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Overview: Riluzole is used to treat amyotrophic lateral sclerosis (ALS), which is also known as Lou Gehrig’s disease. Common side effects include feeling unusually weak or tired, nausea, stomach pain, and dizziness. Call your health care provider right away if you notice yellowing of your skin or the whites of your eyes, a fever, dry cough, or trouble breathing. These symptoms may signal a serious side effect of riluzole.

Uses

What is riluzole used for?

Riluzole is commonly used to treat amyotrophic lateral sclerosis (ALS), which is also known as Lou Gehrig's disease.

Riluzole may also be used for other conditions as determined by your health care provider.

How does riluzole work (mechanism of action)?

Riluzole may affect nerve activity and survival. This medicine may help slow the progression of amyotrophic lateral sclerosis (ALS).

How is riluzole supplied (dosage forms)?

Brands and other names

  • Exservan
  • Rilutek 
  • Tiglutik

Dosage forms and strengths

  • 50 mg/10 mL oral suspension
  • 50 mg oral tablets

How should I store riluzole?

Oral Tablets. Riluzole tablets should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from bright light.

Oral Liquid. Riluzole liquid should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store upright in a cool, dry place. Do not freeze. Throw away any riluzole liquid that is not used within 15 days after opening the bottle.

Side Effects

What are the most common side effects of riluzole?

The most common side effects of riluzole are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Feeling unusually weak or tired
  • Nausea or stomach pain
  • Dizziness
  • Reduced lung function
  • High blood pressure 
  • Reduced sensitivity or numbness in the mouth (oral liquid)

There may be other side effects of riluzole that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of riluzole?

While less common, the most serious side effects of riluzole are described below, along with what to do if they happen.

Severe Allergic Reactions. Riluzole may cause allergic reactions, which can be serious. Stop taking riluzole and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking riluzole. Liver damage can be life-threatening. Keep all appointments to have your blood checked. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Low Neutrophil Levels (Neutropenia). Riluzole may cause low levels of a type of white blood cell (called neutrophils), which is known as neutropenia. Neutrophils help prevent infection. Having a low level of neutrophils may increase your risk of infection. Tell your health care provider right away if you have any of the following symptoms of low neutrophil levels.

  • Fever, chills, or sweats
  • Tiredness
  • Sore throat, cough, or shortness of breath
  • Mouth or throat sores
  • Swollen lymph nodes

Lung Inflammation. Riluzole can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Get emergency help if you have a dry cough or trouble breathing.

Warnings & Precautions

Who should not use riluzole?

Allergies to Ingredients. People who are allergic to any of the following should not take riluzole.

  • Exservan
  • Rilutek 
  • Riluzole
  • Tiglutik
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific riluzole products they stock.

What should I know about riluzole before using it?

Do not take riluzole unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share riluzole with other people, even if they have the same condition as you. It may harm them.

Keep riluzole out of the reach of children.

If you will be using oral riluzole liquid, you will take it by mouth or through a percutaneous endoscopic gastrostomy (PEG) tube. 

Before measuring your dose of oral riluzole liquid, gently shake the bottle for at least 30 seconds.

Use an accurate measuring device to measure your dose of oral riluzole liquid. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

Write the date you open the bottle of oral riluzole liquid. It is good for 15 days after opening and must be thrown away after that date, even if there is some medicine left in the bottle.

People who are Japanese can be at greater risk for some side effects from riluzole. Talk to your health care provider about your risks if you are Japanese. 

Keep all your appointments, including laboratory appointments. Your health care provider will monitor certain blood levels to make sure you are tolerating the medicine.

What should I tell my health care provider before using riluzole?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if riluzole is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Lung problems 

Other Medicines and Supplements. Riluzole may interact with other medicines and supplements. Before taking riluzole, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how riluzole could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take riluzole while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if riluzole passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take riluzole while breastfeeding.

Interactions

Does riluzole interact with foods or drinks?

Riluzole should be taken at least one hour before or two hours after a meal.

It is unknown if drinking alcohol will affect riluzole. The risk of dizziness may increase if you drink alcohol while taking riluzole. It is best to limit the amount of alcohol that you drink.

Does riluzole interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking riluzole.

  • Ciprofloxacin (Cipro), which is an antibiotic used to treat certain infections
  • Fluvoxamine (Luvox), which is a medicine commonly used for obsessive-compulsive disorder (OCD)
  • Mexiletine, which is a medicine used for an abnormal heartbeat or rhythm (arrhythmia)
  • A birth control pill
  • Vemurafenib (Zelboraf), which is a medicine used for certain types of cancer
  • Zileuton (Zyflo), which is medicine used to treat asthma
  • Allopurinol (Aloprim, Lopurin, Zyloprim), which is a medicine used to treat gout and other conditions 
  • Methyldopa, which is a medicine used to reduce blood pressure
  • Sulfasalazine (Azulfidine), which is a medicine used for certain inflammatory conditions, such as ulcerative colitis or rheumatoid arthritis

Some other medicines may alter the blood levels of riluzole. Tell your health care provider about all medicines that you take or have recently taken

This may not be a complete list of medicines that can interact with riluzole. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much riluzole?

If you or someone else has used too much riluzole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of riluzole?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.