Usual Adult Dose for Parkinson's Disease

Monotherapy:
Recommended dose: 1 mg orally once a day

Adjunct therapy:
Initial dose (in patients on concomitant levodopa): 0.5 mg orally once a day
Initial dose (in patients not on concomitant levodopa): 1 mg orally once a day
Maintenance dose: 0.5 mg to 1 mg orally once a day

Maximum dose: 1 mg orally once a day

Comments: May be used as adjunct therapy in patients on levodopa therapy, with or without other drugs used in the treatment of Parkinson's disease.

Renal Dose Adjustments

Mild to Moderate Renal Dysfunction: No adjustment recommended
Severe Renal Dysfunction: Data not available

Liver Dose Adjustments

Mild Liver Dysfunction (Child-Pugh 5 to 6): 0.5 mg orally once a day
Moderate to Severe Liver Dysfunction (Child-Pugh 7 to 15): Use is not recommended

Dose Adjustments

Concomitant CYP450 1A2 inhibitors (e.g., ciprofloxacin): A dose of 0.5 mg orally once a day should not be exceeded.

When this drug is used in combination with levodopa, the levodopa dose may need to be reduced, according to clinical response.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• This drug may be taken with or without food

• Cardiovascular: Hypertension, postural/orthostatic hypotension
• Dermatologic: Melanoma
• Hepatic: Liver function
• Musculoskeletal: Exacerbation of dyskinesia (if used concomitantly with levodopa)
• Nervous system: Falling asleep during activities of daily living and somnolence, serotonin syndrome
• Psychiatric: Suicidal ideation and behavior, falling asleep during activities of daily living and somnolence, re-emergence or worsening of symptoms of depression, impulse control disorders

• Rasagiline interacts with other drugs such as MAO inhibitors, meperidine (pethidine), potent CYP450 1A2 inhibitors, tramadol, St John's Wort, dextromethorphan, and methadone. Prescribers should be aware for the potential for interactions with rasagiline. A wash-out period may be required between ceasing rasagiline and commencing other medicines and vice versa.

• If you, your family member, or caregiver notice symptoms such as agitation, hostility, depression, thoughts about suicide or dying, or changes in thinking or behavior that are out of character, contact your health provider immediately.
• Inform your health provider is you experience new or increased gambling urges, sexual urges, or other urges while taking this drug.
• There is a potential for sedating effects associated with this drug, including somnolence and the possibility of falling asleep while engaged in activities of daily living. Avoid driving or operating heavy machinery until you know how this drug affects you.
• Avoid foods containing a very large amount of tyramine (e.g., aged cheese) while taking recommended doses of this drug due to the potential to significantly increase blood pressure.