Effects of tyramine administration in Parkinson's disease patients treated with selective MAO-B inhibitor rasagiline

J. Antonelle deMarcaida, Steven R. Schwid, William B. White, Karen Blindauer, Stanley Fahn, Karl Kieburtz, Matthew Stern, Ira Shoulson, Cheryl Deeley, James Pool, Addison Taylor, Catherine Anderson, Alan Forster, Amy Colcher, Jay Beim, Sharron Card, Denyse Turpin, Ted Roberts, Gareth Perry, Dennis EsterbrooksSyed Mohiuddin, Steven Jenkins, Jean Marso, Andrew Siderowf, Mary Matthews, Aryon Mooss, Lois Rasmussen, Gretchen Tietjen, Andrea Korsnack, Roger Kurlan, Charlyne Hickey, Marie Saint-Hilaire, Carol Derksen, Brain Maddux, John Brown, Addison Taylor, Catherine Anderson, David Grimes, Marian Evatt, Carol Ingram, Anwar Ahmed, Ruth Kolb, Sheila Belber

Research output: Contribution to journalArticle

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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 ≥ 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 ≥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 levodova in PD patients without specific dietary tyramine restriction.

Original languageEnglish (US)
Pages (from-to)1716-1721
Number of pages6
JournalMovement Disorders
Volume21
Issue number10
DOIs
StatePublished - Oct 1 2006

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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    deMarcaida, J. A., Schwid, S. R., White, W. B., Blindauer, K., Fahn, S., Kieburtz, K., Stern, M., Shoulson, I., Deeley, C., Pool, J., Taylor, A., Anderson, C., Forster, A., Colcher, A., Beim, J., Card, S., Turpin, D., Roberts, T., Perry, G., ... Belber, S. (2006). Effects of tyramine administration in Parkinson's disease patients treated with selective MAO-B inhibitor rasagiline. Movement Disorders, 21(10), 1716-1721. https://doi.org/10.1002/mds.21048