Faculty Collaboration Database

Effects of tyramine administration in Parkinson's disease patients treated with selective MAO-B inhibitor rasagiline. Mov Disord 2006 Oct;21(10):1716-21

Date

07/21/2006

Pubmed ID

16856145

DOI

10.1002/mds.21048

Scopus ID

2-s2.0-33750296512 (requires institutional sign-in at Scopus site)   83 Citations

Abstract

Rasagiline is a novel, potent, and selective MAO-B inhibitor shown to be effective for Parkinson's disease. Traditional nonselective MAO inhibitors have been associated with dietary tyramine interactions that can induce hypertensive reactions. To test safety, tyramine challenges (50-75 mg) were performed in 72 rasagiline-treated and 38 placebo-treated Parkinson's disease (PD) patients at the end of two double-blind placebo-controlled trials of rasagiline. An abnormal pressor response was prespecified as three consecutive measurements of systolic blood pressure (BP) increases of >or= 30 mm Hg and/or bradycardia of < 40 beats/min. In the first study involving 55 patients with early PD on rasagiline monotherapy, no patients randomized to rasagiline (1 mg/2 mg; n = 38) or placebo (n = 17) developed systolic BP (SBP) or heart rate changes indicative of a tyramine reaction. In the second trial involving 55 levodopa-treated patients, 3 of 22 subjects on rasagiline 0.5 mg/day and 1 of 21 subjects on placebo developed asymptomatic, self-limiting SBP elevations >or= 30 mm Hg on three measurements. No subject on 1 mg/day rasagiline (0/12) experienced significant BP or heart rate changes following tyramine ingestion. These data demonstrate that rasagiline 0.5 to 2 mg daily is not associated with clinically significant tyramine reactions and can be used as monotherapy or adjunct to levodopa in PD patients without specific dietary tyramine restriction.

Author List

deMarcaida JA, Schwid SR, White WB, Blindauer K, Fahn S, Kieburtz K, Stern M, Shoulson I, Parkinson Study Group TEMPO, PRESTO Tyramine Substudy Investigators and Coordinators

Author

Karen A. Blindauer MD Chief, Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Oral
Aged
Antiparkinson Agents
Blood Pressure
Dose-Response Relationship, Drug
Double-Blind Method
Drug Therapy, Combination
Female
Food-Drug Interactions
Heart Rate
Humans
Indans
Levodopa
Male
Middle Aged
Monoamine Oxidase Inhibitors
Parkinson Disease
Risk Factors
Tyramine