Rasagiline

• Risk factors: Eating foods that are rich in tyramine | Taking levodopa at the same time

Rasagiline (Azilect) can cause or worsen high blood pressure. Rasagiline (Azilect) can also make you more sensitive to tyramine, a substance in your body that can raise your blood pressure. Eating food that’s very high in tyramine (more than 150 mg) while taking this medication can lead to dangerously high blood pressure that might require emergency medical treatment. Because of this risk, avoid food that contains large amounts of tyramine, such as aged cheeses, cured meats, pickled or fermented food, and alcohol. Let your provider know if your blood pressure is consistently above normal.

• Risk factors: Taking antidepressants | Taking meperidine (Demerol), tramadol (Ultram), methadone (Dolophine), propoxyphene, and MAOIs

Taking rasagiline (Azilect) with other medications that raise serotonin levels in your body can lead to a potentially life-threatening condition called serotonin syndrome. Serotonin is a natural chemical that your brain and nerves use to communicate, but at very high levels, serotonin can cause confusion, hallucinations, coma, seizures, fainting, shivering, sweating, high fevers, racing heart, high blood pressure, muscle stiffness or twitching, and tremors. If you experience any of these symptoms, stop taking rasagiline (Azilect) and get medical help right away.

Don't take rasagiline (Azilect) if you're taking meperidine (Demerol), tramadol (Ultram), methadone (Dolophine), propoxyphene, or MAO inhibitors (including MAO-B inhibitors). It's also not recommended to take rasagiline (Azilect) if you're taking medications to treat your depression, such as citalopram (Celexa), fluoxetine (Prozac), or venlafaxine (Effexor). After stopping rasagiline (Azilect), wait at least 14 days to start any medications for depression. Before you start rasagiline (Azilect), wait at least 5 weeks after stopping your depression medications, since some antidepressants take a long time to clear out of your body.

• Risk factors: History of drowsiness | History of sleep problems | Taking sedatives or medications that make you drowsy | Taking medications that raise your dopamine levels

Rasagiline (Azilect) and other medications that raise your dopamine levels can make you fall asleep out of nowhere, even if you don't feel sleepy. Because of this risk, avoid driving or doing things that require you to focus until you know how this medication affects you, especially if you normally feel sleepy or if you've fallen asleep suddenly in the past. Let your provider know if you feel very sleepy during the daytime or if you fall asleep during activities where you need to concentrate.

Rasagiline (Azilect) can cause sudden drops in your blood pressure. This can make you dizzy or lightheaded, especially when getting up after sitting or lying down. To avoid falling, get up slowly when you stand from a sitting or lying down position. This is more likely to happen during the first two months of taking rasagiline (Azilect) and should get better over time.

• Risk factors: History of certain mental health conditions | Taking levodopa at the same time

Rasagiline (Azilect) and other medications for Parkinson’s disease can cause hallucinations and changes in behavior and thinking, such as paranoia, delusions, confusion, aggressive behavior, uneasiness, trouble sleeping, disturbing dreams, and less awareness of your surroundings. Generally, these symptoms can occur shortly after you start taking these medications, and they might get better once you stop taking this medication or if your dose is lowered. Because of this risk, you shouldn't take rasagiline (Azilect) if you have certain mental health conditions. Certain mental health medications, such as haloperidol (Haldol) or perphenazine, can worsen your Parkinson's disease and might affect how well rasagiline (Azilect) works.

Rasagiline (Azilect) and other Parkinson's disease medications can cause changes in people's behavior, including strong sexual or gambling urges, urges to spend a lot of money, and binge eating. These medications can also make it hard to control these urges. If these urges start to have a negative impact on your life, let your provider know. You might not know you have these urges while taking rasagiline (Azilect), so your provider might ask if you've recently had these behaviors at your next visit.

Although rare, stopping rasagiline (Azilect) or lowering your dose too quickly can cause side effects similar to those of neuroleptic malignant syndrome (NMS). This is a life-threatening condition caused by certain mental health medications. It can cause very high fevers, irregular pulse, sweating, muscle stiffness, confusion, and changes in blood pressure. NMS is treatable if it's recognized early. Don't stop taking rasagiline (Azilect) or lower your dose without talking to your provider so they can instruct you on how to stop the medication safely.