Azilect Reviews: Efficacy, Side Effects, and Warnings

Azilect (rasagiline) is a medication prescribed to manage the motor symptoms of Parkinson’s disease, a progressive disorder that affects movement. This article covers its mechanism, effectiveness, side effects, and other considerations.

What is Azilect and How Does It Work?

The active ingredient in Azilect, rasagiline, is a monoamine oxidase type B (MAO-B) inhibitor. The MAO-B enzyme in the brain breaks down neurotransmitters like dopamine. Rasagiline works by selectively and irreversibly inhibiting this enzyme, which prevents dopamine from being broken down.

This action increases dopamine levels in the striatum, a brain region involved in motor control. The resulting enhanced dopaminergic activity is the source of Azilect’s therapeutic effects on motor symptoms. Unlike some other medications in its class, rasagiline is metabolized into non-amphetamine compounds.

Azilect is approved for use as a monotherapy to treat initial Parkinson’s symptoms. It is also indicated as an adjunctive therapy, where it is added to a treatment regimen that includes levodopa in more advanced stages of the disease. This dual role allows it to be integrated into treatment plans as the condition progresses.

Patient-Reported Efficacy and Benefits

In clinical trials for early-stage Parkinson’s, Azilect used as a monotherapy resulted in significant improvements compared to a placebo. The primary measure in these studies was the Unified Parkinson’s Disease Rating Scale (UPDRS), which assesses mental and physical abilities. Patients taking 1 mg of rasagiline daily showed meaningful improvements in their total UPDRS scores.

For patients with more advanced Parkinson’s, Azilect is beneficial as an adjunct to levodopa therapy. When added to a levodopa regimen, rasagiline decreases “off” time—the period when symptoms return between doses. This provides more consistent motor control throughout the day.

Patients using Azilect have reported improvements in motor symptoms such as tremors, stiffness, and slowness of movement. By addressing these motor deficits, the medication can improve a patient’s quality of life, though individual results and the extent of benefits can vary.

Potential Side Effects and Risks

When taken alone, common side effects of Azilect can include:

• Flu-like symptoms
• Joint pain (arthralgia)
• Indigestion (dyspepsia)
• Headache

When used with levodopa, there is an increased risk of new or worsened dyskinesia, which involves involuntary movements. Orthostatic hypotension, a sudden drop in blood pressure upon standing, may also occur, especially in the first two months of treatment.

A significant risk is a hypertensive crisis, a severe increase in blood pressure. Although Azilect is a selective MAO-B inhibitor, which lowers this risk compared to older drugs, severe reactions have been reported. This can occur if the medication is taken with certain other drugs or with foods high in tyramine.

Another serious risk is serotonin syndrome, which can happen when combined with medications like SSRI or SNRI antidepressants and may cause agitation, confusion, and fever. The FDA label also warns about the potential for hallucinations, psychotic-like behaviors, and impulse control disorders, such as intense urges to gamble. There is also a noted potential risk for melanoma, a type of skin cancer.

Key Considerations and Interactions

Certain drug interactions require attention beyond those that cause hypertensive crisis or serotonin syndrome. The antibiotic ciprofloxacin can increase Azilect concentration, requiring a dosage adjustment. Cough suppressants containing dextromethorphan and the herbal supplement St. John’s Wort should be avoided entirely.

To prevent a dangerous spike in blood pressure, dietary restrictions are necessary. Patients must avoid tyramine-rich foods such as aged cheeses, air-dried meats, sauerkraut, and tap beers. Discussing dietary habits with a healthcare provider is an important step before beginning treatment.

Individuals with liver impairment may need dosage adjustments or be advised against taking Azilect. Before starting Azilect, a thorough discussion with a doctor is necessary. This should cover all current medications, including over-the-counter drugs and supplements, as well as any existing health conditions to ensure it can be used safely and effectively.