme. This causes dopamine levels in the space between nerve cells to increase, which helps with communication, between them.

The specific processes involved in off-label uses are still unclear, although certain studies indicate a mode of action, through the enhancement of serotonin levels.

The liver primarily breaks down Rasagiline. Then eliminated from the body through the kidneys.

Rasagiline mesylate serves as the component in rasagiline.

Typically, these ingredients may consist of substances, like mannitol and colloidal silicon dioxide.

Rasagiline is commonly found in strengths as oral tablets.

The typical recommended dosage usually falls between 0.5 and 1 milligram, per day.

For uses that are not officially approved the recommended dosage may vary depending on the doctors judgment. Is usually lower.

Rasagiline is mostly given in the form of tablets.

In instances rasagiline is employed as part of combination therapy alongside other medications, for the treatment of Parkinsons disease.

If you happen to miss a dose it's an idea to take the medication as soon as you can unless its almost time, for your next scheduled dose.

Many patients frequently experience feelings of queasiness and discomfort in the abdomen.

There have been reported instances of sleeplessness and feelings of unease.

This is a situation that requires urgent medical attention.

There have been observations of higher blood pressure levels, especially in overdose cases.

Adjusting the dosage and providing treatment for symptoms are management practices.

Taking agents can increase the likelihood of developing serotonin syndrome.

Taking rasagiline together with antihypertensive medications may lead to an increase in blood pressure levels.

Although there aren't interactions, with food, it's essential to avoid consuming alcohol as it can worsen the potential side effects.

Patients who have a known allergy or sensitivity to the drug rasagiline should not take it.

Patients who have previously experienced medical conditions such, as liver disorders should exercise caution.

Patients with liver damage need to be monitored.

Individuals with neurological disorders must seek guidance from a healthcare professional.

Regularly checking blood pressure is not a good idea but essential as rasagiline has the potential to cause high blood pressure. Using a blood pressure monitor is recommended, especially when starting the medication and adjusting the dosage.

Regular neurological assessments are necessary to evaluate the effectiveness of the medication and identify any adverse effects, on the nervous system.

It is essential to conduct thorough laboratory evaluations, which should include tests to assess liver function and complete blood counts.

To avoid any consequences or potential issues with drug interactions, it is highly recommended to have regular discussions, with healthcare professionals.

When it comes to adults, it may be necessary to carefully adjust medication doses because their bodies may process and distribute drugs differently due to changes, in their physiology.

Given the increased likelihood of outcomes in this particular group, it is crucial to maintain close monitoring and surveillance.

Rasagiline falls into a pregnancy risk category that is not clearly determined, so it should be used with caution during pregnancy and breastfeeding.

Healthcare providers are responsible for carefully considering the advantages and risks before prescribing rasagiline in these situations.

Considering the amount of definitive information available regarding the use of rasagiline, in children, the safety and effectiveness of this medication still remain uncertain.

If the medication is given, it is essential to adjust and customize the dosages based on the specific requirements of each patient. Typically it is advisable to start with doses, within the recommended range.

Typical signs of an overdose can include high blood pressure, serotonin-related symptoms, and severe disturbances in mental health.

It is crucial to stop taking the medication to provide symptom relief and seek urgent medical advice in drug overdose cases.

The consequences of an overdose can have lasting effects impacting both the neurological and cardiovascular systems, with potential long-term complications.

The medication must be kept in a container at average room temperature and away from sunlight and moisture to ensure its effectiveness, as a medicine.

It is recommended to dispose of any medication that's unused or expired by following the medication disposal guidelines provided by the FDA. The preferable method of disposal is through participation in a take-back program.

Always make sure to close the container after administering the medication. Avoid transferring tablets to containers that are not the original ones.