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Exservan
Exservan (riluzole) is an oral film formulation used for the treatment of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. ALS is a neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness, loss of motor function, and eventual paralysis. Exservan helps slow the progression of ALS by reducing damage to motor neurons, although it is not a cure for the disease. The oral film is a dissolvable form of riluzole, offering an alternative for patients who have difficulty swallowing.
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Frequently Asked Questions
How long does it take for Exservan to start working?
Exservan does not provide immediate relief of symptoms, but it works over time to slow the progression of ALS. It may take several weeks to months of treatment to see the effects on disease progression.
Can Exservan cure ALS?
No, Exservan is not a cure for ALS. It helps slow the progression of the disease and can extend survival or delay the need for tracheostomy, but it does not stop the disease entirely.
What should I do if I miss a dose of Exservan?
If you miss a dose, take it as soon as you remember, unless it is close to the time for your next dose. Do not double up on doses to make up for the missed one.
Can I take Exservan with food?
No, Exservan should be taken on an empty stomach. You should take it at least one hour before or two hours after eating to ensure proper absorption.
Is Exservan safe for long-term use?
Yes, Exservan is intended for long-term use in ALS patients. However, regular monitoring of liver function and other side effects is necessary to ensure the medication remains safe and effective.
Comprehensive Drug Guide
How Does Exservan Work?
Exservan works by inhibiting the release of glutamate, a neurotransmitter that is believed to be involved in the nerve damage seen in ALS. Excessive glutamate can lead to overactivation of nerve cells and cell death. By reducing glutamate activity, Exservan helps to protect motor neurons, slowing the progression of muscle weakness and functional decline in ALS patients.
Common Dosages
- Adults: The recommended dose is 50 mg (one oral film) twice daily, taken at least one hour before or two hours after a meal. The film should be placed on the tongue and allowed to dissolve completely without chewing or swallowing.
Typical Dosing
FDA Approved Indications
- Amyotrophic lateral sclerosis (ALS): To slow the progression of the disease and extend survival or time to tracheostomy (a procedure to assist breathing).
Advice From The Pharmacist
- Take Exservan on an empty stomach, either one hour before or two hours after meals, to ensure proper absorption.
- Place the oral film on your tongue and allow it to dissolve. Do not chew or swallow the film whole.
- Avoid drinking alcohol while taking Exservan, as it can increase the risk of liver damage.
- Routine blood tests will be needed to monitor liver function and ensure the medication is safe for continued use.
- If you experience any unusual symptoms, such as persistent nausea, vomiting, or yellowing of the skin or eyes, contact your healthcare provider immediately.
Side Effects of Exservan
Common Side Effects
- Nausea
- Dizziness
- Weakness
- Diarrhea
- Decreased appetite
Uncommon/Severe Side Effects
- Liver damage (elevated liver enzymes, jaundice)
- Severe allergic reactions (hives, swelling, difficulty breathing)
- Lung problems, including interstitial lung disease (shortness of breath, cough)
Risks and Warnings of Exservan
- Liver Toxicity: Exservan can cause liver damage, leading to elevated liver enzymes or jaundice. Regular liver function tests are recommended, and the medication should be discontinued if significant liver issues arise.
- Neutropenia: A reduction in white blood cells (neutropenia) can occur in rare cases, increasing the risk of infection.
- Lung Disease: There is a risk of developing lung problems, such as interstitial lung disease. Patients should report any new or worsening respiratory symptoms.
Interactions with Exservan
Common Drug Interactions
- CYP1A2 inhibitors: Medications like fluvoxamine and ciprofloxacin may increase the levels of riluzole in the blood, leading to a higher risk of side effects.
- CYP1A2 inducers: Smoking or drugs like rifampin may reduce the effectiveness of Exservan by lowering its concentration in the bloodstream.
- Alcohol: Increases the risk of liver damage and should be avoided while taking Exservan.
Alternatives to Exservan
- Rilutek (riluzole): The original oral tablet form of riluzole used to treat ALS.
- Tiglutik (riluzole suspension): A liquid suspension formulation of riluzole for ALS patients who have difficulty swallowing tablets.
- Edaravone (Radicava): An intravenous treatment for ALS that works by reducing oxidative stress, which is believed to contribute to motor neuron damage
