Index of drugs

Treatment of idiopathic Parkinson's disease as monotherapy (without levodopa) or as adjunctive therapy (with levodopa) in patients with fluctuations in the efficacy of levodopa as a result of dose depletion.

1 tabl contains 1 mg of rasagiline (in the form of mesylate).

A strong, irreversible, selective MAO-B inhibitor that increases the extracellular concentration of Dopamine in the striatum. Increased dopamine concentration followed by increased dopaminergic activity probably contributes to the beneficial effects of rasagiline, observed in models of motor dysfunction of dopaminergic neurons. 1-aminoindan - the active, major metabolite - is not an MAO-B inhibitor. After oral administration, rasagiline is rapidly absorbed, reaching C_max in the blood after about 0.5 h. The absolute bioavailability of a single dose of rasagiline is approximately 36%. The food does not affect the value of T_max rasagiline, although C values_max and AUC are reduced by 60% and 20%, respectively, when the preparation is taken with a high-fat meal. Rasagiline binds to 60-70% plasma proteins. It is almost completely biotransformed in the liver. Metabolism proceeds through two major pathways: N-dealkylation and / or hydroxylation, resulting in: 1-aminoindan, 3-hydroxy-N-propargyl-1-aminoindan and 3-hydroxy-1-aminoindan. Both metabolic pathways depend on the cytochrome P-450 system, and CYP1A2 is the main isoenzyme involved in the metabolism of rasagiline. The drug is mainly excreted in the urine (62.6%) and to a lesser extent in the faeces (21.8%); less than 1% rasagiline is excreted unchanged in urine. T_0,5 is 0.6-2 hours.

Hypersensitivity to rasagiline or to any of the excipients. Concomitant treatment with other MAO inhibitors (including herbal preparations containing St John's wort) or pethidine - a gap of at least 14 days should be observed between discontinuation of rasagiline and initiation of treatment with MAO inhibitors or pethidine. Severe impairment of liver function.

Patients treated with dopamine agonists and / or other dopaminergic medications may experience impulse control disorders. Patients should be monitored regularly for the development of impulse control disorders. Patients and their caregivers should be informed about the behavioral symptoms of impulse control disorders observed in people treated with rasagiline, including cases of compulsions, intrusive thoughts, pathological gambling, increased libido, hypersexuality, impulsive behavior, compulsive spending or unrestrained shopping. Because rasagiline enhances the effects of levodopa, the side effects of levodopa may increase and exacerbation of pre-existing dyskinesias may occur. Decreasing the dose of levodopa may reduce these side effects. Cases of antihypertensive effect have been reported with the concomitant use of rasagiline and levodopa. Patients with Parkinson's disease are particularly susceptible to side effects associated with lowering the pressure due to walking disorder. The occurrence of cases of melanoma during the clinical trials of the drug suggested the possible relationship with the use of rasagiline. The collected information indicates that Parkinson's disease, and not the use of any particular medicine, is associated with an increased risk of skin cancer (not only melanoma). Any suspected skin lesion should be examined by a specialist. Caution should be exercised when initiating rasagiline in patients with mild hepatic impairment. The use of rasagiline should be avoided in patients with moderate hepatic impairment. If mild hepatic impairment develops in a moderate form, rasagiline should be discontinued. The preparation is not recommended for children and adolescents due to the lack of data on safety and efficacy.

There are no clinical data on the use of rasagiline in pregnant women. Caution should be exercised when prescribing to pregnant women.Rasagiline inhibits prolactin secretion and can therefore inhibit lactation. It is not known whether rasagiline is excreted in human milk. Caution should be exercised when administering rasagiline to breast-feeding women.

monotherapy. Very common: headache. Common: flu-like syndrome, skin cancer, leukopenia, hypersensitivity reactions, depression, hallucinations, conjunctivitis, dizziness, angina, rhinitis, flatulence, dermatitis, musculoskeletal pain, neck pain, arthritis, sudden urinary urgency, fever, bad mood. Uncommon: decreased appetite, cerebrovascular accident, myocardial infarction, vesicular-vesicular rash.Supportive treatment. Very often: dyskinesias. Common: decreased appetite, hallucinations, nightmares, dystonia, carpal tunnel syndrome, balance disorders, orthostatic hypotension, abdominal pain, constipation, nausea, vomiting, dry mouth, rash, joint pain, neck pain, weight loss, falls. Uncommon: cutaneous melanoma, confusion, cerebrovascular accident, angina. Following post-marketing experience, patients with the use of antidepressants / SNRI in combination with rasagiline have experienced reports of serotonin syndrome accompanied by agitation, confusion, stiffness, fever and myoclonus. In post-marketing experience, cases of elevated blood pressure have been reported in patients treated with rasagiline, including rare reports of hypertensive crisis following consumption of an unknown amount of high-tyramine foods. There has been one post-marketing experience of elevated blood pressure in a patient using both rasagiline and tetrahydrozine hydrochloride, an ophthalmic vasoconstrictor. Patients treated with dopamine agonists and / or other dopaminergic medications may experience pathological gambling addiction, increased libido, hypersexuality, compulsive spending or buying, gluttony or compulsive overeating. After the introduction of rasagiline, a similar form of impulse control disorders was reported, including compulsions, intrusive thoughts and compulsive behavior.

Oral: 1 mg once daily with or without levodopa. There is no need to change the dosage in the elderly and in patients with impaired renal function. Use caution when starting treatment in patients with mild hepatic impairment. If mild hepatic impairment develops in a moderate form, rasagiline should be discontinued. The drug can be taken with or without food.