Drug interactions
Carbidopa-levodopa + Rasagiline
Severity: Moderate
Carbidopa-levodopa and Rasagiline: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Rasagiline is commonly added to levodopa and enhances its antiparkinsonian effect, so dopaminergic adverse effects such as dyskinesia, nausea and orthostatic hypotension may increase. Hypertensive reactions are uncommon at recommended rasagiline doses because it is selective for MAO-B, but they remain possible, especially at higher doses.
What this interaction means in plain words
Carbidopa-levodopa and Rasagiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbidopa-levodopa belongs to Central Nervous System; Rasagiline belongs to Central Nervous System.
Why it happens
MAO-B inhibition reduces dopamine breakdown, adding to levodopa's dopaminergic effect, with loss of selectivity at higher doses.
What to do
Monitor for dyskinesia and blood pressure changes when starting rasagiline, and lower the levodopa dose if dopaminergic adverse effects emerge. Do not exceed the recommended rasagiline dose.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Carbidopa-levodopa
- Carbidopa-levodopa + Isocarboxazid Contraindicated
- Carbidopa-levodopa + Phenelzine Contraindicated
- Carbidopa-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-levodopa Major
- Asenapine + Carbidopa-levodopa Major
Other interactions of Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Carbidopa-levodopa with Rasagiline?
MediHelp rates the interaction as moderate. Carbidopa-levodopa and Rasagiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rasagiline is commonly added to levodopa and enhances its antiparkinsonian effect, so dopaminergic adverse effects such as dyskinesia, nausea and orthostatic hypotension may increase. Hypertensive reactions are uncommon at recommended rasagiline doses because it is selective for MAO-B, but they remain possible, especially at higher doses.
How serious is the interaction between Carbidopa-levodopa and Rasagiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for dyskinesia and blood pressure changes when starting rasagiline, and lower the levodopa dose if dopaminergic adverse effects emerge. Do not exceed the recommended rasagiline dose.
What other medicines interact with Carbidopa-levodopa?
MediHelp also lists interactions of Carbidopa-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-levodopa page.
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