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Riluzole (Rilutek)
📌 Patients aged >75 years were not included in the original Riluzole trials. ⚠️ Trials did not measure quality of life or survival beyond 18 months. Always interpret trial evidence with caution in older populations.
💊 About: Always check the BNF link here
- ✅ Used in Motor Neurone Disease (ALS) - approved by NICE.
- ⚖️ Not prescribed in every case of MND (specialist decision).
- 🚫 Often not used in Primary Lateral Sclerosis (PLS), which progresses more slowly.
⚙️ Mode of Action
- 🧪 Blocks tetrodotoxin-sensitive sodium channels.
- ⬇️ Reduces glutamate release → limits excitotoxicity on motor neurons.
📋 Indication & Dose
- ALS (severe): Riluzole 50 mg BD, taken before meals to reduce nausea.
- 💷 Annual cost in UK ≈ £3,718 (NICE-approved, prescribed under specialist advice).
⚠️ Contraindications
- 🚫 Liver disease / abnormal LFTs.
🤝 Interactions
- 📖 See BNF for up-to-date details.
💥 Side Effects
- 🧪 Liver toxicity → check LFTs every 3 months.
- 🤢 Nausea, vomiting, weakness, somnolence, tachycardia.
- 🤕 Headache, dizziness, vertigo, pain, paraesthesia.
- 🧾 Neutropenia → stop drug immediately.
📚 References
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