Rasagiline mesylate

The main ingredient of this product is rasagiline mesylate. Chemical name: (R)-N-2-propynyl-1-mylin mesylate Molecular formula: C,H,,N-CH,SO,H Molecular weight: 267.34 Excipients: mannitol, corn starch, pregelatinized starch, stearic acid, talc and silicon dioxide.

MAO inhibitors Rasagiline should not be used in combination with other MAO inhibitors (including over-the-counter natural remedies such as St. John's wort) due to the risk of non-selective MAO inhibitors causing hypertensive crisis (see [Contraindications]). Meperidine Serious adverse reactions have been reported with the combined use of rasagiline with meperidine and MAO inhibitors (including other selective MAO-B inhibitors) (see [Contraindications]). Sympathomimetics Drug interactions have been reported with the combined use of MAO inhibitors and sympathomimetics. Therefore, given the MAO inhibitory activity of rasagiline, its combined use with sympathomimetics (such as nasal or oral decongestants and cold remedies containing ephedrine or pseudoephedrine) is not recommended (see [Precautions]). Dextromethorphan Drug interactions have been reported with the combined use of non-selective MAO inhibitors and dextromethorphan. Therefore, given the MAO inhibitory activity of rasagiline, its combined use with dextromethorphan is not recommended (see [Precautions]). SNRI/SSRI/Tricyclic and Tetracyclic Antidepressants Avoid the co-administration of rasagiline with fluoxetine and fluvoxamine (see Precautions). See Adverse Reactions for the co-administration of rasagiline with selective serotonin reuptake inhibitors (SSRis)/selective 5-tryptamine norepinephrine reuptake inhibitors (SNRIs) in clinical trials. Serious adverse reactions have been reported when MAO inhibitors are co-administered with SSRIs, SNRIs, tricyclics, and tetracyclic antidepressants. Therefore, given the MAO inhibitory activity of rasagiline, caution should be exercised when co-administered with antidepressants. In vitro metabolism studies of drugs that affect CYP1A2 activity have shown that cytochrome P4501A2 (CYP1A2) is the major metabolizing enzyme of rasagiline. When the cYP1A2 inhibitor rasagiline and ciprofloxacin (CYP1A2 inhibitor) were used together, the AUC of rasagiline increased by 83%. When rasagiline and theophylline (CYP1A2 enzyme substrate) were used together, the pharmacokinetic parameters of both were not affected. Therefore, strong CYP1A2 inhibitors may change the plasma level of rasagiline and should be used with caution. CYP1A2 inducers may reduce the plasma level of rasagiline in smoking patients due to induction of CYP1A2 enzyme metabolism. The results of in vitro studies on other cytochrome P450 isoenzymes showed that rasagiline at a concentration of 1ug/ml (equivalent to 160 times the C.mp of 5.9~8.5ng/ml when Parkinson's disease patients were given multiple repeated doses of rasagiline 1mg) did not inhibit the cytochrome P450 isoenzymes CYP1A2, CYP2A6, CYP2c9, cYP2C19, cYP2D6, CYP2E1, CYP3A4 and C YP4A. The above results indicate that rasagiline has a low potential for clinically significant drug interactions with substrates of these enzymes within the therapeutic concentration range. Levodopa and other Parkinson's disease medications When patients with Parkinson's disease who have been taking levodopa for a long time take rasagiline for co-therapy, levodopa has no significant effect on the clearance of rasagiline. Rasagiline oral clearance increased by 28% when rasagiline and entacapone were co-administered. Tyramine/rasagiline interaction The results of five positive controlled trials of tyramine (conducted in healthy volunteers and patients with Parkinson's disease, respectively) and the results of postprandial blood pressure monitoring in patients at home (464 patients took 0.5 or 1 mg rasagiline or placebo daily for 6 months as a combination therapy with levodopa without tyramine restrictions during the period) showed that there were no reports of tyramine/rasagiline interactions without tyramine restrictions. Therefore, rasagiline is safe to take without dietary restrictions on tyramine.