Rasagiline, as a selective MAO-B inhibitor, is mainly used for the treatment of Parkinson's disease, and its efficacy and drug interactions need to be closely monitored. The following will explain from three aspects: mechanism of action, clinical efficacy, and drug interactions.

1. Mechanism of action

(1) MAO-B selective inhibition

By irreversibly inhibiting monoamine oxidase type B, reducing dopamine degradation, prolonging synaptic dopamine action time, and improving motor symptoms of Parkinson's disease.

(2) Neuroprotective potential

In vitro studies have shown that it may delay neuronal degeneration by inhibiting alpha synuclein aggregation and reducing oxidative stress, but clinical evidence is still limited.

2. Clinical efficacy

(1) Monotherapy

Early Parkinson's disease patients can improve UPDRS scores by 2-3 points with better efficacy than selegiline alone, and there is no need for dietary restrictions (at a dose of 1mg/day).

(2) Combination therapy

Combined use with levodopa can reduce dosing by about 30%, but may increase the risk of dyskinesia and require adjustment of levodopa dosage.

3. Drug interactions

(1) Antidepressants

Combination use of SSRI/SNRI drugs (such as fluoxetine and sertraline) is prohibited as it may cause serotonin syndrome and should be discontinued for at least 5 weeks before use.

(2) Analgesic drugs

The combination of opioids such as pethidine and tramadol can cause serious reactions, including high fever and coma, which should be absolutely avoided.

(3) Sympathomimetic drug

Cold medicine containing pseudoephedrine may cause hypertensive crisis, and preparations containing sympathomimetic amine components should be avoided during medication.

(4) CYP1A2 impact

Omeprazole and other CYP1A2 inhibitors may increase the blood concentration of rasagiline, and it is recommended to monitor adverse reactions when used in combination.