Wow! A couple of days ago for cause, I decided to monitor my b/p. I found I was becoming hypertensive starting a couple of hours after taking the 1 mg Azilect on an empty stomach-no food interaction. I then researched and read that Azilect's half-life or peak of absorption is around 3 hours so Azilect is just doing what Azilect is known to do. However, I have an enlarged aortic arch and don't want aneurysm so I have decided to give a half a dose twice a day a try. Sure I have contacted the prescribing doctor but it's a holiday weekend and I thought while waiting to hear from his office someone here might have some experience to relate. This morning the half dose practice worked well for limiting the b/p to mild hypertension. I especially wonder if there is a divided dose regimen that was recommended to anyone here. Another day another PD obstacle analyzed and managed. 
Azilect 1 mg dose divided(?) in two. What... - Cure Parkinson's
Azilect 1 mg dose divided(?) in two. What's the schedule
On further consideration of the b/p problem I believe I will simply take the second half when my b/p has been back in normal for at least three hours and continue to monitor. We are individuals after all.
This is becoming more like a personal log but for whatever help it may be to others, despite some embarrassment to myself I have to reply to my own post again. I just read that theanine a green tea caffeine component is on the restrict list for Azilect. Of course stupid me I have been using green tea extract and drinking green tea.
I asked my neurologist about taking it in 2 doses as I was getting very dizzy, and he said I could take it any way I chose. In the end I followed someone on this sites advice and just take it at night before bed as it is too hard to chop it in half! The dizziness and nausea has reduced.
There seem to be a lot of foods on the restricted list, but I think small amounts are probably OK. I really miss blue cheese!
Buzz, were you monitoring your BP before taking Azilect? Just checking what makes you sure it's Azilect. Sinimet changes my BP for example.
Sometimes check b/p but the sinemet was keeping it on the low side. I think I found out why the b/p was getting up so much. I've used a supplement with good result (since long before beginning Azilect) that contains 50 mg of theanine. I've been taking that supplement 5 or 6 times a day. Today I am reducing that to 2 a day and continuing 1 mg Azilect at the usual time and will monitor b/p after 3 hours then every hour for awhile to find out if it is the supplemental theanine causing the issue.
Azilect does come in a 0.5 mg dose. When I first started on it that's what I took
I took Azilect several years and found I needed to go off it once or twice year for about three weeks to reduce my bp.
Aha! A case history supporting one of my thoughts, that Azilect is concentrating/building up in my tissues. Thanks for the info. Right now I am ruling out sources of theanine from the supplements I take. Today so far the b/p has not risen above 145, better than day before yesterday. I just haven't taken any GABA-plex capsules, they contain 50 mg theanine. Right now it's 6 hours since 1 mg of Azilect and my b/p is back to normal--120/80. I'm going to take a GABA-plex wait an hour and a half and check again. I prefer methodical experiments.
Ok I can share what I have learned, that a mere 50 mg theanine (an herbal anti-anxiety) does case the b/p to jump while I am even on the downside of the Azilect absorption curve. I have been taking around 5 or 6 GABBA-plex (the product containing 50 mg theanine) every day for months so I must have much theanine in my tissues. Every morning I take Azilect and my b/p jumps. This morning I took no GABBA-plex and it jumped but 6 hrs after taking Azilect my b/p returned to normal. Then I tested the idea that theanine was behind it, 2 hours after taking a GABBA-plex the b/p was over 140 and at 2.5 hrs over 150. Now, 3.5 hours it is coming back down around 130. So, there it is. The anti-anxiety theanine interacts with Azilect even in the steady state 6 hours following dosing. Wish I hadn't 2 full unopened bottlles of Gabba-plex on the shelf. I won't take it as long as I continue to be prescribed Azilect. To anyone that has read me touting the benefit of GABBA-plex, there is reason (hypertension) not to use it if you are using azilect or a similar Rx.
This is tantamount to a random drive by comment. I tuned in for a second and saw your posting. If memory serves, this supplement has 5 mg of piperine and I think this is what is causing your spike in BP. Piperine makes other drugs/supplements better absorbed by a minimum of 30 percent. 20 mg of piperine increases the absorption of curcumin by 2,000 percent.
"Bioperine has been clinically tested in the United States and shown to significantly enhance the bioavailability of supplemented nutrients through increased absorption. Studies show that Bioperine increases the absorption of coenzyme Q10 by approximately 30%, with some trials demonstrating a 20-fold increase in bioavailability"
physiciannaturals.com/biope...
Here is a study:
Effects of L-theanine or caffeine intake on changes in blood pressure under physical and psychological stresses
Conclusions
"The findings above denote that L-theanine not only reduces anxiety but also attenuates the blood-pressure increase in high-stress-response adults."
jphysiolanthropol.biomedcen...
In so many words, theanine only lowers blood pressure when a high blood pressure state exists. So you can still take theanine but without the piperine component.
I fail to understand how that study applies as my issue is about my hypertension that is predictable. That can be verified by anyone using a drug interaction application. There one can read of a significant interaction between Azilect and theanine, hypertension, unfortunately. In other conditions I know theanine can address anxiety and lower b/p. That is why I was benefiting from it, I experienced anxiety spells from taking C/L. Know better do better.
Basically theanine only lowers BP when high BP is present. It does not raise BP so your the interaction with azilect is not caused by theanine. So if theanine is not the cause of your BP spike, piperine or another component of GABAPlex is, tyrosine.
Piperine is an MAO B inhibitor which just happens to also raise Azilect's bioavailability. And Aziliect is also an MAO B inhibitor. So there are 2 possible modes of action in which piperine can raise BP.
Inhibition of monoamine oxidase by derivatives of piperine, an alkaloid from the pepper plant Piper nigrum, for possible use in Parkinson's disease.
" Notably, the compounds tested were selective towards MAO-B....."
ncbi.nlm.nih.gov/pubmed/231...
"Azilect is contraindicated for use with meperidine, tramadol, methadone, propoxyphene and MAO inhibitors (MAOIs), including other selective MAO-B inhibitors...."
Tyrosine is converted into levodopa, noradrenaline and adrenaline and is most definitely contraindicated while taking an MAO inhibitor:
"Anyone taking monoamine oxidase (MAO) inhibitors should not take tyrosine or phenylalanine supplements or even eat foods that contain significant amounts of these amino acids—both have been shown to cause dangerous spikes in blood pressure when combined with these medications."
vitaminstuff.com/amino-acid...
The combination of piperine and tyrosine most likely raised your BP because of their interaction with Azilect. If anything, theanine probably put the brakes on an even higher rise in your BP.
Well I will find out soon in a few days after I take a few days to get theanine out of me. I will then add EGCG back into my daily regimen. You know because green tea contains theanine. Your memory is great about the amount of piperine in a GABA-plex capsule, it's said to be a warming agent.
I take 10 mg of piperine per day with my largest dose of supplements because it gives me more bang for the buck. I would not use it if I were on prescription drugs. I shudder to think about taking piperine with a dopamine agonist.
Buzz, thank you for sharing. I have been taking azilect for two or three months now with out any side effects. However, recently after taking Azilect I noticed an increased heart rate by about 30 beats a minute or more while I was trying to sleep. Trying to figure out what might have caused this I wondered if it was simply because of taking Azilect at night versus in the morning. I also then remembered that I ate high tyramine foods such as blue cheese, olives, etc. for the previous two evenings. I decided that this was the cause because it was unusual , Not a pattern, and the only thing different was my diet. if I understood correctly, I think there can be a bit of a residual effect after eating certain foods.
I have also switched from taking Azilect at night to taking Azilect in the morning and I prefer it. Of course, I am much less likely to eat blue cheese and olives in the morning 🙂
I have been told that azilect is frequently prescribed in the beginning at two doses: 1/2 mg in the morning and 1/2 mg at night. There shouldn't be any problem just breaking your Azilect in half, for 2 smaller doses, at least that is what a neurologist told me.
I was glad that you shared this information because the prevailing sentiment is that there isn't really a cause to worry about contraindications with azilect but I find this event that I had a bit curious and will watch it in the future.
Good luck!!
Thanks we can use some good luck. My b/p bump upon taking my azilect continues to become less. Ina couple of days I'm going to try to start EGCG (the decaffeinated form) to find out if that product has any significant b/p effect. I'm hoping not. You know I learned that the theanine is a part of the caffeine in green tea. BTW have you read the canadian research on the amount of residual pesticides in Chinese green teas? Yuck!
Seeking Advise
Has anyone had issues with balance getting worse on Azilect?
Any suggestions for managing this kind of dyskinesia?
TAPERING OFF AZILECT
