Hiperavia (Rasagiline Tartrate)

Hiperavia is indicated for the symptomatic treatment of Parkinson’s disease and can be prescribed either as a stand‑alone therapy or in combination with other antiparkinson medications to optimize motor control.

• Early‑stage Parkinson’s disease to improve motor symptoms and functional ability.
• Adjunct therapy with levodopa/carbidopa to reduce off‑time and enhance overall response.
• Maintenance treatment for patients who have achieved initial benefit from levodopa, helping to sustain motor stability.
• Use in patients experiencing motor fluctuations to smooth out periods of rigidity or bradykinesia.

• Rasagiline tartrate irreversibly binds to the active site of monoamine oxidase B (MAO‑B) enzymes in the brain, selectively inhibiting their activity. By blocking MAO‑B, the drug prevents the breakdown of dopamine and other catecholamines, leading to increased extracellular dopamine concentrations. The enhanced dopaminergic neurotransmission helps to compensate for the loss of dopaminergic neurons characteristic of Parkinson’s disease, thereby improving motor function.

Like all medications, rasagiline may cause adverse reactions; they are generally categorized by frequency and severity.

Common

• Headache – mild to moderate intensity.
• Nausea or dyspepsia – occasional stomach discomfort.
• Dizziness or light‑headedness – especially upon standing.
• Insomnia or vivid dreams – disturbances in sleep pattern.
• Joint or muscle pain – transient musculoskeletal aches.
• Fatigue – feeling of reduced energy.
• Dry mouth – reduced salivation.

Serious

• Hypertensive crisis – sudden high blood pressure when combined with tyramine‑rich foods or certain sympathomimetics.
• Severe liver enzyme elevation – significant increase in hepatic transaminases.
• Serotonin syndrome – agitation, hyperthermia, and neuromuscular abnormalities when used with serotonergic agents.
• Allergic reactions – rash, pruritus, or angioedema indicating hypersensitivity.

When prescribing rasagiline, clinicians should evaluate patient history and monitor for conditions that may increase risk of adverse events.

• Assess cardiovascular status, especially for hypertension, before initiating therapy.
• Review dietary habits to avoid excessive tyramine intake.
• Monitor liver function tests periodically during treatment.
• Evaluate for a history of psychiatric disorders, including depression or impulse control issues.
• Use caution in patients with renal impairment; dose adjustment may be required.
• Consider potential interactions with serotonergic drugs and avoid concurrent use when possible.
• Advise patients to report any signs of hypersensitivity or severe headache promptly.

Rasagiline can affect the metabolism or action of several other medicines; awareness of these interactions helps to minimize risk.

Avoid

• Tyramine‑rich foods (aged cheeses, cured meats) and sympathomimetic agents (e.g., pseudoephedrine) due to risk of hypertensive crisis.
• Other MAO inhibitors (e.g., phenelzine) because combined inhibition may cause severe hypertension.
• Serotonergic drugs (SSRIs, SNRIs, tricyclic antidepressants, linezolid) to prevent serotonin syndrome.

Use with caution

• Levodopa/carbidopa – may enhance dopaminergic effects and require dose adjustment.
• Antihypertensive agents – monitor blood pressure as rasagiline may potentiate hypotensive effects.
• Antiplatelet or anticoagulant therapy – observe for increased bleeding tendency.