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The safety and warning information for Rasagiline (Azilect) is crucial for ensuring safe use and avoiding potential risks. Below is a concise guide to help you understand the necessary precautions and actions.

• High Blood Pressure: Rasagiline may increase or exacerbate high blood pressure. It also heightens sensitivity to tyramine, which can dangerously elevate your blood pressure. Foods high in tyramine, such as aged cheeses, cured meats, and certain alcoholic beverages, should be avoided. Notify your healthcare provider if your blood pressure readings are consistently high.

• Serotonin Syndrome: Using Rasagiline with other medications that boost serotonin levels can lead to a serious condition known as serotonin syndrome. Symptoms include confusion, hallucinations, seizures, and high fever. Should these occur, discontinue use and seek immediate medical attention. Be cautious when combining Rasagiline with antidepressants, meperidine, tramadol, methadone, propoxyphene, or MAO inhibitors.

• Sleepiness and Sudden Sleep Onset: Rasagiline may cause unexpected sleepiness. Avoid driving or engaging in activities that require full alertness until you know how the medication affects you. Consult your provider if you experience excessive daytime drowsiness or unexpected sleep episodes.

• Low Blood Pressure: This medication can cause sudden drops in blood pressure, leading to dizziness. Rise slowly from sitting or lying positions, especially during the first two months of treatment.

• Hallucinations and Behavioral Changes: Usage can result in hallucinations or behavioral changes, such as paranoia and confusion. These effects may diminish after dose adjustment or discontinuation. Discuss any history of mental health disorders with your provider.

• Impulsive Behaviors: Rasagiline may provoke uncontrollable urges like gambling or excessive shopping. Report any unusual behavioral changes to your provider.

• High Fevers and Confusion: Abrupt cessation or rapid dosage reduction can induce symptoms similar to neuroleptic malignant syndrome, a potentially fatal condition. Always consult your healthcare provider before making changes to your dosage.

Contraindications: Rasagiline should not be used in combination with certain medications, including meperidine, tramadol, methadone, propoxyphene, MAO inhibitors, cyclobenzaprine, dextromethorphan, and St. John's Wort. Consult your healthcare provider if you are taking any of these substances before starting Rasagiline.

When taking rasagiline, you may experience some common side effects like dizziness, drowsiness, joint pain, heartburn, nausea, dry mouth, weight loss, or stomach/abdominal discomfort. These effects are usually mild, but if they persist or worsen, it’s important to consult your healthcare provider. To minimize dizziness and lightheadedness, try to get up slowly from a sitting or lying position, especially when you start the medication.

Some users report headaches, joint pain, stomach upset, depression, flu-like symptoms, and falls, which generally don't pose serious risks but should be discussed with your provider if they become bothersome. In rare cases, rasagiline can lead to more severe side effects such as fainting, loss of balance, or mental changes like confusion and hallucinations. If you notice muscle stiffness, twitching, uncontrollable movements, or swelling of the ankles/legs, seek medical advice promptly.

Serious side effects, though rare, require immediate attention. These include serotonin syndrome, characterized by symptoms like hallucinations, seizures, confusion, high fevers, and racing heart. Another rare condition, neuroleptic malignant syndrome (NMS), presents with very high fevers, muscle stiffness, and changes in blood pressure. Additionally, sudden sleep episodes during daily activities can occur without prior drowsiness, increasing risks during tasks like driving.

Rasagiline may rarely cause a severe rise in blood pressure (hypertensive crisis), with symptoms such as severe headache, chest pain, and vision changes. If these occur, seek urgent medical care. Allergic reactions are uncommon but serious; if you experience symptoms like rash, swelling, or difficulty breathing, get medical help immediately. Always inform your doctor of all medications you're taking to avoid harmful interactions.

When taking Rasagiline, it's crucial to be aware of potential interactions with other medications and supplements. Inform your doctor and pharmacist about all the drugs and supplements you use, including prescription, over-the-counter, vitamins, and herbal products.

Significant Drug Interactions

Avoiding Certain Medications: Rasagiline should not be used with certain drugs due to the risk of serious interactions. These include:

• MAO inhibitors (like isocarboxazid, Linezolid, phenelzine, Tranylcypromine).
• Drugs that can increase serotonin, which may lead to serotonin syndrome. This includes some antidepressants (such as SSRIs like Fluoxetine and SNRIs like Venlafaxine), certain pain medications (like Tramadol, methadone), and herbal supplements like St. John's Wort.
• Medications that can cause high blood pressure when combined with rasagiline, such as decongestants (phenylephrine, pseudoephedrine) and stimulants (amphetamine, ephedrine).

Potentially Dangerous Combinations: Some medications can be problematic when used with rasagiline and should typically be avoided unless your doctor determines the combination is necessary. These include:

• Appetite suppressants (such as phentermine).
• Drugs for attention deficit disorder (like Methylphenidate, Atomoxetine).
• Migraine medications (such as Sumatriptan).

Cautious Use: Other drugs may increase the likelihood of side effects but might be managed under medical supervision. If prescribed together, your doctor might adjust dosages or usage frequency. Examples include certain diabetic medications (such as insulin and Metformin).

Always consult your healthcare provider regarding the timing of starting or stopping rasagiline relative to these medications. This is especially important if you have taken fluoxetine within the past five weeks. Your healthcare provider will guide you on the necessary waiting periods to prevent interactions.