Azilect (Rasagiline) belongs to the family of medications known as monoamine oxidase inhibitors (M.O.S.. It is used to treat Parkinson's Disease. It acts on the nervous system to increase the levels of a chemical called dopamine. Low dopamine levels in the brain are responsible for many of the symptoms of Parkinson's disease, so Azilect (Rasagiline) works by rebalancing the levels of dopamine.

Azilect (Rasagiline) may be taken alone or in combination with levodopa or a dopamine agonist (i.e., Ropinirole, Pramipexole) to treat the symptoms of Parkinson's disease.

Azilect (Rasagiline) may be available under multiple brand names and/or in several different forms. Any specific brand name of Azilect (Rasagiline) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Azilect (Rasagiline) may not be used for all of the conditions discussed here.

Your doctor may have suggested Azilect (Rasagiline) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Azilect (Rasagiline), speak to your doctor. Do not stop taking Azilect (Rasagiline) without consulting your doctor.

Do not give Azilect (Rasagiline) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Azilect (Rasagiline) if their doctor has not prescribed it. Do not stop taking Azilect (Rasagiline) without consulting your doctor.

The recommended dose of Azilect (Rasagiline) is 1 mg once daily. The recommended starting dose of Azilect (Rasagiline) for someone already taking levodopa is 0.5 mg, which may then be increased to 1 mg once daily if necessary. The recommended starting dose for someone taking a dopamine agonist is 1 mg taken once daily.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Azilect (Rasagiline) may be taken with or without food.

It is important that Azilect (Rasagiline) be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Azilect (Rasagiline) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Azilect (Rasagiline). If you are concerned about side effects, discuss the risks and benefits of Azilect (Rasagiline) with your doctor.

The following side effects have been reported by at least 1% of people taking Azilect (Rasagiline). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• accidental injury
• Constipation
• decreased interest or ability in sexual activity
• Diarrhea
• difficulty moving or controlling movements
• dizziness
• Dry Mouth
• falls
• feeling unwell
• flu-like symptoms
• hair loss
• headache
• heartburn
• joint pain
• lack of coordination
• leg cramps
• loss of appetite
• muscle aches
• nausea
• neck pain
• rash
• red eyes
• runny nose
• sensation of spinning
• sweating
• trouble sleeping
• urgent need to urinate
• vomiting
• weakness
• weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal heartbeat
• behavioural changes (compulsive gambling, compulsive shopping)
• bruising
• dizziness or fainting when rising from a sitting or lying position
• Fever
• hallucinations (hearing, seeing, or feeling things that aren't actually there)
• increase in unusual movements of body (e.g., twisting movements of body, uncontrolled chewing movements, uncontrolled movements of face, neck, back, arms, or legs)
• lip smacking or puckering
• restlessness or desire to keep moving
• severe stomach pain
• signs of Anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of Depression (loss of interest in activities, sleeping too much, difficulty sleeping, eating more or less than usual, difficulty concentrating)
• signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, cough, headache, stiff neck, weight loss, or listlessness)
• signs of unusual bleeding (bloody or black, tarry stools, vomiting of blood or material that looks like coffee grounds, blood in urine)
• sudden onset of falling asleep without warning

Get medical help immediately if any of the following signs of extremely high blood pressure (caused by the use of Azilect (Rasagiline) with certain foods or other medications) occur:

• chest pain (severe)
• enlarged pupils
• fast or slow heartbeat
• headache (severe)
• increased sensitivity of eyes to light
• increased sweating (possibly with fever or cold, clammy skin)
• nausea and vomiting (severe)
• stiff or sore neck

Stop taking the medication and seek immediate medical attention if any of the following occur:

• agitation or irritability
• dizziness (severe) or fainting
• high or Low Blood Pressure
• increased sweating (possibly with fever or cold, clammy skin)
• rapid or irregular pulse
• severe headache
• shortness of breath, wheezing, difficult breathing
• signs of a Anaphylaxis (severe allergic reaction) (e.g., Hives; difficulty breathing; or swelling of the mouth, lips, tongue, or throat; peeling, blistering skin)
• signs of Heart Attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
• signs of Stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Azilect (Rasagiline).

0.5 mg
Each white-to-off-white, round, flat, bevelled tablet, marked with "GIL" and "0.5" below on one side and plain on the other, contains Azilect (Rasagiline) 0.5 mg. Nonmedicinal ingredients: colloidal silicon dioxide, mannitol, pregelatinized starch, starch, stearic acid, and talc.

1 mg
Each white-to-off-white, round, flat, bevelled tablet, marked with "GIL" and "1" below on one side and plain on the other, contains Azilect (Rasagiline) 1 mg. Nonmedicinal ingredients: colloidal silicon dioxide, mannitol, pregelatinized starch, starch, stearic acid, and talc.

Do not take Azilect (Rasagiline) if you:

• are allergic to Azilect (Rasagiline) or to any of the ingredients of the medication
• are taking any of the following medications:
• antidepressants – at least 14 days must pass after stopping antidepressants (at least 5 weeks for Fluoxetine) before starting Azilect (Rasagiline); anyone starting an antidepressant must wait at least 14 days after stopping Azilect (Rasagiline)
• Cyclobenzaprine
• Dextromethorphan
• MAO inhibitors (e.g., Phenelzine, Tranylcypromine) – at least 14 days must pass after stopping Azilect (Rasagiline)
• Meperidine
• Methadone
• propoxyphene
• St. John's wort
• sympathomimetics including amphetamines and cold medications; and weight-reducing products that contain Pseudoephedrine, phenylephrine, or ephedrine
• Tapentadol
• Tramadol
• have moderate-to-severe liver disease

There may be an interaction between Azilect (Rasagiline) and any of the following:

• Acetazolamide
• alcohol
• Aliskiren
• alpha-adrenergic receptor blockers (e.g., Doxazosin, Terazosin)
• amphetamines (e.g., Dextroamphetamine)
• angiotensin converting enzyme inhibitors (ACEIs; e.g., Captopril, Lisinopril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• apraclonidine
• Atomoxetine
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Bezafibrate
• brimonidine
• Bromocriptine
• Buprenorphine
• Bupropion
• Buspirone
• Cabergoline
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Carbamazepine
• ciprofloxacin
• Citalopram
• Clonidine
• cyclobenzaprine
• cyproheptadine
• Cyproterone
• Deferasirox
• dexmethylphenidate
• dextromethorphan
• Diabetes medications (e.g., acrabose, Glyburide, insulins, Rosiglitazone, Saxagliptin)
• diethylpropion
• disulfiram
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Domperidone
• Entacapone
• ephedrine
• ethinyl Estradiol
• Fentanyl
• Gemfibrozil
• Hydralazine
• Hydrocodone
• Hydromorphone
• ketoconazole
• levodopa
• Linezolid
• lithium
• MAO inhibitors (e.g., phenelzine, tranylcypromine, Selegiline)
• meperidine
• methadone
• methyldopa
• methylene blue
• Methylphenidate
• Metoclopramide
• Mexiletine
• Midodrine
• Mirtazapine
• Oxycodone
• Phenobarbital
• phenylephrine
• Pizotifen
• Primaquine
• primidone
• propoxyphene
• pseudoephedrine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• Repaglinide
• rifampin
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, Fluvoxamine, Paroxetine, Sertraline)
• selegline
• serotonin-norepinephrine reuptake inhibitors (SNRI antidepressants; e.g., Venlafaxine)
• St. John's wort
• sympathomimetic medications (e.g., pseudoephedrine, phenylephrine, ephedrine)
• tapentadol
• Tetrabenazine
• tolcapone
• tramadol
• tricyclic and tetracyclic antidepressants (e.g., amitriptyine, Doxepin, Nortriptyline)
• "triptan" migraine medictions (e.g., Sumatriptan, Zolmitriptan)
• Tryptophan
• xylometazoline

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Azilect (Rasagiline). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Azilect (Rasagiline).

Antidepressant medication: Severe reactions are possible when Azilect (Rasagiline) is combined with medications and natural products used to treat depression. Avoid combining Azilect (Rasagiline) and antidepressants. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are also possible.

If you have taken antidepressants recently, discuss with your doctor how Azilect (Rasagiline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azilect (Rasagiline), and whether any special monitoring is needed.

Behaviour changes: People taking Azilect (Rasagiline) have experienced abnormal behaviour such as compulsive gambling, compulsive shopping, hypersexuality, and binge eating. If you experience these symptoms or any other behaviour change while taking Azilect (Rasagiline), contact your doctor immediately.

Kidney function: Azilect (Rasagiline) should not be used by people with moderate or severe kidney function impairment. If you have reduced kidney function or Kidney Disease, discuss with your doctor how Azilect (Rasagiline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azilect (Rasagiline), and whether any special monitoring is needed.

Liver function impairment: Liver disease or reduced liver function may cause Azilect (Rasagiline) to build up in the body, causing side effects. If you have reduced liver function or liver disease, discuss with your doctor how Azilect (Rasagiline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azilect (Rasagiline), and whether any special monitoring is needed. People with mild liver function impairment may be given 0.5 mg of Azilect (Rasagiline) daily. Do not take Azilect (Rasagiline) if you have moderate or severe liver function impairment.

Skin Cancer: People taking Azilect (Rasagiline) have a higher risk of developing skin cancer. It is unclear whether this increased risk is due to Parkinson's disease or to Azilect (Rasagiline). You and your doctor should check your skin regularly for signs of skin cancer (e.g., moles that have an irregular shape or border, moles that change colour, or moles that are larger than 6 mm).

Sudden onset of sleep: People taking Azilect (Rasagiline) have reported suddenly falling sleep without warning signs of sleepiness or drowsiness. Be careful if driving or operating machinery while taking Azilect (Rasagiline). If you experience excessive drowsiness or falling asleep suddenly, avoid operating machines or driving and contact your doctor immediately.

Pregnancy: Azilect (Rasagiline) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Azilect (Rasagiline), contact your doctor immediately.

Breast-feeding: Azilect (Rasagiline) can reduce the amount of milk produced by a breast-feeding mother. It is not known if Azilect (Rasagiline) passes into breast milk. If you are a breast-feeding mother and are taking Azilect (Rasagiline), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Azilect (Rasagiline) have not been established for children.