rasagiline tartrate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
rasagiline tartrate: clinical details
Prescribing considerations
- Confirm adult idiopathic Parkinson’s disease as the indication, either as monotherapy or adjunctive treatment with levodopa for end-of-dose fluctuations.
- Review prescription, over-the-counter and herbal products for MAO-inhibitor, serotonergic, sympathomimetic and CYP1A2 interactions.
- Counsel about postural hypotension, dyskinesia with levodopa, sudden sleep, hallucinations, impulse-control disorders and suspicious skin lesions.
- Use cautiously in mild hepatic impairment and avoid use in moderate hepatic impairment.
Contraindications and cautions
- Hypersensitivity to rasagiline or a product excipient
- Severe hepatic impairment
- Concurrent treatment with another MAO inhibitor, including St John’s wort
- Concurrent treatment with pethidine
Monitoring
- Routine blood-test monitoring is not generally required solely for rasagiline.
- Monitor clinically for postural hypotension, falls and worsening dyskinesia when used with levodopa.
- Ask patients and carers about sleep attacks, hallucinations, confusion and changes in impulse control.
- Review new or changing skin lesions and changes in hepatic status.
Clinical pharmacology
Rasagiline is a potent, irreversible selective MAO-B inhibitor that increases extracellular striatal dopamine. It is rapidly absorbed and extensively metabolised in the liver, mainly through CYP1A2; its major active metabolite, 1-aminoindan, does not inhibit MAO-B.
Formulation and product differences
- The selected Brown & Burk product is a white to off-white, circular, uncoated oral tablet.
- Its listed excipients include microcrystalline cellulose, maize and pregelatinised starches, citric acid monohydrate, colloidal silicon dioxide, stearic acid and talc.
- Product appearance and excipients should be checked when switching manufacturer if allergies or tolerability concerns exist.
rasagiline tartrate preparations and strengths
Tablet
Route: Oral
Strengths: 1 mg
rasagiline tartrate interactions
Rasagiline has clinically important prescription, non-prescription and herbal interactions. A pharmacist or prescriber should review all current products.
Other MAO inhibitors, including St John’s wort
Concurrent use is contraindicated because excessive MAO inhibition can cause a hypertensive crisis.
Pethidine
Concurrent use is contraindicated because serious central nervous system reactions can occur.
Antidepressants, including SSRIs, SNRIs and tricyclic or tetracyclic agents
Serotonin toxicity is possible; fluoxetine and fluvoxamine should be avoided and other antidepressants require prescriber review.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.