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www.nutritionucanlivewith.com Posted: Tue May 13, 2008 5:08 pm Post subject: News: Tyramine challenge to Azilect Dear Friend, The FDA requires that the medication rasagiline (Azilect) carry a warning with regard to high-tyramine foods. The following study indicates that this may not be a concern for people using 1 mg per day. If you use Azilect, I recommend you discuss this with your physician. Best, Kathrynne ------------ Safety and tolerability of tyramine challenge in levodopa-treated Parkinson's disease patients receiving rasagiline JR Wilkinson, S Reichwein, MB Stern High dietary tyramine is safe for PD patients on 1 mg daily rasagiline, according to this study. Twenty patients were randomized to receive rasagiline at 1 mg or 2 mg daily, or placebo, for 10 weeks. Patients were free of uncontrolled hypertension, cardiovascular disease, and history of stroke. Mean duration of PD was approximately 5 years, ranging from 0 to 16 years. All patients were taking levodopa. Patients received 5 tyramine challenges: 75 mg 7 days before commencing rasagiline; 25, 50, and then 75 mg on days 22-24 respectively; and then 75 mg again at the end of the study. Blood pressure monitoring was conducted during the challenges and at home over the course of the study. A significant response to tyramine was defined as systolic BP >180 mm, or a rise >30 mm; diastolic BP >105 mm or a rise >20 mm; or a heart rate >120 bpm or a rise >20 bpm. No patient receiving 1 mg/day rasagiline experienced a significant response to any tyramine challenge. Two patients receiving 2 mg/day experienced significant responses, neither of whom displayed clinical manifestations: Patient 1: 25 mg tyramine increased BP from 156/99 to approximately 185/100, which returned to normal without intervention after 15 minutes. In the same patient, 50 mg tyramine induced a larger response which returned to normal after 40 minutes. No further tyramine challenges were performed in this patient. Patient 2: 75 mg tyramine on day 24 increased BP from 137/89 to 168/85, and on day 75 from 146/81 to 191/108, both times returning to normal without intervention. _________________ Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/ Posted: Tue Jun 17, 2008 6:30 pm Post subject: Azilect and High Blood Pressure You mentioned that some patients had reported high blood pressure after taking Azilect. I just started and after titrating up from 0.5mg to 1 mg...my normally low BP (117/68) shot up to 144/84 and I had irregular tachycardia. I read on line some people were sensitive to the caffeine in chocolate (I do not drink coffee) So I cut out ALL caffeine (tea, coffee, candy, etc) and BP went to 124/74 (still high) and no more tachycardia---this seems consistent with some other posts. I have always been sensitive to caffeine. Azilect seems to exaggerate it. Kathrynne Holden, MS, RD Thank you for posting this information. That is a very good point--some people are acutely sensitive to caffeine, even in very small amounts. The fact that omitting all forms of caffeine has helped you lower your blood pressure and relieve tachycardia is an important point, as it allows you to benefit from continued use of Azilect. Thank you for posting! _________________ Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/ Rayilyn Brown Director AZNPF Arizona Chapter National Parkinson Foundation [log in to unmask] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn