Selective irreversible monoamine oxidase B inhibitor
ATC code: N04BD02 (Rasagiline)
Brand names
Rasagilina Cinfa, Azilect, Rasagilina Normon
A selective irreversible MAO-B inhibitor – the enzyme degrading dopamine at nigrostriatal synapses. Reduced dopamine breakdown raises and prolongs its action. Compared with selegiline, no amphetamine metabolites – less psychostimulation and insomnia. Half-life 3 hours, but effect lasts until MAO-B recovers (several weeks). ADAGIO suggested neuroprotection, but reanalysis confirmed only symptomatic efficacy.
First line
First-line in early Parkinson's disease in patients under 65 as monotherapy to delay levodopa per 2021 and SEN 2024. In advanced disease, added to levodopa for motor fluctuations – reduces «off» time by 0.9 hours/day (LARGO, PRESTO). Dose 1 mg once daily, no titration.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Rasagiline is a selective monoamine oxidase B (MAO-B) inhibitor. It is prescribed only for Parkinson's disease as monotherapy in early stages or as add-on to levodopa ( 2018 and MDS 2018 guidelines). In biohacker circles, rasagiline is promoted as a neuroprotectant for life extension. The ADAGIO 2009 trial did not confirm a disease-modifying effect. There are no clinical studies in healthy adults. The drug has specific risks: orthostatic hypotension, hypertensive crises when combined with tyramine-rich foods at high doses (aged cheeses, fermented foods, soy sauce), and serotonin syndrome when combined with antidepressants. If rasagiline was recommended for longevity, consider seeking a second opinion.
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Limited data. Parkinson's is rare in women of reproductive age.
Not used during lactation – suppresses milk production.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Rasagiline is evaluated for the following indications with varying evidence strength: Parkinson's disease (evidence tier A), Memory and concentration enhancement (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Rasagiline (≥ 1 in 100): Headache, Flu-like symptoms, Joint pain, Depression, Dyspepsia. See the Safety section for uncommon and serious reactions.
FDA category C. Limited data. Parkinson's is rare in women of reproductive age.
Not used during lactation – suppresses milk production.
Rasagiline is contraindicated in: Rasagiline hypersensitivity; Severe hepatic impairment; Concomitant other MAO inhibitors, fluoxetine and fluvoxamine, pethidine, tramadol, sympathomimetics, dextromethorphan; Pheochromocytoma; Pregnancy and lactation. Full list in the Safety section.