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Eldepryl vs Azilect
Introduction
For patients with Parkinson's disease, certain drugs that alter the concentrations of compounds in the brain linked to movement and balance can help manage symptoms. Eldepryl and Azilect are two such drugs that are prescribed for this neurodegenerative disorder. They each impact different neurotransmitters in the brain but both have beneficial effects on motor function in patients with Parkinson's disease. Eldepryl is a monoamine oxidase type B (MAO-B) inhibitor which increases levels of dopamine by preventing its breakdown. On the other hand, Azilect also belongs to MAO-B inhibitors class but it has an irreversible binding feature to the enzyme offering more sustained inhibition of MAO-B activity thereby potentially providing longer-lasting control over Parkinson’s symptoms.
Eldepryl vs Azilect Side By Side
Attribute | Eldepryl | Azilect |
---|---|---|
Brand Name | Eldepryl | Azilect |
Contraindications | Cannot be taken with certain types of antidepressants such as SSRIs, tricyclics, or tetracyclics due to the risk of serotonin syndrome. | Cannot be taken with certain types of antidepressants such as SSRIs, tricyclics, or tetracyclics due to the risk of serotonin syndrome. |
Cost | Brand name: around $120 for 30 tablets (5 mg), Generic: $0.60-$1.50 per day | Brand name: about $650 for 30 tablets (1 mg), Generic: starting as low as $3.33/day |
Generic Name | Selegiline | Rasagiline |
Most Serious Side Effect | Severe headaches or blurred vision, chest pain with sudden numbness or weakness, hallucinations or unusual thoughts and behaviors, feeling light-headed like you might faint. | Signs of an allergic reaction, unusual changes in mood or behavior, hallucinations, increased uncontrolled movements, severe nausea, vomiting and diarrhea, high fever and stiff muscles indicating serotonin syndrome. |
Severe Drug Interactions | Risk of serotonin syndrome when combined with certain antidepressants. | Risk of serotonin syndrome when combined with certain antidepressants. |
Typical Dose | 5 mg taken twice a day, up to a maximum of 10 mg twice a day. | 0.5 mg/day taken once daily, can be increased to 1 mg per day. |
What is Eldepryl?
Selegiline (the generic name for Eldepryl) and Rasagiline (the generic name for Azilect) are both monoamine oxidase inhibitors (MAOIs), a class of drugs that were major advancements from the previous generation of treatments for Parkinson's disease. Selegiline was first approved by the FDA in 1989. Eldepryl works by increasing levels of certain chemicals in the brain to help improve symptoms like shakiness, stiffness, difficulty moving and so on. It does this by blocking an enzyme called MAO-B which breaks down dopamine, thus allowing it to stay in the brain longer than usual.
On the other hand, Azilect also helps to increase dopamine levels but it is more potent and selective than Eldepryl which results in fewer side effects such as nausea or insomnia compared to other Parkinson’s medications that have stronger effects on different neurotransmitters.
What conditions is Eldepryl approved to treat?
Eldepryl and Azilect are both approved for the treatment of Parkinson's disease:
- Eldepryl is used as an adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy.
- Azilect, on the other hand, can be used alone as monotherapy or along with other medications such as levodopa/carbidopa to treat symptoms of Parkinson’s disease.
How does Eldepryl help with these illnesses?
Eldepryl works in the management of Parkinson's disease by blocking monoamine oxidase type B (MAO-B) enzymes in the brain. This enzyme is responsible for breaking down dopamine, a neurotransmitter that plays an essential role in motor control and reward systems within the brain. In individuals with Parkinson's disease, there are relatively lower levels of dopamine. Hence, by inhibiting MAO-B enzymes, Eldepryl increases available concentrations of dopamine which can help alleviate symptoms such as tremors and rigidity associated with this condition.
Similarly, Azilect also works by selectively inhibiting MAO-B enzymes to increase dopamine levels within the nervous system but it is often preferred due to its once-daily dosing regimen compared to Eldepryl which requires multiple doses throughout the day for effective symptom management. It should be noted that while both these medications aid in managing symptoms of Parkinson's disease they do not cure or slow down its progression.
What is Azilect?
Azilect, or rasagiline, is an irreversible monoamine oxidase type B (MAO-B) inhibitor and functions by increasing the levels of dopamine in the brain. This helps to improve symptoms like mobility and muscle stiffness often seen in Parkinson's disease patients. Azilect was first approved by the FDA in 2006.
Unlike Eldepryl (selegiline), which also inhibits MAO-B but can metabolize into amphetamine derivatives that may cause side effects such as insomnia and agitation, Azilect does not have this metabolic pathway. Furthermore, Azilect acts solely on MAO-B whereas selegiline at higher dosages also affects MAO-A; this makes Azilect a more selective treatment option with fewer potential side effects.
The most common side effects associated with Azilect include flu-like symptoms, joint pain, depression, indigestion and it has less chance than Eldepryl to cause insomnia due to its different metabolic process. Both medications are useful for managing Parkinson’s disease yet each presents unique benefits that might be better suited to individual patient needs.
What conditions is Azilect approved to treat?
Azilect has been approved by the FDA for use in treating:
- Parkinson's disease as a standalone treatment
- As an adjunct therapy to levodopa in patients with end-of-dose fluctuations.
This medication holds importance due to its ability to potentially slow down progression of Parkinson’s, providing hope and improved quality of life for many patients living with this degenerative disorder.
How does Azilect help with these illnesses?
Azilect, like Eldepryl, works by inhibiting a specific type of enzyme in the brain known as monoamine oxidase B (MAO-B). This enzyme is responsible for breaking down dopamine, a neurotransmitter that plays an essential role in motivation, reward sensations and motor functions. By reducing the activity of MAO-B, Azilect increases the levels of dopamine available in the brain thereby alleviating some symptoms associated with Parkinson's disease such as tremors and stiffness. It may also slow disease progression. However unlike Eldepryl which can be metabolised to amphetamine-like compounds resulting into potential side effects such as insomnia and jitteriness, Azilect does not have these metabolic byproducts making it more tolerable for some patients. Hence it might be considered when a patient cannot tolerate other Parkinson's disease medications or in combination with them to improve effectiveness.
How effective are both Eldepryl and Azilect?
Both selegiline (Eldepryl) and rasagiline (Azilect) have proven to be successful in treating patients with Parkinson's disease, and were approved by the FDA within a span of 19 years. Since they act on different enzymes involved in dopamine metabolism, they may be prescribed under disparate circumstances. The effectiveness of selegiline and rasagiline was directly studied in a double-blind clinical trial in 2004; both drugs showed similar efficacy for managing symptoms of Parkinson’s disease as well as comparable safety profiles. In this study, none of the different metrics used to measure efficacy differed significantly between patients receiving Eldepryl or Azilect.
A 1991 review demonstrated that selegiline is effective at alleviating symptoms of Parkinson's from early stages of treatment. It has an advantageous side effect profile over many other anti-Parkinsonian medications and is well-tolerated across various patient populations. Selegiline has become one of the most commonly used adjunct therapies for Parkinson's disease worldwide due to its ability to delay symptomatic progression by protecting dopaminergic neurons.
An extensive review conducted in 2015 indicated that rasagiline seems more potent than placebo at improving motor function while posing a similar risk profile compared to other common anti-Parkinsonian agents. Nonetheless, like bupropion, it is often considered after initial treatments prove ineffective or intolerance develops towards them. Most research involves co-prescription alongside levodopa so data confirming its efficacy as standalone therapy are not as robust as that for selegiline but still promising enough considering results obtained so far.
At what dose is Eldepryl typically prescribed?
Oral dosages of Eldepryl typically start at 5 mg taken twice a day. For some patients, this dosage can be effective in managing the symptoms of Parkinson's disease. If there is no response after several weeks, your doctor may incrementally increase the dose up to a maximum of 10 mg twice a day. In comparison, Azilect dosages usually begin at 0.5 mg once daily and may be increased by your physician to a maximum of 1 mg per day if needed. As always, it's important that you follow your healthcare provider's instructions when taking these medications.
At what dose is Azilect typically prescribed?
Azilect treatment typically begins at a dosage of 0.5 mg/day taken once daily. If necessary, the dosage can be increased to 1 mg per day after two weeks if there is no response or insufficient improvement in symptoms. It's important to remember that Azilect should always be used as directed by your healthcare provider and it's essential not to exceed the recommended maximum dose of 1 mg per day. This approach allows for gradual accommodation to potential side effects and provides an opportunity for assessing patient's response to this medication.
What are the most common side effects for Eldepryl?
Common side effects of Eldepryl include:
- Dizziness
- Stomach upset or pain, constipation
- Dry mouth
- Sleep problems (insomnia)
- Unusual dreams
- Rash
Typical side effects for Azilect can include:
- Flu-like symptoms including fever and chills
- Joint pain
- Nausea and vomiting,
- Depressed mood, anxiety or abnormal thinking behaviour
-Dyskinesia (difficulty in performing voluntary movements) -Balance issues such as dizziness or fainting.
As always, you need to consult your doctor if any of these side effects persist or worsen.
Are there any potential serious side effects for Eldepryl?
While Eldepryl and Azilect are both used to treat symptoms of Parkinson's disease, they can have different side effects. For Eldepryl, these may include:
- Severe headaches or blurred vision
- Chest pain with sudden numbness or weakness, especially on one side of the body
- Hallucinations or unusual thoughts and behaviors
- Feeling light-headed like you might faint
For Azilect, potential serious side effects could be:
- Uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement)
- A fall caused by sudden dizziness
- High levels of serotonin in the body - agitation hallucinations fever fast heart rate overactive reflexes nausea vomiting diarrhea loss of coordination.
If any severe symptoms occur while taking either medication it is strongly advised to seek immediate medical assistance.
What are the most common side effects for Azilect?
Azilect, while generally well-tolerated, can present some side effects:
- Nausea and vomiting
- Abdominal discomfort or loss of appetite
- Dry mouth or throat issues
- Problems with sleep (insomnia)
- Headache and dizziness
- Mild skin rash
- Joint or muscle pain While less common, Azilect may also cause a fast heartbeat in some patients. More serious but rare side effects include confusion and agitation. Always consult your healthcare provider about potential side effects before starting any new medication.
Are there any potential serious side effects for Azilect?
While Azilect is generally well-tolerated, it's important to be aware of potential serious side effects. These may include:
- Signs of an allergic reaction: this can entail swelling in your face or throat, difficulty breathing, hives, itching and fever. If you experience these signs after taking Azilect, seek emergency medical attention.
- Unusual changes in mood or behavior: this could involve feelings of agitation, hostility or confusion.
- Hallucinations: seeing or hearing things that are not present can occur as a result of taking Azilect.
- Increased uncontrolled movements
- Severe nausea, vomiting and diarrhea
- High fever and stiff muscles; these symptoms could suggest the development of a potentially life-threatening condition called serotonin syndrome.
If any such symptoms emerge while you're on Azilect therapy, discontinue use immediately and consult with your healthcare provider for further direction.
Contraindications for Eldepryl and Azilect?
Eldepryl and Azilect, like most medications used for Parkinson's disease, may actually worsen some of the motor symptoms in certain patients. If you notice an increase in tremors or rigidity, or any other worsening of your Parkinson's symptoms after starting these drugs, please seek immediate medical attention.
Neither Eldepryl nor Azilect can be taken if you are taking, or have been taking certain types of antidepressants such as selective serotonin reuptake inhibitors (SSRIs), tricyclics or tetracyclics. Always tell your physician which medications you are currently using; these antidepressants will require a washout period to clear from the system before it is safe to start with Eldepryl or Azilect due to potential risk of serotonin syndrome - a rare but potentially dangerous drug interaction that can cause severe physical and cognitive symptoms.
How much do Eldepryl and Azilect cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Eldepryl (5 mg) averages around $120, which works out to approximately $4/day.
- The price for a month's supply (30 tablets) of Azilect (1 mg) is about $650, working out to roughly $21.67/day.
Thus, if you are considering costs alone, then brand-name Eldepryl is significantly less expensive on a per-day treatment basis than Azilect. However, it’s important to remember that cost should not be the only factor in determining which drug may work best for your health condition.
As for generic versions:
- Selegiline (generic form of Eldepryl), available in packs from 30 up to 90 capsules with approximate costs ranging from $0.60-$1.50 per day.
- Rasagiline (generic form of Azilect), available in packs from 15 up to 1000 capsules starting as low as $3.33/day and can go higher depending upon dosage and package size chosen.
Again, while generics often offer substantial savings over their branded counterparts, efficacy and personal tolerance must always be considered when choosing between medications.
Popularity of Eldepryl and Azilect
Selegiline, also known under the brand name Eldepryl, is a monoamine oxidase inhibitor (MAOI) that works by slowing the breakdown of certain natural substances in the brain. In 2020, it was estimated that about 20 thousand prescriptions for Selegiline were filled in US pharmacies. Although this may seem like a small number compared to other medications, its use has been stable over recent years due to its specific niche in treating Parkinson's disease.
Rasagiline or Azilect is another MAOI and serves a similar purpose to Eldepryl but with some differences. It was prescribed to roughly 500 thousand people across America last year alone. This medication accounts for approximately one-tenth of all MAOIs used nationally and has seen an increase in prescription rates since its introduction into the market back in 2006. While both drugs serve similar purposes, doctors have increasingly chosen Azilect due to studies suggesting fewer dietary restrictions compared with older MAOIs.
Conclusion
Both Eldepryl (selegiline) and Azilect (rasagiline) have a long-standing record of usage in patients with Parkinson's disease, and are supported by multiple clinical trials demonstrating their effectiveness over placebo treatments. In some instances, these drugs may be used together but this requires careful consideration by a physician due to potential drug interactions. Both drugs work primarily by inhibiting monoamine oxidase type B (MAO-B), an enzyme that breaks down dopamine in the brain.
Azilect is often considered as first-line monotherapy or as an addition to levodopa therapy for patients with early-stage or advanced Parkinson's disease respectively. Eldepryl, on the other hand, is usually prescribed as adjunctive treatment to levodopa/carbidopa medication for people who are experiencing motor fluctuations.
Both medications are available in generic form which can significantly reduce costs especially for those paying out-of-pocket. An adjustment period might be necessary for both Eldepryl and Azilect indicating that benefits might not be evident right away.
The side-effect profiles of both drugs are similar; they're generally well-tolerated but can cause side effects like nausea, dry mouth or lightheadedness among others. It's essential for patients using either drug to closely monitor their health status especially when initiating treatment and seek immediate medical help if they notice any worsening symptoms.
Refrences
- Knudsen Gerber, D. S. (2011, January 1). Selegiline and Rasagiline: Twins or Distant Cousins? Guidelines. The Consultant Pharmacist. American Society of Consultant Pharmacists.http://doi.org/10.4140/tcp.n.2011.48
- McCormack, P. L. (2014, October 17). Rasagiline: A Review of Its Use in the Treatment of Idiopathic Parkinson’s Disease. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40263-014-0206-y
- Mínguez-Mínguez, S., Solís-García del Pozo, J., & Jordán, J. (2013, August). Rasagiline in Parkinson's disease: A review based on meta-analysis of clinical data. Pharmacological Research. Elsevier BV.http://doi.org/10.1016/j.phrs.2013.05.005
- Bryson, H. M., Milne, R. J., & Chrisp, P. (1992, August). Selegiline. PharmacoEconomics. Springer Science and Business Media LLC.http://doi.org/10.2165/00019053-199202020-00005
- Oldfield, V., Keating, G. M., & Perry, C. M. (2007). Rasagiline. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200767120-00006
- Levin, O. S., & Babkina, O. V. (2016). A role of the MAO-B inhibitor rasagiline in treatment of Parkinson’s disease. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Media Sphere Publishing Group.http://doi.org/10.17116/jnevro20161167194-100