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General Medication Fact Sheet for Riluzole
| Field | Information |
|---|---|
| Generic Name | Riluzole |
| Brand Name Versions | Rilutek, Tiglutik, Exservan |
| Boxed/Label Warning | Liver Toxicity: Monitor liver function regularly. Neutropenia: Monitor neutrophil counts. |
| Purpose | Treatment of Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease |
| Mechanism of Action | Inhibits glutamate release, inactivates voltage-dependent sodium channels, and interferes with intracellular events that follow transmitter binding at excitatory amino acid receptors. |
| Dosage Forms | Oral tablets, Oral suspension |
| Available Strengths | 50 mg (tablets), 5 mg/mL (suspension) |
| Dosage Frequency | Typically taken twice daily, 12 hours apart |
| Common Side Effects | Nausea, weakness, decreased lung function, abdominal pain, elevated liver enzymes, dizziness |
| Serious Side Effects | Liver toxicity, neutropenia (low white blood cell count), respiratory problems |
| Drug Interactions | CYP1A2 inhibitors (e.g., caffeine, theophylline), CYP1A2 inducers (e.g., smoking, rifampin), drugs that affect liver function |
| Important Notes | Monitor liver function before and during treatment. Report any signs of infection or respiratory distress to your doctor immediately. |
| Storage | Store at room temperature away from moisture and light. Keep out of reach of children. |
| Missed Dose | Take the missed dose as soon as you remember unless it is almost time for your next dose. Do not double the dose. |
| Alternatives | Edaravone (Radicava), Tofersen (Qalsody), Sodium Phenylbutyrate/Taurursodiol (Relyvrio), NurOwn (experimental) |
Riluzole Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| Edaravone (Radicava) | Free radical scavenger; reduces oxidative stress | Administered intravenously or orally; may slow the decline in clinical function in some ALS patients. |
| Tofersen (Qalsody) | Antisense oligonucleotide targeting SOD1 mRNA | Used for ALS patients with a SOD1 mutation. Given by intrathecal injection. |
| Sodium Phenylbutyrate/Taurursodiol (Relyvrio) | Combination drug with multiple mechanisms, including reducing endoplasmic reticulum stress and mitochondrial dysfunction | Oral medication to slow disease progression in ALS. |
Riluzole Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Nausea | Liver toxicity (elevated liver enzymes, jaundice) |
| Weakness | Neutropenia (increased risk of infection) |
| Decreased lung function | Respiratory problems (difficulty breathing) |
| Abdominal pain | Allergic reactions (rash, itching, swelling, difficulty breathing) |
| Dizziness | Pneumonia |
Riluzole Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| Amyotrophic Lateral Sclerosis (ALS) | 50 mg | 50 mg twice daily | Take 12 hours apart. Take on an empty stomach (at least 1 hour before or 2 hours after a meal) |
