Rasagiline (Azilect) is a selective and irreversible monoamine oxidase type B (MAO-B) inhibitor, which was first approved for marketing in the United States in 2006. This medication is indicated for the treatment of Parkinson's disease (PD) and can be used as monotherapy or adjunctive therapy.

How to Use Rasagiline (Azilect)

Recommended Standard Dosages

Monotherapy: Take 1 mg of rasagiline orally once daily.

Adjunctive therapy (without levodopa): Take 1 mg of rasagiline orally once daily.

Adjunctive therapy with levodopa: The recommended initial dosage is 0.5 mg taken orally once daily.

If the patient tolerates the 0.5 mg dosage but fails to achieve an adequate clinical response, the dosage may be increased to 1 mg once daily.

Administration Time and Method

Rasagiline can be taken with or without food, once daily at a fixed time each day.

The medication is available as tablets in two strengths: 0.5 mg and 1 mg. Patients should select the appropriate strength of tablets as prescribed by their doctor.

Precautions for Concomitant Use

When rasagiline is used in combination with levodopa (with or without other PD medications such as dopamine agonists, amantadine, or anticholinergics), the dosage of levodopa may be adjusted based on the individual patient's response.

Dosage Adjustment of Rasagiline (Azilect)

Adjustment Due to Drug Interactions

When a patient is concurrently using ciprofloxacin or other CYP1A2 inhibitors, the dosage of rasagiline should not exceed 0.5 mg once daily.

Adjustment for Patients with Hepatic Impairment

Patients with mild hepatic impairment should not exceed a rasagiline dosage of 0.5 mg once daily.

Patients with moderate or severe hepatic impairment should not use rasagiline.

Safety Limits for Dosage

The recommended dosage of rasagiline should not be exceeded, as there is a risk of hypertension.

At the recommended dosage, the medication exerts a selective inhibitory effect on MAO-B. However, as the dosage is gradually increased beyond the recommended daily dosage, the selectivity for MAO-B decreases in a dose-dependent manner.

Medication Use in Special Populations for Rasagiline (Azilect)

Patients with Hepatic Impairment

The plasma concentration of rasagiline may increase by 2-fold in patients with mild hepatic impairment, up to 7-fold in patients with moderate hepatic impairment, and also increase in patients with severe hepatic impairment.

Patients with Renal Impairment

Patients with mild or moderate renal impairment may use the same recommended dosage as patients with normal renal function.

Since 1-aminoindan is not an MAO inhibitor, dosage adjustment is not required for patients with mild to moderate renal impairment.

No studies have been conducted in patients with severe renal impairment.