Rasagiline | Side Effects, Dosage, Uses & More
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Generic Name:

rasagiline, Oral tablet

All Brands

  • Azilect
SECTION 1 of 5

Highlights for rasagiline

Oral tablet
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Rasagiline is used to treat the symptoms of Parkinson’s disease.

2

This drug comes in the form of a tablet you take by mouth. 

3

Rasagiline is available as a brand-name drug called Azilect. It’s not available as a generic drug.

4

When rasagiline is taken by itself, the more common side effects can include flu symptoms, joint pain, depression, or upset stomach. If rasagiline is combined with other medications, it can cause other side effects. These can include swelling of the arms or legs, trouble sleeping, cough, stomach problems, or low blood pressure

5

In some cases, rasagiline can cause serious side effects. These can include high blood pressure, serotonin syndrome, muscle movement problems, or hallucinations. 

IMPORTANT INFORMATION

Hypertension (high blood pressure)

Rasagiline can cause or worsen high blood pressure. If you’re taking rasagiline, eating foods that contain high levels (more than 150 mg) of a chemical called tyramine can cause severe high blood pressure. You may need to be admitted to the hospital. Foods with high levels of tyramine include aged, fermented, cured, smoked, or pickled foods. Your doctor can tell you more.

Falling asleep during the day

Rasagiline may cause you to be drowsy or fall asleep during the day. Tell your doctor if you have these symptoms. This can be dangerous in some cases, such as falling asleep while driving. If you are extremely sleepy or have fallen asleep during the day, your doctor may have you stop taking rasagiline.

Orthostatic hypotension

Rasagiline can cause low blood pressure that occurs when you stand after sitting or lying down. This can result in dizziness or fainting. Low blood pressure can occur more often in the first two months of treatment. It tends to happen less often over time.

Mental health effects

Rasagiline may cause hallucinations (seeing or hearing things that aren’t there), confusion, aggressive behavior, agitation, or delirium (confused thinking). It may also cause increased urges to gamble, have sex, spend money, or binge-eat, or cause other intense urges. Tell your doctor right away if you have any changes to your behavior that you can’t control or can’t explain. Your doctor may decrease your dosage of rasagiline, or have you stop taking this medication.

What is rasagiline?

This drug is a prescription drug. It comes in the form of a tablet you take by mouth.

This drug is available as a brand-name drug called Azilect. It’s not available as a generic drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications such as levodopa.

Why it's used

This drug is used to treat the symptoms of Parkinson’s disease. These include tremor, slowed movements, or muscle stiffness. They also include loss of automatic movements such as blinking or smiling.

How it works

This drug belongs to a class of drugs called monoamine oxidase-B inhibitors (MAOIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

How it works

This drug belongs to a class of drugs called monoamine oxidase-B inhibitors (MAOIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Dopamine is a hormone that helps your body control movement. With conditions such as Parkinson’s, the cells that produce dopamine die. This drug blocks a protein called monoamine oxidase (MAO), which breaks down dopamine in the body. This increases the amount of dopamine in your brain.

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rasagiline Side Effects

Oral tablet

More Common Side Effects

The more common side effects of rasagiline depend on whether it’s taken alone or in combination with other drugs.

  • The more common side effects that can occur with use of rasagiline by itself include:

    • orthostatic hypotension (low blood pressure when standing after sitting or  lying down). Symptoms can include dizziness or fainting.  
    • joint pain
    • depression
    • heartburn
    • flu symptoms, such as:
      • fever
      • chills
      • tiredness
      • muscle aches
  • The more common side effects that can occur with use of rasagiline in combination with levodopa include:

    • problems with muscle movement
    • weight loss
    • orthostatic hypotension (low blood pressure when standing up after sitting or lying down). Symptoms can include dizziness or fainting.
    • nausea and vomiting
    • joint pain
    • dry mouth
    • falls
    • disturbing dreams
    • swelling in the tendons
    • stomach pain
  • The more common side effects that can occur with use of rasagiline in combination with other medications include:

    • swelling of the arms and legs
    • falls
    • joint pain
    • cough
    • trouble sleeping 

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Serotonin syndrome. Symptoms can include:

    • hallucinations (sensations that seem real but are not)
    • headache
    • loss of consciousness
    • sweating
    • high fever
    • muscle problems
    • shakiness
  • Psychiatric problems. Symptoms can include:

    • hallucinations
    • confusion
    • paranoia (increased suspicion and distrust of others)
    • disorientation
    • aggressive behavior
    • agitation
    • delirium
  • Impulse problems. Symptoms can include:

    • intense desire to gamble
    • increased sexual urges
    • increased urge to spend money
    • binge eating
  • Falling asleep or feeling extremely sleepy during the day

  • Hypertensive crisis (a severe increase in blood pressure). Symptoms can include:

    • very high blood pressure
    • headache
    • blurred vision
    • chest pain
    • shortness of breath
    • seizures
  • Extreme sleepiness. Symptoms include:

    • getting sleepy during the day
    • falling asleep without warning while doing daily activities such as talking, eating, or driving a car
  • Skin lesions/cancer (melanoma). Some people with Parkinson’s disease may have an increased chance of getting a skin cancer called melanoma. Symptoms can include:

    • lesions (areas of damaged tissue) that are blue or blue-black
    • lesions or spots with more than one color, or that have flecks of a different color
    • any mole or spot that changes in color or size over time
    • lesions with irregular borders
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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rasagiline May Interact with Other Medications

Oral tablet

Rasagiline can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interaction

If you’re taking rasagiline, eating foods that contain high levels (more than 150 mg) of a chemical called tyramine can cause severe high blood pressure. This may cause you to be admitted to the hospital.

You should avoid eating foods with too much tyramine in one meal. These foods include aged cheese, herring, or other foods that are aged, fermented, smoked, or pickled. Small amounts of these foods are ok for most people. Your doctor can tell you more.

Alcohol interaction

The use of drinks that contain alcohol can increase your blood levels of rasagiline. This raises your risk of side effects from rasagiline, such as feeling drowsy or falling asleep during the day.

Also, some beers, especially tap beers, contain a chemical called tyramine. Having too much tyramine in one sitting raises your risk of hypertensive crisis (severe high blood pressure).

If you drink alcohol, talk to your doctor about whether it’s safe for you to take this drug.

Medications that might interact with this drug

Pain drugs

Taking rasagiline with certain pain medications can cause a condition called serotonin syndrome. This condition can lead to being admitted to the hospital, or even death. Do not take these medications with rasagiline. Examples of these drugs include:

  • meperidine
  • methadone
  • tramadol
  • propoxyphene

Muscle relaxers

Cyclobenzaprine is used to relax the muscles. Taking this drug with rasagiline can cause a condition called serotonin syndrome. With this condition, you may need to be admitted to the hospital. This condition can even cause death. Do not take cyclobenzaprine with rasagiline.

Cough drugs

Dextromethorphan is used to treat cough. When taken with rasagiline, it can cause episodes of psychosis or bizarre behavior. Do not take dextromethorphan with rasagiline.

Monoamine oxidase inhibitors (MAOIs)

Taking rasagiline with other MAOIs raises your risk of hypertensive crisis. This condition causes severe high blood pressure that may result in organ damage and require you to be admitted to the hospital. Do not take these drugs with rasagiline. Examples of these drugs include:

  • selegiline
  • phenelzine
  • tranylcypromine
  • isocarboxazid

Decongestants

Taking rasagiline with certain medications used to clear the nasal passages raises your risk of hypertensive crisis. This condition causes severe high blood pressure that could cause organ damage and require you to be admitted to the hospital. Examples of these drugs include:

  • phenylephrine
  • pseudoephedrine
  • xylometazoline
  • oxymetazoline

Antidepressants

Taking rasagiline with certain drugs used to treat depression can cause a condition called serotonin syndrome. This condition may require you to be admitted to the hospital, or even cause death. Do not take these drugs with rasagiline. Examples of these drugs include:

  • mirtazapine
  • amitriptyline
  • nortriptyline
  • doxepin
  • imipramine
  • citalopram
  • escitalopram
  • paroxetine
  • fluoxetine
  • fluvoxamine
  • sertraline
  • venlafaxine

Some of these antidepressants can also cause the amount of rasagiline in your body to get too high. This raises your risk of side effects from rasagiline. Do not take these drugs with rasagiline. Examples of these drugs include:

  • imipramine
  • amitriptyline

Bupropion is also used to treat depression. Taking this drug with rasagiline raises your risk of hypertensive crisis (extremely high blood pressure). Do not take this drug with rasagiline.

Antibiotics

Isoniazid is used to treat infections caused by bacteria. Taking this drug with rasagiline raises your risk of fever, hypertensive crises, convulsions, or death. It can also cause the amount of rasagiline in your body to get too high. This raises your risk of side effects from rasagiline.

Ciprofloxacin is another antibiotic. When taken with rasagiline, it can also cause the amount of rasagiline in your body to get too high. This raises your risk of side effects from rasagiline.

Heart drugs

When taken with rasagiline, certain drugs used to treat heart problems can cause the amount of rasagiline in your body to get too high. This raises your risk of side effects from rasagiline.  Examples of these drugs include:

  • propafenone
  • propranolol
  • verapamil
  • amiodarone

Heartburn drugs

When taken with rasagiline, certain drugs used to treat heartburn (a type of indigestion) can cause the amount of rasagiline in your body to get too high. This raises your risk of side effects from rasagiline. Examples of these drugs include: 

  • cimetidine
  • famotidine

Herbal supplements

St. John’s wort is an herbal supplement. It’s used most often to help relieve depression or anxiety. Taking this supplement with rasagiline can cause a condition called serotonin syndrome. With this condition, you may need to be admitted to the hospital. It can even cause death. Do not take St. John’s wort with rasagiline.

HIV drugs

Atazanavir is used to treat human immunodeficiency virus (HIV). Taking this drug with rasagiline can increase the amount of rasagiline in the body. This raises the risk of side effects from rasagiline.

Mental health drugs

Fluvoxamine is often used to treat obsessive-compulsive disorder (OCD). Taking this drug with rasagiline raises your risk of serotonin syndrome. With this condition, you may need to be admitted to the hospital. It can even cause death. Taking these drugs together can also increase the amount of rasagiline in the body. This raises your risk of side effects from rasagiline. Do not take fluvoxamine with rasagiline.

Hormone treatments

Ethinyl estradiol is a hormone treatment that can be used to treat symptoms of menopause. It can also be used in combination with progesterone in oral birth control tablets. Taking this drug with rasagiline can increase the amount of rasagiline in the body. This raises the risk of side effects from rasagiline.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver problems
People with liver problems

Talk with your doctor about whether this drug is safe for you. Taking this drug can cause increased amounts of this drug in your body. This raises your risk of side effects. Do not use this drug if you have moderate to severe liver problems. If you have mild liver disease, you can only use 0.5 mg of this drug.

pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding
Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.

for children
For children

This medication has not been studied in children. It should not be used in people younger than 18 years.

call doctor
When to call the doctor

Call your doctor if you become pregnant while taking this drug.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take rasagiline (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Parkinson’s disease

Brand: Azilect

Form: Oral tablet
Strengths: 0.5 mg, 1 mg
Adult dosage (ages 18–64 years)
  • Rasagiline taken by itself: The typical dosage is 1 mg once daily.
  • Rasagiline taken with levodopa: The typical dosage is 0.5 mg once daily.
  • Rasagiline taken with other medications for Parkinson’s disease: The typical dosage is 1 mg once daily.
Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Patients with liver problems:

If you have mild liver problems, your doctor will likely prescribe you 0.5 mg of rasagiline once daily. If you have moderate to severe liver problems, you should not use this drug.

 Warnings

Always follow your doctor’s instructions for taking this drug. Do not take higher doses of rasagiline than recommended by your doctor. High doses raise your risk of severe, life-threatening high blood pressure.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

If you don’t take this drug at all, your symptoms of Parkinson’s disease may not be controlled. If you stop taking it suddenly, you can have confusion and high fever. Do not stop taking this drug without talking to your doctor.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • drowsiness
  • dizziness
  • agitation
  • hallucinations (seeing or hearing things that aren’t real)
  • convulsions
  • coma
  • high blood pressure

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your symptoms of Parkinson’s disease should get better or be more controlled.

This drug is used for long-term treatment.

You can take this drug with or without food

Taking it with food may help to reduce upset stomach.

Store this drug carefully

  • Keep this drug at room temperature of 77°F (25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor you while you take this drug. They will check for side effects of this drug. You may have testing done to make sure your heart is working well. Your doctor may also check your:

  • blood pressure
  • levels of tiredness and sleepiness
  • skin, looking for skin cancer (people with Parkinson’s disease are at higher risk of melanoma)

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does rasagiline Cost?

Oral tablet

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These prices represent the lowest priced national pharmacies for rasagiline on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 5, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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