As a key medication for treating Parkinson's disease, the side effects of Azilect (Rasagiline) have attracted significant attention.

What Are the Side Effects of Azilect (Rasagiline)?

Common Reactions with Monotherapy

Systemic symptoms: Flu-like symptoms (5%), fatigue.

Musculoskeletal system: Arthralgia (7%), falls (5%).

Digestive system: Dyspepsia (7%).

Psychiatric system: Depression (5%), headache (14%).

Others: Conjunctivitis, fever, paresthesia (incidence ≥ 2%).

Additional Reactions When Combined with Levodopa

Dyskinesia: 18% of patients experience dyskinesia (e.g., involuntary tremors), which is significantly higher than that in the placebo group (10%).

Cardiovascular system: Orthostatic hypotension (9% in the combination therapy group).

Digestive system: Nausea (12%), constipation (9%), vomiting (7%).

Weight changes: 9% of patients experience weight loss.

Cutaneous reactions: Rash (6%), ecchymosis (5%).

Serious Side Effects of Azilect (Rasagiline) Requiring Vigilance

Hypertensive Crisis ("Cheese Reaction")

Rasagiline may inhibit monoamine oxidase (MAO).

If patients consume tyramine-rich foods (e.g., aged cheese, pickled herring, red wine) or amine-containing medications (e.g., pseudoephedrine).

It may trigger life-threatening sudden blood pressure elevation.

Symptoms include severe headache, blurred vision, chest pain, convulsions, and coma; seek medical attention immediately.

Serotonin Syndrome

May occur when combined with antidepressants (e.g., SSRIs, tricyclic antidepressants).

High fever, muscle rigidity.

Confusion, autonomic dysfunction.

Contraindicated combination: Rasagiline can only be initiated 5 weeks after discontinuing fluoxetine.

Hepatic Toxicity

Patients with mild to moderate hepatic impairment need to reduce the dose to 0.5mg per day.

Contraindicated in patients with severe hepatic impairment (Child-Pugh score ≥ 10).

Risk of Malignant Melanoma

Patients with Parkinson's disease themselves have a higher risk of developing melanoma; regular skin examinations are required during medication use.

Precautions for Taking Azilect (Rasagiline)

Dietary and Medication Contraindications

Avoided foods: Fermented foods, soy products, draft beer, red wine.

Contraindicated medications: Pethidine, tramadol, dextromethorphan, St. John's wort, sympathomimetic drugs (e.g., ephedrine).

Dosage and Monitoring

Monotherapy: 1mg per day; no dose adjustment is needed.

Combination therapy: Initial dose of 0.5mg per day, which can be increased to 1mg per day.

Levodopa dosage: If dyskinesia or hallucinations occur, the dose of levodopa can be reduced by 10%-13%.

Patient Education

Recognize the symptoms of hypertensive crisis and seek medical attention immediately.

Avoid taking cold medicines or supplements without authorization.

Conduct regular dermatological examinations.