Rasagiline is a selective monoamine oxidase B inhibitor primarily used in monotherapy or combination therapy for Parkinson's disease, which can improve motor symptoms and may delay disease progression. Medication should pay attention to dosage adjustment, drug interactions, and special population management, especially to be alert to serious adverse reactions such as hypertension crisis.

1. Indications

(1) Single drug therapy for Parkinson's disease

Suitable for early Parkinson's disease patients, as an initial treatment, it can significantly improve motor symptoms and delay the use of levodopa. A daily dose of 1mg can maintain stable therapeutic effect.

(2) Combination therapy

Combined use of levodopa in mid to late stage patients can reduce the "off period" time by about 30% and lower the demand for levodopa dosage. The recommended starting dose for combination therapy is 0.5mg.

2. Medication precautions

(1) Dose adjustment

For patients with liver dysfunction, the dosage should be reduced to 0.5mg/day, and it is contraindicated for severe liver damage. When CYP1A2 inhibitors (such as ciprofloxacin) are used in combination, the dosage should be limited to 0.5mg/day.

(2) Dietary restrictions

During treatment, avoid consuming foods with high levels of tyramine (such as aged cheese and fermented products). Dietary restrictions are more relaxed than traditional MAOIs at regular doses, but moderate control should be maintained.

(3) Drug interactions

Do not use in combination with SSRI/SNRI antidepressants, pethidine, etc., as it may cause serotonin syndrome. Co administration with sympathomimetic drugs may induce hypertensive crisis.

3. Medication for special populations

(1) Pregnancy period

Animal studies have shown embryonic toxicity, while human data is limited. Use only when the potential benefits outweigh the risks, and strictly use contraception until 2 weeks after discontinuation.

(2) Lactation period

Medications may be secreted with breast milk, it is recommended to discontinue medication or breastfeeding. There is currently no clear human safety data to support breastfeeding use.

(3) Elderly patients

Patients over 65 years old do not need to adjust the dosage, but need to strengthen blood pressure monitoring. Individuals with combined cognitive impairments need to assess their risk of falling.

4. Adverse reaction management

Common reactions such as headaches and joint pain are usually mild. Immediate medical attention should be sought when unexplained hypertension, hallucinations, or worsening movement disorders occur. Avoid sudden changes in position during medication to prevent orthostatic hypotension.