riluzole at a glance
Medicine class
Glutamate-modulating nervous-system treatment
Licensed use
Amyotrophic lateral sclerosis
Starting treatment
Initiated by a specialist experienced in motor neurone disease
Available forms
Film-coated tablets, an orodispersible film and an oral suspension suitable for some enteral tubes
What is riluzole used for?
The selected products are licensed for ALS. Evidence and licensing do not extend to other forms of motor neurone disease.
Extending survival or the time before mechanical ventilation in people with ALS.
How does riluzole work?
Glutamate is an excitatory chemical messenger that may contribute to motor-neurone damage in ALS. Riluzole is thought to inhibit glutamate-related processes, although its precise mechanism remains unclear.
riluzole preparations and strengths
Oral suspension
Route: Oral
Strengths: 5 mg/mL
Tablet
Route: Oral
Strengths: 50 mg
How to take riluzole
Use the prescribed formulation exactly as directed. Administration differs between products.
For the orodispersible film, use dry hands, place the film on the tongue and let it dissolve. Do not chew, spit, talk or take it with liquid while it dissolves. Take care with food if the mouth feels temporarily numb.
Shake the oral suspension gently for at least 30 seconds and check that it looks evenly mixed. Measure it with the supplied oral syringe and wash the syringe afterwards; dilution is unnecessary.
The oral suspension may be given through compatible enteral feeding tubes following the product instructions.
High-fat meals can reduce absorption from riluzole tablets; ask a pharmacist about food instructions for the exact product supplied.
riluzole side effects
Common or expected effects
- Tiredness or weakness
- Feeling sick
- Abnormal liver blood tests
- Headache, dizziness or sleepiness
- Tingling or numbness in the mouth
- Diarrhoea, abdominal pain or vomiting
- Temporary reduced mouth sensation with the orodispersible film
Get urgent medical advice
- Fever, which can indicate a severe reduction in white blood cells
- Yellow skin or eyes, widespread itching or persistent sickness suggesting liver injury
- New dry cough or worsening breathlessness suggesting interstitial lung disease
- Facial or throat swelling, breathing difficulty or another severe allergic reaction
- Severe persistent upper abdominal pain, which may indicate pancreatitis
riluzole in pregnancy
Product information contraindicates riluzole during pregnancy because human experience is lacking. Anyone planning pregnancy, who may be pregnant or who becomes pregnant while taking riluzole should contact their specialist or prescriber promptly for a treatment review.
riluzole while breastfeeding
Product information contraindicates riluzole while breastfeeding, and it is unknown whether it enters human milk. Discuss feeding and treatment options with the specialist team before breastfeeding or changing treatment.
riluzole interactions
Clinical interaction studies are limited. Riluzole is mainly metabolised through CYP1A2, so medicines and exposures affecting this enzyme may alter riluzole levels.
CYP1A2 inhibitors, including fluvoxamine, quinolone antibiotics, theophylline, diclofenac and amitriptyline
These could slow riluzole elimination and potentially increase exposure or adverse effects.
CYP1A2 inducers, including rifampicin and omeprazole
These could increase riluzole elimination and potentially reduce exposure.
Caffeine
Caffeine could potentially slow riluzole elimination, so substantial changes in intake should be discussed with the clinical team.
Common questions about riluzole
Answers are fully visible for fast scanning and source review.
Is riluzole a cure for motor neurone disease?
No. It may modestly slow the course of ALS, but it does not cure the disease or reverse existing nerve damage.
Will riluzole improve strength or other ALS symptoms?
Usually not noticeably. Product information reports no established improvement in motor function, lung function, muscle strength, fasciculations or other motor symptoms.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.