DangerousContraindicated
5-HTP
5-HTP can increase serotonin synthesis and is unsafe with MAO-inhibiting therapy.
Recommendation: Avoid 5-HTP while taking rasagiline.
Rasagiline
Prescription ·Strong evidence ·Reviewed May 2026
Rasagiline is an irreversible MAO-B inhibitor used for Parkinson disease as monotherapy or adjunctive therapy. At recommended doses it is selective for MAO-B, but contraindicated serotonergic, opioid, sympathomimetic, and MAOI combinations can still cause serotonin syndrome or hypertensive reactions. Dose reduction is required with ciprofloxacin or other CYP1A2 inhibitors.
What it's good for
What to watch for
- Headache
- Arthralgia
- Dyspepsia
- Concomitant meperidine, tramadol, methadone, propoxyphene, St. John's Wort, cyclobenzaprine, dextromethorphan, another MAOI, or certain antidepressants without appropriate washout
- Do not use with other MAO inhibitors3
The bottom line
Evidence rating strong. Most-documented uses: monotherapy for parkinson disease motor symptoms, adjunctive therapy with levodopa to reduce off time, once-daily dosing. 3 sources indexed (2002–2026), with 4 interaction records on file.
The science
How it works, mechanistically.
Core mechanism
Rasagiline irreversibly inhibits MAO-B, reducing dopamine breakdown in the brain and increasing dopaminergic signaling relevant to Parkinson motor symptoms. Because inhibition is irreversible, pharmacodynamic effects persist beyond the short plasma half-life. CYP1A2 is important for metabolism, and inhibitors can raise rasagiline exposure enough to increase adverse-effect risk.1,2
Class
Monoamine oxidase B inhibitor
Dosing
Dosing & protocol.
Common range
Monotherapy or adjunct therapy without levodopa: 1 mg orally once daily. Adjunct to levodopa: start 0.5 mg once daily and increase to 1 mg once daily if needed and tolerated. Use 0.5 mg once daily and do not exceed 0.5 mg daily with ciprofloxacin or other CYP1A2 inhibitors or in mild hepatic impairment; avoid in moderate or severe hepatic impairment.
Recommended form
Oral tablet once daily
May be taken with or without food. A tyramine-restricted diet is not generally required at recommended doses, but very high-tyramine intake should be avoided and patients must follow labeling warnings.
Safety
Full safety detail.
Side effects
- Headache
- Arthralgia
- Dyspepsia
- Depression
- Dyskinesia with levodopa
- Orthostatic hypotension
- Hallucinations or impulse-control symptoms
- Falling asleep during activities
- Hypertension or hypertensive reactions
- Serotonin syndrome with serotonergic agents
Contraindications
Interactions
Interaction records.
DangerousContraindicated
L-Tryptophan
L-Tryptophan supplementation increases serotonin precursor availability during MAO-B inhibitor therapy.
Recommendation: Avoid L-Tryptophan supplements with rasagiline.
DangerousContraindicated
St. John's Wort
St. John's Wort is listed among contraindicated products with rasagiline because of serotonin syndrome risk.
Recommendation: Do not combine St. John's Wort with rasagiline.
SeriousCaution
Rhodiola Rosea
Rhodiola may have stimulant or monoaminergic effects that could add to MAO-B inhibition.
Recommendation: Avoid unless the neurologist approves; monitor blood pressure, agitation, insomnia, and serotonergic symptoms.
Sources
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Randomized controlled trials
2- 1Rasagiline as adjunct to levodopa in patients with Parkinson's disease and motor fluctuationsNeeds reviewNo linkRascol O et al. · Lancet · 2005
Adjunctive rasagiline reduced daily off time in patients with motor fluctuations.
- 2A controlled trial of rasagiline in early Parkinson disease: the TEMPO studyNeeds reviewNo linkParkinson Study Group · Archives of Neurology · 2002
The TEMPO study supported rasagiline symptomatic benefit in early Parkinson disease.
Reference material
1- 3RASAGILINE tablets, US Prescribing InformationNeeds reviewURLU.S. National Library of Medicine · DailyMed · 2026
Labeling describes 1 mg daily monotherapy or adjunct-without-levodopa dosing, 0.5 mg adjunct-to-levodopa initiation, 0.5 mg limit with CYP1A2 inhibitors, contraindicated drugs, tyramine interaction information, and serotonin syndrome warnings.
Keep exploring
Deep dives & adjacent profiles.
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
Use this with your stack
Rasagiline in NutriStack.
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