Rigakin Uses

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What is Rigakin?

Rigakin (Rigakin) is an inhaled prescription medicine used to treat symptoms of Parkinson's disease that come back (OFF episodes) while you are taking another medicine called carbidopa and Rigakin.

Rigakin is not to be used in place of any medicine you take daily for Parkinson's disease.

It is not known if Rigakin is safe or effective in children.

Rigakin indications

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Oral

Parkinsonism

Adult: Initially, 125 mg bid; increase gradually every 3-7 days according to response. Max dose: 8 g daily in divided doses.

Oral

Parkinsonism in conjunction with carbidopa

Adult: Patients not previously on Rigakin therapy: Initially, 25 mg carbidopa with 100 mg Rigakin tid; gradually increase in increments of 12.5 mg carbidopa with 50 mg Rigakin or 25 mg carbidopa with 100 mg Rigakin every day or on alternate days. Maintenance dose: 75-200 mg carbidopa with 750 mg to 2 g Rigakin daily in divided doses. Max carbidopa dose: 200 mg daily. Patients previously on Rigakin monotherapy: 20-25% of the dose previously taken 3 or 4 times daily. Patient previously on other Rigakin/dopa-decarboxylase combination therapy: Initial dose should provide the same daily Rigakin dose.

Oral

Parkinsonism in conjunction with benserazide

Adult: Patients not previously on Rigakin therapy: Initially, 50 mg 3 or 4 times daily; gradually increase in increments of 100 mg once or twice wkly. Increase initial dose to 100 mg tid for advanced disease stages. Maintenance dose: 400-800 mg daily in divided doses; most require <600 mg daily. Patients previously on Rigakin monotherapy: 10-15% of the usual dose previously taken. Patient previously on other Rigakin/dopa-decarboxylase combination therapy: Initially, 50 mg 3 or 4 times daily.

Elderly: Initially, 50 mg once or bid, then increase by 50 mg every 3rd or 4th day.

How should I use Rigakin?

Use Rigakin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Rigakin is for use only in people who are currently taking carbidopa and Rigakin. Do not stop taking your daily Parkinson's medications or change your dosing schedule without your doctor's advice.

For best results, use Rigakin when an "off episode" begins (when your Parkinson's symptoms start to return). Do not use Rigakin more than 5 times per day.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Rigakin is a powder that comes with a special inhaler device and blister packs containing capsules of the medicine. You will load 2 capsules (one at a time) into the inhaler device each time you use the medicine. Pushing the handle of the device onto the mouthpiece will pierce the capsule and release the medicine into the inhaler.

Do not swallow a Rigakin capsule. It is for use only in the Rigakin inhaler device.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Rigakin.

Do not stop using Rigakin suddenly after long-term regular use, or you could have unpleasant withdrawal symptoms (fever, confusion, muscle stiffness, changes in breathing and heart rate). Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat. Keep each capsule in the blister pack until you ready to load the inhaler device. Do not store capsules inside the device.

Throw away the device when your capsules run out. Always use the inhaler device that comes with each new prescription.

Uses of Rigakin in details

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Rigakin is used to treat symptoms such as stiffness, tremors, spasms, and poor muscle control associated with Parkinson disease and parkinsonism-like symptoms caused by taking certain other drugs such as chlorpromazine, fluphenazine, perphenazine.

Rigakin description

The naturally occurring form of dihydroxyphenylalanine and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonian disorders and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [PubChem]

Rigakin dosage

Rigakin Dosage

Generic name: Rigakin 42mg

Dosage form: capsule

Medically reviewed on January 3, 2019.

Rigakin capsules are for oral inhalation only and should be used only with the Rigakin inhaler.

Important Administration Instructions

Rigakin capsules are for oral inhalation only and should be used only with the Rigakin inhaler. Rigakin capsules must not be swallowed as the intended effect will not be obtained. Rigakin capsules should be stored in their blister package and only removed immediately before use.

Recommended Dosage

Rigakin should be taken when symptoms of an OFF period start to return.

The recommended dosage of Rigakin is oral inhalation of the contents of two 42 mg capsules (84 mg) as needed, up to 5 times a day. The maximum dose per OFF period is 84 mg, and the maximum daily dosage is 420 mg. Rigakin has been shown to be effective only in combination with carbidopa/Rigakin.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

More about Rigakin (Rigakin)

Professional resources

Related treatment guides

Rigakin interactions

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What other drugs will affect Rigakin?

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Increased postural hypotension and possible reduced absorption with TCAs. Reduced effects with phenothiazines, butyrophenones, thioxanthenes and other antipsychotic agents; reserpine, papaverine, phenytoin, isoniazid. Reversal of effects of Rigakin monotherapy with pyridoxine. Exacerbation of abnormal involuntary movements and possibly delayed absorption with anticholinergics. Additive hypotensive effects with antihypertensive agents. Increased CNS toxicity with methyldopa. Exacerbation of parkinsonian symptoms with metoclopramide.

Potentially Fatal: Increased risk of hypertensive crises with nonselective MAOIs. Increased risk of cardiac arrhythmias with cyclopropane or halogenated anaesthetics.

Rigakin side effects

See also:
What are the possible side effects of Rigakin?

The following serious adverse reactions are discussed below and elsewhere in the labeling:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

Adverse Reactions in Study 1

Table 1 lists the adverse reactions that occurred in at least 2% of patients with Parkinson's disease who were treated with Rigakin 84 mg and higher than placebo for OFF periods in Study 1. Study 1 was a double-blind, placebo-controlled study, in which 114 patients received Rigakin 84 mg (two 42 mg capsules) for an average of 2 doses per day, to a maximum of 5 times a day, and 112 patients received placebo. Rigakin-treated patients were 45-82 years of age (mean 63.5 years of age) and were predominantly male (72%) and white (94%). All patients were also treated with oral carbidopa/Rigakin. The most common adverse reactions (≥ 5% and higher than placebo) in Study 1 were cough, nausea, upper respiratory tract infection, and sputum discolored.

Table 1: Adverse Reactions at an Incidence ≥2% and More Frequent with Rigakin than with Placebo in Study 1
Adverse Reactions Rigakin 84 mg

N=114

%

Placebo

N=112

%

Respiratory, thoracic and mediastinal disorders
Cough 15 2
Sputum discolored 5 0
Nasal discharge discoloration 2 0
Oropharyngeal pain 2 0
Gastrointestinal disorders
Nausea 5 3
Vomiting 3 0
Infections and infestations
Upper respiratory tract infection 6 3
Nasopharyngitis 3 2
Bronchitis/pneumonia 2 0
Nervous system disorders
Dyskinesia 4 1
Headache 2 0
Injury, poisoning and procedural complications
Fall 3 2
Laceration 2 0
Skin abrasion 2 0
General disorders and administration site conditions
Chest discomfort 2 0
Investigations
Blood bilirubin increased 2 0
Red blood cell count decreased 2 0
Musculoskeletal and connective tissue disorders
Pain in extremity 2 1
Psychiatric disorders
Insomnia 2 1
Vascular disorders
Orthostatic hypotension/blood pressure decreased 2 0

Adverse Reactions Leading to Discontinuation in Study 1

In Study 1, 6 of 114 patients (5%) in the Rigakin 84 mg group and 3 of 112 patients (3%) in the placebo group discontinued because of adverse reactions. The most common of these adverse reactions was cough, which lead to discontinuation in 2% of patients in the Rigakin 84 mg group and none in the placebo group.

Rigakin contraindications

See also:
What is the most important information I should know about Rigakin?

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Monoamine oxidase (MAO) inhibitors and Rigakin should not be given concomitantly and these inhibitors must be discontinued 2 weeks prior to initiating therapy with Rigakin. Rigakin is contraindicated in patients with known hypersensitivity to the drug and in narrow angle glaucoma.

Because Rigakin may activate a malignant melanoma, it should not be used in patients with suspicious, undiagnosed skin lesions or a history of melanoma.

Active ingredient matches for Rigakin:

Levodopa in Netherlands.


List of Rigakin substitutes (brand and generic names)

Sort by popularity
Unit description / dosage (Manufacturer)Price, USD
Capsule; Oral; Levodopa 100 mg (Cambridge)
Capsule; Oral; Levodopa 250 mg (Cambridge)
Capsule; Oral; Levodopa 500 mg (Cambridge)
Tablet; Oral; Levodopa 100 mg (Cambridge)
Tablet; Oral; Levodopa 250 mg (Cambridge)
Tablet; Oral; Levodopa 500 mg (Cambridge)
L-dopa powder$ 15.19
Levodopa powder$ 7.31
Levodopa 250 mg
L-dopa powder$ 15.19
Levodopa powder$ 7.31
Levodopa 250 mg
L-dopa powder$ 15.19
Levodopa powder$ 7.31
Levodopa 250 mg
Madopar-F Levodopa 200mg, Benserazide50mg TAB / 10 (NPIL (Cognex))$ 1.11
10's (NPIL (Cognex))$ 1.27
MADOPAR-F tab 10's (NPIL (Cognex))$ 1.11
Majormet 1000's
Syndpa Plus Carbidopa 25mg, Levodopa 100mg TAB / 10$ 0.26
Syndpa Plus Carbidopa 25mg, Levodopa 100mg TAB / 10$ 0.26

References

  1. DailyMed. "CARBIDOPA; ENTACAPONE; LEVODOPA: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "levodopa". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "levodopa". http://www.drugbank.ca/drugs/DB01235 (accessed September 17, 2018).

Reviews

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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