Carbidopa and levodopa and Rasagiline interaction

DUOPA is contraindicated in patients who are currently taking a nonselective monoamine oxidase (MAO) inhibitor (e.g., phenelzine and tranylcypromine) or have recently (within 2 weeks) taken a nonselective MAO inhibitor.

DUOPA is contraindicated in patients taking nonselective monoamine oxidase (MAO) inhibitors ( 4 )

Monoamine Oxidase (MAO) Inhibitors The use of nonselective MAO inhibitors with DUOPA is contraindicated [see Contraindications ( 4 ) ] .

The use of selective MAO-B inhibitors (e.g., rasagiline and selegiline) with DUOPA may be associated with orthostatic hypotension.

Discontinue use of any nonselective MAO inhibitors at least two weeks prior to initiating DUOPA.

Decreasing the levodopa dose may lessen or eliminate this side effect ( 5.7 )

In Study 3, rasagiline (1 mg/day) given in conjunction with levodopa, produced an increased incidence of significant blood pressure elevation (systolic > 180 or diastolic > 100 mm Hg) of 4% compared to 3% for placebo [see Adverse Reactions ( 6.1 )] .

When used as an adjunct to levodopa (Studies 3 and 4), the risk for developing post-treatment high blood pressure (e.g., systolic > 180 or diastolic >100 mm Hg) combined with a significant increase from baseline (e.g., systolic > 30 or diastolic > 20 mm Hg) was higher for rasagiline (2%) compared to placebo (1%).

In Study 2 where rasagiline was given as an adjunct therapy in patients not taking concomitant levodopa, there were 5 reports of orthostatic hypotension in patients taking rasagiline 1 mg (3.1%) and 1 report in patients taking placebo (0.6%) [see Adverse Reactions ( 6.1 )] .

When used as an adjunct to levodopa, postural hypotension was also reported as an adverse reaction in approximately 6% of patients treated with rasagiline 0.5 mg, 9% of patients treated with rasagiline 1 mg and 3% of patients treated with placebo.