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JACK J. CHEN, PHARM.D., BCPS, CGP, is Associate Professor (Neurology), School of Pharmacy, and Clinical Associate Professor of Neurology, School of Medicine; and ANH-VUONG LY, PHARM.D., is Director of Drug Information and Assistant Professor, School of Pharmacy, Loma Linda University, Loma Linda, CA.

Address correspondence to Dr. Chen at the School of Pharmacy, Loma Linda University, 11262 Campus Street, West Hall, Loma Linda, CA 92350 (jjchen{at}llu.edu).

Purpose. The pharmacology, pharmacokinetics, clinical efficacy, and safety of rasagiline are reviewed. Summary. Rasagiline is a novel, investigational propargylamine that irreversibly and selectively inhibits monoamine oxidase type B (MAO-B). Rasagiline demonstrates complete and selective inhibition of MAO-B and is at least five times more potent than selegiline. Unlike selegiline, which is metabolized to amphetamine derivatives, rasagiline is biotransformed to the nonamphetamine compound aminoindan. Clinical studies have revealed that rasagiline is associated with improved outcomes in patients with early Parkinson’s disease (PD) and also reduces "off" time in patients with moderate to advanced PD with motor fluctuations. Rasagiline is rapidly absorbed by the gastrointestinal tract and readily crosses the blood–brain barrier. The optimal therapeutic dosage is 0.5–1 mg administered orally once daily. Rasagiline appears to be well tolerated, although elderly patients may be more prone to treatment-emergent adverse cardiovascular and psychiatric effects. At the recommended therapeutic dosage of up to 1 mg once daily, tyramine restriction is unnecessary. In addition to MAO-B inhibition, rasagiline has demonstrated neuroprotective properties in experimental laboratory models. The mechanisms whereby rasagiline exerts neuroprotective effects are multifactorial and include upregulation of cellular antioxidant activity and antiapoptotic factors. Conclusion. Rasagiline is an investigational selective and irreversible inhibitor of MAO-B that has demonstrated efficacy and safety for the treatment of PD. Whether rasagiline is associated with clinically significant neuroprotection is the subject of ongoing clinical trials. Index terms: Absorption; Aminoindan; Antiparkinson agents; Blood–brain barrier; Dosage; Drug comparisons; Drugs, body distribution; Geriatrics; Mechanism of action; Metabolism; Parkinson disease; Permeation; Pharmacokinetics; Rasagiline mesylate; Selegiline; Toxicity

 

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				J. J. Chen Duplicate publication Am. J. Health Syst. Pharm., December 1, 2006; 63(23): 2310 - 2310. [Full Text] [PDF]

				A.-V. Ly Duplicate publication Am. J. Health Syst. Pharm., December 1, 2006; 63(23): 2310 - 2310. [Full Text] [PDF]