Rasagiline is used to treat symptoms of Parkinson's disease (stiffness, tremors, spasms, poor muscle control). Rasagiline is sometimes used with another medicine called levodopa.

Rasagiline may also be used for purposes not listed in this medication guide.

Tell your doctor about all medicines you have used in the 2-week period before you start taking rasagiline. Many drugs can interact with rasagiline, and some drugs should not be used together.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

If you take rasagiline alone, your dose may be different than if you take rasagiline with other Parkinson's medications. Follow your doctor's dosing instructions very carefully.

Rasagiline may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor.

Get familiar with the list of foods you should avoid to help prevent certain side effects of rasagiline.

Call your doctor if your Parkinson's symptoms do not improve, or if they get worse while using rasagiline.

Store at room temperature away from moisture and heat.

Do not stop using rasagiline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using rasagiline.

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.

You should not take rasagiline if you are allergic to it.

Do not use rasagiline if you have used any other MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine, and others.

Many drugs can interact and cause dangerous effects. Some drugs should not be used together with rasagiline. Your doctor may change your treatment plan if you also use:

• cyclobenzaprine (a muscle relaxer);

• dextromethorphan (contained in many over-the-counter cough medicines);

• meperidine (Demerol);

• methadone;

• St. John's wort; or

• tramadol (Ultram, Ultracet).

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with rasagiline and cause a serious condition called serotonin syndrome.

Tell your doctor if you have ever had:

• high or low blood pressure;

• liver or kidney disease; or

• if you take ciprofloxacin (an antibiotic).

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Ask your doctor about skin symptoms to watch for.

Tell your doctor if you are pregnant or breastfeeding.

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of rasagiline can be fatal.

Overdose symptoms may include drowsiness, dizziness, severe headache, rapid pulse, feeling agitated or irritable, muscle spasms in your neck or jaw, sweating, cold or clammy skin, shallow breathing, fainting, or seizure (convulsions). These symptoms may be delayed for 12 to 24 hours after an overdose.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

You will need to avoid eating foods that contain very high amounts of tyramine, such as aged cheeses (e.g., Stilton or blue cheese) during your treatment with rasagiline. Talk to your doctor or dietitian about which foods you should avoid during your treatment or if you do not feel well after eating or drinking certain foods while taking rasagiline.

Avoid driving or hazardous activity until you know how rasagiline will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid drinking alcohol, especially red wine, vermouth, and tap beers or ale.

Also avoid eating foods that are high in tyramine, such as aged cheeses, fava beans, soy sauce, herring, pickled or processed meats and fish, and meats that are aged, dried, smoked, or fermented. Eating tyramine while you are taking rasagiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Rasagiline may cause serious side effects. Call your doctor at once if you have:

• severe headache, blurred vision, pounding in your neck or ears;

• extreme drowsiness or falling asleep suddenly, even after feeling alert;

• unusual changes in mood or behavior;

• hallucinations;

• a light-headed feeling, like you might pass out; or

• worsening symptoms of Parkinson's disease (especially uncontrolled muscle movements).

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Some people taking rasagiline with levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking rasagiline. Talk with your doctor if this occurs.

Common side effects of rasagiline may include:

• depressed mood;

• sleep problems (insomnia), strange dreams;

• involuntary muscle movements;

• loss of appetite, weight loss;

• indigestion, stomach pain, nausea, vomiting, constipation;

• joint pain or stiffness;

• rash;

• cough or other flu symptoms;

• dry mouth; or

• swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using rasagiline with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor if you have taken an antidepressant during the 2-week period before you start taking rasagiline.

Many drugs can affect rasagiline, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.