Riluzole

A to Z Drug Facts

Riluzole

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(RILL-you-zole)

Rilutek

Class: Neuroprotective

Action Unknown; however, the following properties may be related to effects: Inhibits glutamate release; inactivates voltage-dependent sodium channels; interferes with intra-cellular events following transmitter binding at excitatory amino acid receptors. These effects may protect neural tissues against degenerative changes.

Indications Treatment of patients with amyotrophic lateral sclerosis (ALS; Lou Gehrig's disease).

Contraindications Standard considerations.

Route/Dosage

ADULTS: PO 50 mg q 12 hr.

Interactions

Caffeine, theophylline, amitriptyline, quinolones: May reduce riluzole elimination. Cigarette smoke, rifampin, omeprazole: May enhance riluzole elimination.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Hypertension; tachycardia; palpitations; peripheral edema. CNS: Headache; hypertonia; depression; dizziness; insomnia; somnolence; vertigo; circumoral paresthesia; aggravation reaction; agitation; tremor. DERM: Pruritus; eczema; alopecia; exfoliative dermatitis. EENT: Rhinitis; sinusitis. HEPA: Abnormal liver function tests. GI: Nausea; vomiting; dyspepsia; anorexia; diarrhea; constipation; flatulence; abdominal pain; stomatitis; dry mouth; oral moniliasis. GU: Urinary tract infection; dysuria. META: Weight loss. RESP: Decreased lung function; cough. OTHER: Asthenia; arthralgia; back pain; malaise.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly: Age-related compromised renal and hepatic function may cause a decrease in clearance of riluzole. Renal impairment: Use with caution in patients with renal impairment. Hepatic function impairment: Use with caution in patients with current evidence or history of abnormal liver function indicated by significant elevations of liver enzymes. Baseline elevations of several LFTs (especially elevated bilirubin) should preclude use of riluzole. Monitoring: Measure serum aminotransferases before and during therapy. Evaluate serum SGPT levels every month during the first 3 months of treatment, every 3 months during the remainder of the first yr and periodically thereafter. Special populations: Females and Japanese patients may possess a lower metabolic capacity to eliminate riluzole as compared to males and Caucasian subjects respectively.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Medication is most effective on an empty stomach. Take at least 1 hr before or 2 hrs after a meal for best effect.
Store at room temperature; protect from bright light.

Assessment/Interventions

Obtain patient history.
Obtain baseline laboratory tests, including BUN, SGPT, Hgb and Hct. Perform and evaluate these tests periodically during treatment, (eg, SGPT levels monthly for 3 months, every 3 months during the remainder of the yr and periodically thereafter).
Monitor for effectiveness and reduction in symptom progression of the disease.
Assess patient for development of asthenia, nausea, dizziness, diarrhea, decreased level of consciousness and respiratory distress.

OVERDOSAGE: SIGNS & SYMPTOMS
	None reported

Patient/Family Education

Instruct patient to take medication 30 mins before or 2 hrs after a meal.
Take with a full glass of water.
Instruct patient to take medicine at same time each day. If a dose is missed, take the next dose as originally planned.
Instruct patient not to change dose or discontinue medication without consulting healthcare provider. Larger than prescribed doses do not increase effectiveness, but do increase the side effects.
Instruct patient to check with healthcare provider before taking any over-the-counter or prescription medications, and vaccinations.
Have patient report any serious side effects to healthcare provider, including: asthenia, nausea, dizziness, diarrhea, decreased level of consciousness and respiratory distress.
Inform patient of need for frequent laboratory tests while taking medication. Be sure to keep appointments.
Instruct patient to report any fevers to healthcare provider.
Instruct patient to avoid drinking alcohol in excess while taking this medication.
Advise patient that drug may cause dizziness, vertigo or somnolence and not to drive or operate machinery until patient has gained enough experience to gauge whether or not it affects their mental or motor performance adversely.