Introduction
Ragil 0.5 is a medicine used to treat Parkinson's disease. It helps to provide better control of body movements and prevents excessive shaking and stiffness. It increases the concentration of a chemical in the brain called dopamine that plays a major role in movement control.
Ragil 0.5 can be taken alone or in combination with other medicines. It may be taken with or without food. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor.
If you have missed a dose, take it as soon as you remember it. You should never skip any doses and try to finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to your doctor as it can result in confusion, stiff muscles, and a high fever.
Some common side effects of this medicine include joint pain, insomnia (difficulty sleeping), dyspepsia (indigestion), influenza or cold like symptoms, depression, cough and peripheral edema (swelling in the extremities, especially lower limbs).
It even causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. You should undergo periodic examinations to detect skin cancer while taking this medicine as it increases the risk of developing cancer. Inform your doctor if you develop any unusual changes in mood, hallucinations, an abnormally high sex drive, an urge to gamble or uncontrolled spending as these may prove very harmful.
Side effects of Ragil 0.5
Common
- Joint pain
- Insomnia (difficulty in sleeping)
- Indigestion
- Flu-like symptoms
- Depression
- Cough
- Peripheral edema
How to use Ragil 0.5
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Ragil 0.5 may be taken with or without food, but it is better to take it at a fixed time.
How Ragil 0.5 works
Ragil 0.5 works by increasing the amount of dopamine, a chemical messenger that is needed to control movement in the brain.
Indication
Parkinson Disease
Administration
May be taken with or without food. Avoid tyramine-rich foods, beverages or dietary supplements & amines (from cough/cold prep).
Adult Dose
Parkinson Disease
Monotherapy: 1 mg PO qDay
Adjunct without levodopa: 1 mg PO qDay
Adjunct to levodopa: 0.5 mg PO qDay initially, may increase to 1 mg/day if needed and tolerated; consider reducing levodopa dose
Hepatic impairment
Mild (Child-Pugh A): Not to exceed 0.5 mg/day
Moderate-to-severe (Child-Pugh B/C): Do not use
Child Dose
<18 years: Safety and efficacy not established
Renal Dose
Renal impairment: No dosage adjustment required for mild-to-moderate; not studied in severe
Contraindication
Severe hepatic impairment. Concomitant use w/ other MAOIs and pethidine w/in 14 days after discontinuation of therapy; St John's wort.
Mode of Action
Rasagiline is a potent, irreversible monoamine oxidase (MAO)-B selective inhibitor which may cause an increase in extracellular levels of dopamine in the striatum, leading to reduced symptomatic motor deficits of Parkinson's disease.
Precaution
May cause hypertension (including severe hypertensive syndromes) at recommended doses
May exacerbate hypertension; antihypertensive drugs may require dosage adjustment
May cause hypotension, especially orthostatic
May cause serotonin syndrome when used with antidepressants
Daytime drowsiness and somnolence reported during activities of daily living
May cause or exacerbate dyskinesia; decreasing the levodopa dose may lessen or eliminate this side effect
Hallucinations and psychotic-like behavior reported
Impulse control/compulsive behaviors reported; case reports describe patients with intense urges to gamble, increased sexual urges, intense urges to spend money, or binge eat
Withdrawal-emergent hyperpyrexia and confusion reported with rapid dose reduction of drugs that increase central dopaminergic tone; this is characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability
Lactation
There are no data on presence of drug in human milk or effects on breastfed infant; in rats, rasagiline was shown to inhibit prolactin secretion; the clinical relevance in humans is unknown, and there are no data on effects of rasagiline on prolactin secretion in humans
The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and potential adverse effects on breastfed infant from drug or from underlying maternal condition
Side Effect
>10%
EPS (dyskinesia/dystonia) (18%)
Headache (14%)
Nausea (10-12%)
1-10%
Postural hypotension (6-9%)
Constipation (4-9%)
Weight loss (2-9%)
Arthralgia (7%)
Dyspepsia (7%)
Xerostomia (2-6%)
Depression (5%)
Fall (5%)
Flu-like syndrome (5%)
Hallucination (4-5%)
Conjunctivitis (3%)
Fever (3%)
Gastroenteritis (3%)
Rhinitis (3%)
Arthritis (2%)
Bruising (2%)
Malaise (2%)
Neck pain (2%)
Parasthesia (2%)
Vertigo (2%)
<1%
CV
MI
Bundle branch block
Gastrointestinal hemorrhage
Interaction
Increased plasma levels w/ potent CYP1A2 inhibitors (e.g. ciprofloxacin). Increased clearance w/ entacapone.
Potentially Fatal: Increased risk of non-selective MAO inhibition w/ other MAOIs and pethidine that may lead to hypertensive crises.