riluzole
Riluzole (Rilutek) helps slow down worsening of symptoms in people with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. It doesn't improve symptoms, but people taking the medication may be able to slow their need for a breathing tube and live about 2 to 3 months longer. It also comes as a liquid and oral film for people who have trouble swallowing pills.
What is Riluzole (Rilutek)?
What is Riluzole (Rilutek) used for?
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease
How Riluzole (Rilutek) works
Riluzole (Rilutek) is a glutamate antagonist. It lowers the amount of a chemical called glutamate that's released in the body. We don't know what specifically causes ALS, but it's thought to involve nerve damage from high glutamate levels in the brain and spinal cord. By lowering the amount of glutamate released in the body, riluzole (Rilutek) helps to slow down nerve damage and worsening of ALS symptoms, such as muscle weakness.
Drug facts
Side effects of Riluzole (Rilutek)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Less Common Side Effects
- Dizziness
- Vomiting
- Dry mouth
- Joint pain
- Trouble sleeping
- Itching
- Fast heartbeat
Riluzole (Rilutek) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver problems: stomach pain, dark urine, yellowing of your skin or eyes
- Low white blood cells: getting infections, fevers, or sore throat often, feeling extremely tired
- Breathing problems: dry cough, fast or shallow breathing, shortness of breath
The following Riluzole (Rilutek) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bladder pain
bloody or cloudy urine
blurred vision
chills
dark urine
difficult, burning, or painful urination
fast, pounding, or irregular heartbeat or pulse
frequent urge to urinate
general feeling of discomfort or illness
headache
increased cough
itching skin
joint pain
loss of appetite
lower back or side pain
muscle aches and pains
nervousness
persistent loss of appetite or weight loss
pounding in the ears
right upper quadrant tenderness
shivering
slow heartbeat
trouble sleeping
unusual tiredness or weakness
vomiting
yellow eyes or skin
Incidence not known
Black, tarry, stools
decreased frequency or amount of urine
difficult breathing
increased thirst
pale skin
swelling of the face, fingers, or lower legs
ulcers, sores, or white spots in the mouth
unusual bleeding or bruising
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Agitation
back pain
bluish-colored lips, fingernails, or palms
blurred vision
coma
confusion
dark urine
difficulty breathing
dizziness or lightheadedness
drowsiness
headache
irritability
memory loss
pale skin
rapid heart rate
seeing, hearing, or feeling things that are not there
seizures
stiff neck
unusual bleeding or bruising
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
lack or loss of strength
Less common
Difficulty moving
dizziness or lightheadedness
excess air or gas in the stomach or bowels
feeling of constant movement of self or surroundings
full feeling
muscle stiffness
passing gas
rapid weight gain
sensation of spinning
skin rash, encrusted, scaly and oozing
sleepiness or unusual drowsiness
stomach pain
tingling of the hands or feet
unusual weight gain or loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Riluzole (Rilutek)
Pros
- One of two FDA-approved medications that slow progression of ALS
- May prolong life by two to three months
- May delay the need for a breathing tube
- Available in a liquid form and oral film for people who have trouble swallowing pills
- Lower-cost generic available for the tablet
Cons
- Doesn't improve ALS symptoms
- Doesn't improve muscle strength or nerve function
- No lower-cost generic available for the liquid form
- Not available as an IV infusion or injection for those who cannot take medication by mouth
Pharmacist tips for Riluzole (Rilutek)
- It's recommended to avoid drinking alcohol while taking riluzole (Rilutek), since both alcohol and the medication can raise the risk of liver problems.
- It's recommended to avoid smoking while taking riluzole (Rilutek). Smoking can make the medication not work as well. If you smoke, talk to your healthcare provider about steps to quit smoking before starting treatment.
For the liquid form (Tiglutik):
- Gently shake the bottle for at least 30 seconds before using. Use the measuring device that comes with the medication to measure doses. Avoid using kitchen or measuring spoons, since they might not be accurate.
- The liquid form can be taken by mouth or through a feeding tube (silicone or polyurethane material).
For the oral film (Exservan):
- Keep each film in their original foil pouch until you're ready for your dose. Use only one film at a time.
- Make sure your hands are clean and dry before you take out the film, so that the film doesn't stick or start to dissolve in your hands. Once you open a foil pouch, place the film on top of your tongue right away. Once it sticks in place, let it dissolve, and swallow normally as it dissolves. Wash your hands after taking your dose, and throw away the empty foil pouch in the trash.
- Don't cut or split the oral films. Don't chew, spit, or talk while the film dissolves, and don't take the film with any liquids. Doing so can cause you to take an incomplete dose or it can cause the medication to not work as well.
- Flush away any pieces of the film that gets spit out or that doesn't get used after you open the foil pouch, or rinse these pieces with water until they completely dissolve. This prevents children or pets from accidentally taking the medication, which can lead to dangerous health problems.
Common questions about Riluzole (Rilutek)
Yes, the riluzole (Rilutek) tablets can be crushed and added to a spoonful of sugar, food puree, or yogurt. Although the tablet can be crushed, crushing it can raise the risk of taking an incomplete dose. You may not get the full dose if there's some remaining powder that can't be picked up after crushing or if doses are taken with a meal that can block the medication from working as well. If you have trouble swallowing pills, the liquid form (Tiglutik) or the oral film (Exservan) may help, but the crushed tablets, liquid form, and oral film may cause your mouth to feel numb after taking. Ask your healthcare provider for alternatives.
Riluzole comes in many forms with different brand names. Rilutek is the brand name for the tablets, Tiglutik for the liquid form, and Exservan for the oral film that dissolves on your tongue. Tiglutik and Exservan are both options for people who have trouble swallowing pills or have a feeding tube that goes directly to the stomach (G-tube).
Take riluzole (Rilutek), Tiglutik, or Exservan at least 1 hour before or 2 hours after a meal. The medication may not work as well if it's taken with a meal.
In clinical studies, women had about 45% more medication in their system than men. Interestingly, male Japanese participants also had more medication in their system than Caucasian participants. Having more medication in your system can mean more side effects. Take a look at the side effects section below, and talk with your provider if you feel that you're having several side effects from riluzole (Rilutek).
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Risks and warnings for Riluzole (Rilutek)
Riluzole (Rilutek) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver injury and damage
- Risk factors: History of liver damage or disease | Taking other medications that can cause liver damage
Riluzole (Rilutek) can affect how well your liver works and can sometimes lead to severe liver damage. To make sure your liver is working normally, you will need to get blood tests done before you start and while you take riluzole (Rilutek). If you notice unusual symptoms, like fever, rash, lack of appetite, stomach pain, dark urine, or yellowing of your skin or eyes, let your healthcare provider know right away.
Low white blood cell count
In some rare cases, riluzole (Rilutek) can lower your white blood cell count to dangerous levels. If your white blood cell count is too low, your body has trouble fighting infections. Symptoms of low white blood cell count include having fatigue, fevers, sore throat, or infections. If you notice any of these symptoms, let your healthcare provider know right away.
Lung disease
- Risk factors: History of lung disease
Although very rare, riluzole (Rilutek) can cause lung disease. If you develop a dry cough or have trouble breathing while taking riluzole (Rilutek), let your healthcare provider know right away, since you may need to stop the medication.
Riluzole (Rilutek) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg | 60 tablets | $27.56 | $0.46 |
Interactions between Riluzole (Rilutek) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Capmatinib
- Pixantrone
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