Riluzole
RILUTEK
Pronunciation: RIL-yoo-zoel
“Riled tech (with) Real uzi”
integrated augmentative communication wheelchair → ALS medication
What it isGlutamate release inhibitor; amyotrophic lateral sclerosis.
Why this oneIt extends survival by a few months, and it was the first disease-modifying agent in ALS.
What limits itHepatotoxicity requires monthly liver tests initially. Take on an empty stomach; CYP1A2-dependent, so smoking lowers levels.
FDA-approved for
- ALS (1995)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Amyotrophic lateral sclerosis (ALS) | adult | 50 mg BID | 50 mg BID | 50 mg BID |
Renal Undefined
Hepatic Mild-moderate (Child-Pugh A/B): increased exposure, higher risk of adverse reactions; severe: unknown. Not recommended if baseline aminotransferases >5x ULN or evidence of liver dysfunction
Instructions
- Take at least 1 hour before or 2 hours after a meal
- Measure serum aminotransferases before and during treatment
Available strengths
- tab 50 mg
- sol 50 mg/10 mL
- sol 5 mg/mL
- susp 50 mg/10 mL
Cautions
- Hepatic injury (drug-induced, some fatal); monitor ALT monthly x3 mo then periodically; not recommended if ALT >5x ULN; discontinue for liver dysfunction
- Neutropenia (ANC <500); advise reporting febrile illness
- Interstitial lung disease; discontinue if it develops
- Pancreatitis (postmarketing); discontinue if suspected
Adverse reactions
- Asthenia
- Nausea
- Dizziness
- Decreased lung function
- Abdominal pain
Pregnancy Based on animal data, may cause fetal harm
Lactation Unknown if excreted in human milk; detected in rat milk
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 50 mg | tab | 60 BID | $17.60 | offered |
Generic entry2003
NO BOXED WARNINGS
Principal riskHepatotoxicity needing monthly liver tests initially
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
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