rasagiline

7 DRUG INTERACTIONS Meperidine: Risk of serotonin syndrome (4, 7.1) Dextromethorphan: Risk of psychosis or bizarre behavior (4, 7.2) MAO inhibitors: Risk of non-selective MAO inhibition and hypertensive crisis (4, 7.3) 7.1 Meperidine Serious, sometimes fatal reactions have been precipitated with concomitant use of meperidine (e.g., Demerol and other tradenames) and MAO inhibitors including selective MAO-B inhibitors [see Contraindications (4)] .

Mechanism: Combining these medications can cause a life-threatening reaction called serotonin syndrome, where a brain chemical reaches dangerously high levels. This can lead to serious or even fatal health problems.

What to do: Do not take these two medications together. Talk to your doctor about safer pain relief options that do not interact with your other medicine.

7 DRUG INTERACTIONS Meperidine: Risk of serotonin syndrome (4, 7.1) Dextromethorphan: Risk of psychosis or bizarre behavior (4, 7.2) MAO inhibitors: Risk of non-selective MAO inhibition and hypertensive crisis (4, 7.3) 7.1 Meperidine Serious, sometimes fatal reactions have been precipitated with concomitant use of meperidine (e.g., Demerol and other tradenames) and MAO inhibitors including selective MAO-B inhibitors [see Contraindications (4)] . 7.2 Dextromethorphan The concomitant use of rasagiline tablets and dextromethorphan was not allowed in clinical studies. The combination of MAO inh...

Mechanism: Taking these drugs at the same time can cause severe changes in your brain chemistry. This can lead to unusual behavior, confusion, or a loss of touch with reality.

What to do: Avoid using these medications together. Check the labels of over-the-counter cough medicines to make sure they do not contain dextromethorphan.

Product Clinical Comment on Concomitant Use [See Contraindications (4.1)] ; Predominant Effect/Risk [Hypertensive Reaction (HR) [See Warnings and Precautions (5.3)] ; or Serotonin Syndrome (SS) [See Warnings and Precautions (5.7)] ] Altretamine Use with caution If not otherwise specified in this table, consider avoiding concomitant use (see also information on medication-free intervals , use agent at the lowest appropriate dose, monitor for effects of the interaction, advise the patient to report potential effects, and be prepared to discontinue the agent and treat effects of the interactio...

Mechanism: Both drugs increase the levels of certain chemicals in the brain and body. Taking them together can lead to dangerously high blood pressure or a serious condition called serotonin syndrome.

What to do: You should generally avoid taking these two medicines together. If they must be used, your doctor will monitor you very closely for signs of high blood pressure or confusion.

7.6 Ciprofloxacin or Other CYP1A2 Inhibitors Rasagiline plasma concentrations may increase up to 2 fold in patients using concomitant ciprofloxacin and other CYP1A2 inhibitors. Patients taking concomitant ciprofloxacin or other CYP1A2 inhibitors should not exceed a dose of rasagiline tablets 0.5 mg once daily [see Warnings and Precautions (5.4) and Clinical Pharmacology (12.3)] .

Mechanism: Ciprofloxacin blocks the enzyme that breaks down rasagiline, which can double the amount of medicine in your body.

What to do: You should not take more than 0.5 mg of rasagiline once a day if you are also taking ciprofloxacin.

7.8 Dopaminergic Antagonists It is possible that dopamine antagonists, such as antipsychotics or metoclopramide, could diminish the effectiveness of rasagiline.

Mechanism: These two drugs work against each other in the brain, which can stop rasagiline from doing its job.

What to do: Your doctor may need to check if your treatment is still working or consider changing your medications.