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Questions about Azilect as a mono therapy for Parkinson's
Parkinson's Disease | Last Active: May 5, 2020 | Replies (30)Comment receiving replies
Hi @burgle and @ggopher. We took your questions to a Mayo Clinic pharmacist.
@burgle, with respect to Azilect slowing the progression of Parkinson's she writes: "There is some evidence that Azilect may have neuroprotective effects that delay onset of symptoms and progression of neuronal deterioration. It is not well known if this is noticeable to patients or not."
@ggopher, as for your question about interactions with certain foods, she writes:
"Azilect is a Monamine Oxidase B Inhibitor (MAO B Inhibitor). With non-selective MAO inhibitors, or those drugs that inhibit both MAO A and B, there can be severe interactions with tyramine containing foods. These types of foods are aged cheeses, cured meats, sauerkraut, soy sauce and draft beers. Food that has been improperly stored or spoiled may also interact with the medicine. These interactions may lead to severe increases in blood pressure. While this should only occur with the nonselective MAO inhibitors, the product information with Azilect recommends avoiding foods that have very high tyramine amounts (more than 150 mg). Additionally, at doses higher than 1 mg per day, Azilect becomes more non-selective, so the risk of interaction with tyramine containing foods is increased. Basically, you shouldn’t have to worry too much about the dietary restrictions unless you eat a lot of the aged cheeses, cured meats, etc, but it is good to be cautious."
As always I have to add: "There may also be drug interactions with Azilect, so it is important to discuss all of your medications with your doctor or pharmacist before starting this one."
Hope this helps. Have a good long weekend.
Replies to "Hi @burgle and @ggopher. We took your questions to a Mayo Clinic pharmacist. @burgle, with respect..."
Coleen, <br>Did this not get to you?<br>Steve<br><br>Steve
Hi Steve,
This message did slip passed me. You ask very good questions. Understanding daily allowances and food-drug interactions can be confusing at best. Does one ask a pharmacist or a dietician? The pharmacist who helped with the answer above is away for a week. So let's see what we can find out until she gets back.
I found this detailed paper (and abbreviated version) written by Dr Ken Gillman, a retired clinical psychiatrist who has published many scientific papers in the field of neuro-pharmacology and is a leading expert in monoamine oxidase inhibitors (MAOIs) and diet.
Monoamine Oxidase Inhibitors: a Review Concerning Dietary Tyramine and Drug Interactions
http://www.psychotropical.com/images/pdf-downloads/3_MAOI_Diet_Abbreviated_2016_3.1.pdf (abbreviated)
http://www.psychotropical.com/images/Publications-pdfs/MAOI_diet_drug_interactions_2016.pdf (full, 90 pages)
Have you talked to your pharmacist about your questions? Sometimes we overlook pharmacists as a primary resource and integral member of our healthcare team. Do you have access to a dietician?
Hi Colleen,<br><br>Thank you so much. The summary certainly looks encouraging. I'll do some more reading in the referenced material, but it looks like I can talk myself into trying the Azilect.<br><br>I've had various opinions from various nurses, haven't tried a pharmacist (Tricare/Express Scripts so it is a call and not eye-to-eye) and can probably link up with a dietician through my medical/hospital group. I have PD group in a week and I will bring it up then, but it is sponsored by the same folks that have me confused now. <br><br>I'll keep you posted.<br><br>Steve
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Wonderful information, thank you. I do, of course, have a few questions:
1. 150 mg of tyramine isn't something I can grasp - can I assume a normal serving is not an issue?
2. Is 150 mg the limit per day or meal or what?
3. Is a half a corned beef with kraut and a cup broccoli cheddar soup (a Sunday treat) too much? In other words, what is "a lot"?
4. My dosage is .5 mg for 2 weeks then 1 mg so that sounds acceptable.
5. Can you expand on leftovers? Are there sources I should read?
Sorry for all the questions, but I really want to understand how to minimize the risks if I am to start this drug. Hope it works.Thank you for your (and the pharmacist's) help.Steve