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Rivelsa
Rivelsa, the brand name for riluzole, is a medication used to treat amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to loss of muscle control. Rivelsa helps slow the progression of the disease by reducing the release of glutamate, an excitatory neurotransmitter that can cause damage to nerve cells when present in excessive amounts. While it is not a cure for ALS, Rivelsa can help prolong survival and delay the need for mechanical ventilation.
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Frequently Asked Questions
How long does it take for Rivelsa to start working?
Rivelsa is not designed to provide immediate relief but works over time to slow the progression of ALS. Patients may not notice an immediate effect, but it helps extend survival and delay the need for mechanical ventilation.
Can Rivelsa cure ALS?
No, Rivelsa does not cure ALS, but it can help slow the progression of the disease and prolong survival in patients.
What should I do if I miss a dose of Rivelsa?
If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Can I take Rivelsa with food?
Rivelsa should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal, to ensure it is properly absorbed.
Is Rivelsa safe for long-term use?
Yes, Rivelsa is generally safe for long-term use in ALS treatment, but regular monitoring of liver function and white blood cell counts is necessary to detect any potential side effects early.
Comprehensive Drug Guide
How Does Rivelsa Work?
Rivelsa (riluzole) works by inhibiting the release of glutamate, a neurotransmitter that plays a role in nerve cell communication. In patients with ALS, excessive levels of glutamate can lead to the overstimulation and death of motor neurons, which are responsible for controlling muscle movement. By reducing glutamate release, Rivelsa helps slow the degeneration of motor neurons, delaying the progression of muscle weakness and the need for ventilatory support.
Common Dosages
- 50 mg tablets
Typical Dosing
- The usual dose of Rivelsa is 50 mg twice daily, taken every 12 hours on an empty stomach (at least 1 hour before or 2 hours after meals).
- It is important to take Rivelsa consistently to maintain stable drug levels in the body and maximize its effectiveness.
Typical Dosing
FDA Approved Indications
- Treatment of amyotrophic lateral sclerosis (ALS) to extend survival and delay the need for tracheostomy or mechanical ventilation.
Who Shouldn't Take Rivelsa?
- Severe liver impairment or elevated liver enzymes, as riluzole can increase the risk of liver damage.
- Known hypersensitivity to riluzole or any of its components.
Advice From The Pharmacist
- Take Rivelsa on an empty stomach, either 1 hour before or 2 hours after eating, to ensure proper absorption of the medication.
- Avoid alcohol while taking Rivelsa, as alcohol can increase the risk of liver damage.
- Regularly monitor liver function with blood tests, as Rivelsa can cause liver enzyme elevations, which may require dose adjustments or discontinuation.
- Contact your healthcare provider if you experience symptoms of liver problems, such as yellowing of the skin or eyes (jaundice), dark urine, or severe abdominal pain.
- Store Rivelsa at room temperature away from heat and moisture, and keep it in its original packaging to protect it from light.
Side Effects of Rivelsa
Common Side Effects
- Nausea
- Dizziness
- Fatigue
- Weakness
- Decreased appetite
Uncommon/Severe Side Effects
- Liver toxicity: Symptoms may include yellowing of the skin or eyes (jaundice), dark urine, and severe stomach pain.
- Lung problems: Riluzole may cause interstitial lung disease, leading to shortness of breath, cough, or chest pain.
- Neutropenia: A reduction in white blood cells, increasing the risk of infections.
Risks and Warnings of Rivelsa
- Liver toxicity: Rivelsa can cause elevations in liver enzymes, leading to liver damage. Regular liver function tests should be performed during treatment, and the medication should be discontinued if significant liver damage is detected.
- Neutropenia: Rivelsa can cause a reduction in white blood cell counts, which may increase the risk of infection. Patients should be monitored for signs of infection, such as fever or persistent cough.
- Interstitial lung disease: Although rare, Rivelsa may cause inflammation of the lungs, leading to shortness of breath and cough. Contact your healthcare provider immediately if you experience respiratory symptoms.
Interactions with Rivelsa
Common Drug Interactions
- CYP1A2 inhibitors: Medications such as ciprofloxacin or fluvoxamine may increase riluzole levels, potentially leading to more severe side effects.
- CYP1A2 inducers: Smoking or medications like omeprazole may reduce riluzole levels, decreasing its effectiveness.
- Alcohol: Concurrent use of alcohol with Rivelsa can increase the risk of liver damage and should be avoided.
Alternatives to Rivelsa
- Radicava (edaravone): Another medication used to treat ALS, administered by intravenous infusion to slow the progression of the disease.
- Rilutek (riluzole): The original brand of riluzole, also used to treat ALS.
- Tiglutik (riluzole oral suspension): A liquid formulation of riluzole for patients who have difficulty swallowing tablets.
