Nervous System Home > Precautions and Warnings With Rasagiline

There are a number of precautions and warnings with rasagiline to be aware of before starting this medication. These warnings relate to topics such as pregnancy risks, food and drug interactions, and potential side effects. Precautions and warnings with rasagiline also apply to people who are allergic to any components of the drug, have pheochromocytoma, or are undergoing elective surgery.

Rasagiline: What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to taking rasagiline mesylate (Azilect®) if you have:
  • Liver disease, such as liver failure, hepatitis, or cirrhosis
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Rasagiline

Warnings and precautions to be aware of prior to taking rasagiline include the following:
  • The medication has several potentially lethal food and drug interactions. In order to take rasagiline safely, you must commit to avoiding many foods and medications, including several non-prescription medications. Always check with your healthcare provider before taking any medications (see Drug Interactions With Rasagiline and Azilect Food Interactions).
  • Rasagiline can cause hypertensive crisis, which is a life-threatening increase in blood pressure. Tell your healthcare provider right away if you have symptoms of a hypertensive crisis, such as:
    • Headaches
    • Feelings of a rapidly or forcefully beating heart (palpitations)
    • Sore or stiff neck
    • Nausea or vomiting
    • Sweating, with a high fever (or sometimes with cold, clammy skin)
    • Sensitivity to light
    • Rapid heart rate (tachycardia) or low heart rate (bradycardia)
    • Chest pain or throat tightness
    • Dilated (wide open) pupils.
  • The liver helps to remove rasagiline from the body. Therefore, if you have mild liver disease, you may need a lower rasagiline dosage. The medication is not recommended for people with moderate or severe liver disease.
  • Taking rasagiline with levodopa medications (such as Sinemet®, Sinemet® CR, Parcopa®, or Stalevo®) can increase the risk of involuntary muscle movements, called dyskinesias, due to levodopa. Although not usually dangerous, dyskinesias can be quite disturbing and intolerable. If you develop a severe dyskinesia while taking rasagiline and levodopa, your healthcare provider may need to decrease your levodopa dosage.
  • The medication can cause low blood pressure (hypotension). Let your healthcare provider know if you develop signs of low blood pressure while taking rasagiline, such as dizziness, fainting, or lightheadedness.
  • Rasagiline can cause hallucinations (seeing, feeling, tasting, smelling, or hearing things that aren't there). Let your healthcare provider know if you think you may be hallucinating while taking the drug.
  • Studies have suggested that people who take Parkinson's medications (including rasagiline) may have a higher risk of malignant melanoma (a type of skin cancer). However, it is not clear whether this truly is a problem, since this may simply reflect the fact that people with Parkinson's have a higher risk of melanoma than normal.
  • Rasagiline is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Azilect and Pregnancy).
  • It is not known whether rasagiline passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Azilect and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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