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The following safety information highlights crucial warnings and precautions for using Rasagiline (Azilect). It is essential to understand these risks and consult your healthcare provider with any concerns.

• High Blood Pressure: Rasagiline may elevate blood pressure or heighten sensitivity to tyramine, a substance that can significantly raise blood pressure. Consuming foods high in tyramine, such as aged cheeses, cured meats, fermented foods, and alcohol, should be avoided as they can lead to dangerously high blood pressure, potentially requiring emergency medical treatment. Discuss with your provider if you experience consistently high blood pressure.

• Serotonin Syndrome: Combining Rasagiline with medications that increase serotonin levels can result in serotonin syndrome, a life-threatening condition. Symptoms include confusion, hallucinations, seizures, high fever, rapid heartbeat, and muscle stiffness. If you notice these symptoms, immediately discontinue Rasagiline and seek medical attention. Risks are higher when using antidepressants, meperidine, tramadol, methadone, propoxyphene, and other MAO inhibitors.

• Sleepiness and Unexpected Sleep Episodes: Rasagiline can cause sudden sleepiness, even without feeling tired. Avoid activities like driving until you understand how the medication affects you, particularly if you have a history of drowsiness or sleep disorders. Inform your provider if you experience excessive daytime sleepiness or sudden sleep episodes.

• Low Blood Pressure: This medication can lead to sudden drops in blood pressure, causing dizziness or lightheadedness, especially when standing up after sitting or lying down. To prevent falls, rise slowly from sitting or lying positions. These effects are common in the first two months of treatment and should improve over time.

• Hallucinations and Behavioral Changes: Rasagiline may cause hallucinations and changes in behavior or thoughts, such as paranoia, confusion, or aggression. These symptoms usually appear shortly after starting the medication and may improve upon discontinuation or dose adjustment. Those with mental health conditions should avoid Rasagiline. Discuss any changes in behavior with your provider.

• Impulsive Behavior: Some may experience urges such as gambling, excessive spending, or binge eating. If these become problematic, notify your provider. Regular check-ups may include questions about these behaviors.

• High Fevers and Confusion: Abruptly stopping or reducing the dose of Rasagiline can lead to symptoms similar to neuroleptic malignant syndrome, including high fevers and confusion. Always consult your provider before changing your medication regimen.

• Contraindications: Do not use Rasagiline if you are taking meperidine, tramadol, methadone, propoxyphene, other MAO inhibitors, cyclobenzaprine, dextromethorphan, or St. John's wort. These combinations can pose serious health risks. Always discuss your current medications with your healthcare provider before starting Rasagiline.

Common side effects:

• dizziness
• drowsiness
• joint pain
• heartburn
• nausea
• dry mouth
• weight loss
• stomach discomfort

Less common but important to monitor:

• fainting
• loss of balance
• mood changes like confusion or depression
• worsening muscle stiffness or twitching
• swollen ankles
• easy bruising
• unusual urges such as increased gambling or sexual urges
• suddenly falling asleep during daily activities

Serious side effects:

• serotonin syndrome
• hypertensive crisis
• Neuroleptic Malignant Syndrome (NMS)
• allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• MAO Inhibitors (isocarboxazid, Linezolid, methylene blue, Tranylcypromine)
• Serotonin-Enhancing Drugs (SSRIs such as Fluoxetine, paroxetine; SNRIs such as Duloxetine, Venlafaxine)
• Stimulants and Appetite Suppressants (amphetamines, Diethylpropion)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Pain Relievers and Cough Suppressants (dextromethorphan, opioids such as Fentanyl, Tramadol)
• Migraine Treatments ('triptans' such as Sumatriptan, Zolmitriptan)

Interactions with low risk that usually do not require a change in therapy:

• Diabetes Medications (insulin)