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What should I discuss with my health care provider before taking rasagiline?

Do not take rasagiline if you have liver disease or an adrenal gland tumor (also called pheochromocytoma). Do not take rasagiline within 14 days before having surgery. Do not take rasagiline if you have taken any of the following drugs within the past 14 days:

• meperidine (Demerol);

• tramadol (Ultram);

• propoxyphene (Darvon, Darvocet);

• methadone (Methadose, Dolophine);

• over-the-counter cough, cold, or allergy medicines containing dextromethorphan, pseudoephedrine, or phenylephrine;

• St. John's wort;

• mirtazapine (Remeron);

• cyclobenzaprine (Flexeril);

• amphetamines (such as ADHD medication), stimulants, diet pills; or

• other MAO inhibitors such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam).

Some people taking rasagiline have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk than most people for developing melanoma. Talk to your doctor about your specific risk and what skin symptoms to watch for.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether rasagiline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take rasagiline?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Rasagiline is usually taken once daily. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take this medication with a full glass of water. Rasagiline is only part of a complete program of treatment that also includes a diet plan created for you by your doctor or nutrition counselor. While you are taking rasagiline and for 2 weeks after you stop taking it, you must not eat foods that are high in tyramine, listed in the "What should I avoid while taking rasagiline?" section of this leaflet. Eating these foods while you are taking rasagiline can raise your blood pressure to dangerous levels. This may cause life-threatening side effects such as sudden and severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), and sudden numbness or weakness (especially on one side of the body). Call your doctor at once if you have any of these symptoms.

Foods that you may eat include:

• fresh meat, poultry, or fish (including lunch meat, hot dogs, breakfast sausage, and cooked sliced ham);

• any vegetables except broad bean pods (fava beans);

• canned or bottled beer, white wine;

• processed cheese, mozzarella, ricotta, cottage cheese;

• pizza made with cheeses low in tyramine;

• soy milk, yogurt; or

• Brewer's or baker's yeast.

It is important to use rasagiline regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking rasagiline. You will need to stop using the medicine for at least 14 days before your surgery.

Store rasagiline at room temperature away from moisture and heat.

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