Traagiline

Traagiline is a prescription medication that belongs to the class of monoamine oxidase B (MAO-B) inhibitors. It is used in the management of Parkinson's disease to improve motor symptoms by increasing levels of dopamine in the brain through inhibition of the MAO-B enzyme, which normally degrades dopamine.

Indications for traagiline include its use as monotherapy in early Parkinson's disease or as an adjunct to levodopa in patients with motor fluctuations in advanced disease. The goal is to reduce wearing-off and improve mobility. The primary benefit is symptomatic, and evidence for disease-modifying effects remains unsettled.

Mechanism of action involves selective and irreversible inhibition of MAO-B at typical clinical doses, leading to increased dopamine availability in the striatum. At higher concentrations, some inhibition of MAO-A may occur, which can affect tyramine and serotonin metabolism and contribute to drug interactions.

Administration and pharmacokinetics: traagiline is usually given orally, with dosing tailored to the individual regimen. It is metabolized in the liver and excreted in the urine. The onset of symptomatic benefit may take several weeks.

Adverse effects commonly observed include dyskinesia, nausea, dizziness, headache, insomnia, and orthostatic hypotension. Skin reactions and rare hypersensitivity can occur. As with other MAO inhibitors, there is a potential for hypertensive reactions in response to dietary tyramine or certain drug interactions, particularly when used with non-selective MAO inhibitors or serotonergic medications.

Interactions and contraindications: avoid concomitant use with other MAO inhibitors or serotonergic drugs without medical supervision. Cautions include hepatic impairment, pregnancy and lactation considerations, and the potential for interactions with antihypertensive or serotonergic agents. Patients should consult healthcare providers before starting new medications or changing diets, including guidance on tyramine-containing foods.