Riluzole
Indications
Riluzole is used to extend life or delay the need for breathing support in people with amyotrophic lateral sclerosis (ALS), the most common form of motor neurone disease, a condition in which the nerves controlling the muscles gradually stop working.
How It Works
The exact way Riluzole works is not fully known. It is thought to reduce the release and effects of glutamate, a chemical messenger in the brain and spinal cord. Too much glutamate may damage motor nerve cells, so reducing it may help protect them and slow the disease. Riluzole does not cure ALS or reverse damage already done.
Dosage and Administration
The usual adult dose is 50 mg twice daily, every 12 hours, taken at the same times each day, at least 1 hour before or 2 hours after a meal. A higher dose does not give more benefit. If a dose is missed, skip it and take the next dose at the usual time. An oral liquid form may be used for people who have difficulty swallowing, as prescribed.
Interactions
- CYP1A2 inhibitors such as Fluvoxamine, Ciprofloxacin, Enoxacin and caffeine in large amounts: may raise Riluzole levels.
- CYP1A2 inducers such as Rifampicin, Omeprazole and cigarette smoking, and charcoal-grilled foods: may lower levels.
- Medicines that can harm the liver: added risk of liver injury.
- Alcohol: avoid heavy drinking.
Contraindications
- Allergy to Riluzole.
- Liver disease, or liver enzymes (transaminases) more than three times the upper normal limit before starting.
- Pregnancy and breastfeeding.
Side Effects
Common side effects include weakness, nausea, stomach pain, dizziness, sleepiness, tingling around the mouth, fast heartbeat and raised liver tests. Less often it can cause a low white blood cell count (neutropenia) or inflammation of the lungs (interstitial lung disease).
Get urgent medical help if you have fever, sore throat or other signs of infection; a new dry cough or breathlessness; yellowing of the skin or eyes, dark urine or severe tiredness; or signs of a severe allergic reaction.
Pregnancy and Lactation
Riluzole must not be used during pregnancy or breastfeeding. Women who could become pregnant should use reliable contraception.
Precautions and Warnings
- Liver tests are checked every month for the first 3 months, every 3 months for the rest of the first year, and regularly after that.
- Report any fever promptly, as your white cell count may need checking.
- Riluzole may cause dizziness or drowsiness; do not drive if affected.
- Tell your doctor about kidney problems.
Overdose
An overdose may cause confusion, memory loss, fits, coma or blood problems. Seek emergency medical help at once.
Therapeutic Class
Neuroprotective agent for motor neurone disease (glutamate release inhibitor).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Riluzole