Rasator 0.5/Rasator 1 Special Precautions

Hypertension: Exacerbation of hypertension may occur during treatment with Rasagiline. Dosage adjustment may be necessary if elevation of blood pressure is sustained. Monitor patients for new onset hypertension or hypertension that is not adequately controlled after starting rasagiline.
Serotonin Syndrome: Concomitant use of rasagiline with meperidine, tramadol, methadone, and propoxyphene, antidepressants, and non-selective MAO inhibitors have been reported to increase risk of developing Serotonin syndrome. The symptoms of serotonin syndrome included behavioral and cognitive/mental status changes (e.g., confusion, hypomania, hallucinations, agitation, delirium, headache, and coma), and autonomic effects (e.g., syncope, shivering, sweating, high fever/hyperthermia, hypertension, tachycardia, nausea, and diarrhea), and somatic effects (e.g., muscular rigidity, myoclonus, muscle twitching, hyperreflexia manifested by clonus, and tremor). Serotonin syndrome may result to death.
Dyskinesia: When used as an adjunct to Levodopa, Rasagiline may potentiate dopaminergic side effects and exacerbate preexisting dyskinesia.
Impulse Control/Compulsive Behavior: Case reports suggest that patients can experience intense urges to gamble, increased sexual urges, intense urges to spend money, binge eating, and/or other intense urges, and the inability to control these urges while taking one or more medications. Rasagiline increases the central dopaminergic tone that are generally used for the treatment of Parkinson's disease. Consider dose reduction or stopping the medication if a patient develops such urges while taking Rasagiline.
Withdrawal-Emergent Hyperpyrexia and Confusion: A symptom complex resembling neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability), with no other obvious etiology, has been reported in association with rapid dose reduction, withdrawal of, or changes in drugs that increase central dopaminergic tone.
Somnolence: Cases of patients treated with dopaminergic medications have reported falling asleep or somnolence while engaged in activities of daily living. Patients should be advised of the potential to develop drowsiness.
Skin Cancer: The data collected suggests that use of Rasagiline in Parkinson's disease, and not any medicinal products in particular, is associated with a higher risk of skin cancer (not exclusively melanoma). Any suspicious skin lesion should be evaluated by a specialist.
Effects on the Ability to Drive and Use Machines: Cases of mild somnolence has been reported with the use of Rasagiline and other dopaminergic medications. Avoid driving and other potentially dangerous activities.
Rasator 0.5: Hallucinations/Psychotic-like Behavior: Reports indicate that patients may experience new or worsening mental status and behavioral changes, which may be severe, including psychotic-like behavior during treatment with Rasagiline or after starting or increasing the dose.
Rasator 1: Hallucinations/Psychotic-like Behavior: Reports indicate that patients may experience new or worsening mental status and behavioral changes, which may be severe, including psychotic-like behavior during treatment with Rasagiline or after starting or increasing the dose. Other drugs prescribed to improve the symptoms of Parkinson's disease can have similar effects on thinking and behavior. Abnormal thinking and behavior consist of one or more variety of manifestations including paranoid ideation, delusions, hallucinations, confusion, psychotic-like behavior, disorientation, aggressive behavior, agitation, and delirium.
Patients with major psychotic disorder should not be treated with Rasagiline because of the risk of exacerbating the psychosis with an increase in central dopaminergic tone. Consider dose reduction and or drug discontinuation if patient develops hallucinations or psychotic-like behaviors during treatment.
Hepatic Impairment: Rasagiline plasma concentration may increase in patients with hepatic impairment. Patients with mild hepatic impairment should be given the dose of 0.5 mg once daily. Rasagiline should not be used in patients with moderate to severe hepatic impairment.