Reshapil is a highly selective and irreversible monoamine oxidase B (MAO-B) inhibitor used for the treatment of Parkinson's disease, which can be used alone or in combination with levodopa. The following is a brief summary from three aspects: usage, dosage, efficacy, and precautions.

1、 Usage and dosage

1.1 Standard Dose Protocol

Single drug therapy (early Parkinson's disease): The recommended dosage is 1mg, once daily, orally.

Combined use of levodopa (for advanced Parkinson's disease): 1mg is also recommended once daily, and the dosage of levodopa can be appropriately reduced according to clinical symptoms (usually by 10-30%).

Dose adjustment: The initial dose usually does not need to be increased from 0.5mg, except for those with liver dysfunction.

1.2 Usage

It can be taken with meals or on an empty stomach, but taking it with meals can reduce gastrointestinal discomfort.

Take it at a fixed time every day, it is recommended to take it in the morning to avoid taking it at night and affecting sleep.

Swallow the whole piece, it can be broken open but it is not recommended to chew or crush it.

1.3 Adjustment for special populations

Liver function impairment: Patients with mild to moderate liver dysfunction should start at 0.5mg/day; Severely prohibited.

Elderly patients: No need to adjust dosage, but need to strengthen adverse reaction monitoring.

2、 Clinical efficacy

2.1 Improving motor symptoms

Reshapil can delay the demand for levodopa in early Parkinson's disease patients and significantly improve motor performance score (UPDRS).

When used in combination with levodopa, it can reduce the "off period" time and prolong the "on period" duration.

2.2 Delaying disease progression (neuroprotective potential)

Preclinical studies suggest that rasagiline has antioxidant and anti apoptotic effects, but clinical evidence is not yet sufficient and further RCT validation is needed.

2.3 Overall benefits

It has clear therapeutic effects on mild to moderate Parkinson's disease and can be used as a first-line monotherapy or adjuvant drug with good tolerability.

3、 Important precautions

3.1 Diet and casein

There is no need to strictly limit the casein diet, but excessive intake of aged cheese, fermented foods, red wine, etc. should be avoided to prevent hypertension crisis ("cheese reaction").

3.2 Drug Interactions

Absolute prohibition: SSRI antidepressants (fluoxetine, sertraline), SNRI, pethidine, tramadol, St. John's wort, etc. (conversion should be done at least 14 days apart).

Caution: Sympathetic drugs (such as cold medicines containing pseudoephedrine) may induce elevated blood pressure.

3.3 Adverse Reaction Monitoring

Common adverse reactions: headache, joint pain, indigestion, insomnia (mostly mild to moderate).

Be cautious: hypertensive crisis (severe headache, palpitations, blurred vision), serotonin syndrome (agitation, muscle spasms, high fever).

3.4 Handling of missed services

If the missed time is less than 12 hours, take it immediately.

Missed dose time ≥ 12 hours: skip this dose and take it at the regular time the next day. Do not double the dose.