Azilect (rasagiline) for Parkinson’s disease
Fact-checked by What is Azilect?
Azilect (rasagiline) is a once-daily oral medication approved to treat Parkinson’s disease. Available as tablets, it may be used on its own or in combination with other Parkinson’s medications.
Parkinson’s disease occurs when nerve cells in the brain that produce dopamine — a chemical messenger that helps coordinate movement — gradually die. This causes dopamine levels to decline, leading to symptoms such as tremor, stiffness, slowness of movement, and balance problems.
Azilect belongs to a class of medications called monoamine oxidase-B (MAO-B) inhibitors, which act to increase the levels of dopamine in the brain. MAO-B is an enzyme that breaks down dopamine. By inhibiting its function, Azilect allows the available dopamine to stay active in the brain for longer, which may help ease Parkinson’s disease symptoms.
The brand-name medication is sold by Teva Pharmaceuticals, but several generic versions are also available in the U.S.
Therapy snapshot
| Brand name | Azilect |
| Chemical name | Rasagiline |
| Usage | Used alone or in combination with other medications to ease Parkinson’s symptoms |
| Administration | Oral tablets |
Who can take Azilect?
Azilect is approved in the U.S. for the treatment of Parkinson’s disease.
Because of the risk of drug interactions, the medication is contraindicated, or should not be used, alongside any of the following medications and supplements:
- meperidine
- tramadol
- methadone
- propoxyphene
- any other MAO inhibitor
- St. John’s wort, an herbal supplement used for depression and certain other conditions
- cyclobenzaprine
- dextromethorphan
Azilect also should not be used in patients with moderate or severe liver impairment.
In addition to the U.S., the medication is also approved in many other regions, including the European Union.
How is Azilect administered?
Azilect is available as oral tablets and the exact dose depends on whether the therapy is used alone or together with other Parkinson’s medications. The type of medications used also influences Azilect dosage recommendations:
- When Azilect is taken alone or in combination with other therapies that don’t include levodopa, a chemical that is converted into dopamine in the brain, the recommended starting dose is 1 mg per day.
- When Azilect is taken alongside levodopa, with or without other Parkinson’s medications, the recommended starting dose is 0.5 mg per day. This can be increased to 1 mg if the initial dose is well tolerated but does not sufficiently control symptoms.
Dose adjustments may be required for people with mild liver impairments or who are receiving medications that interfere with Azilect’s metabolism.
Azilect in clinical trials
Azilect’s approval for Parkinson’s disease was supported by four randomized clinical trials that lasted 18 to 26 weeks. It was evaluated as a standalone treatment and in combination with other Parkinson’s medications.
- The Phase 3 TEMPO trial (NCT00203060) tested Azilect alone in 404 patients with early Parkinson’s disease. Participants receiving Azilect showed significantly greater improvements in motor symptoms, measured by the Unified Parkinson’s Disease Rating Scale (UPDRS), than those receiving a placebo.
- The ANDANTE Phase 4 clinical trial (NCT01049984) evaluated Azilect as an add-on in patients with early disease who had been on a stable dose of certain Parkinson’s medications that was not sufficient for controlling their symptoms. Results showed that the mean UPDRS score improved by 3.6 points in patients given Azilect, compared with 1.2 points in the placebo group.
- Two additional trials — called PRESTO (NCT00203034) and LARGO — tested Azilect as an add-on to levodopa in patients who were experiencing considerable off time, periods where symptoms aren’t controlled between levodopa doses. In both studies, the amount of daily off time decreased significantly with Azilect relative to the placebo, and motor symptoms also significantly improved.
Potential side effects of Azilect
The most common side effects of Azilect differ depending on whether it is used alone or in combination with other Parkinson’s disease medications. When taken alone, common side effects include:
- flu-like symptoms
- joint pain
- depression
- indigestion
When taken in combination with other Parkinson’s disease medications, side effects may include:
- swelling
- falls or accidental injuries
- abdominal or joint pain
- cough
- insomnia
- involuntary movements (dyskinesia)
- low blood pressure upon standing
- weight loss or loss of appetite
- nausea
- constipation
- dry mouth
- rash
- abnormal dreams
- inflammation around tendons
The drug’s prescribing information also comes with warnings for potentially serious adverse events, including:
- dangerously high blood pressure
- serotonin syndrome, a potentially life-threatening drug reaction caused by excess serotonin in the body, which may occur particularly if Azilect is taken alongside certain medications
- excessive sleepiness or suddenly falling asleep during daily activities
- worsening dyskinesia when used with levodopa
- hallucinations or psychotic-like behavior
- unusual urges or compulsive behaviors, such as gambling or excessive spending
Parkinson's News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
