What are the different names for riluzole?
Riluzole is the generic name for a medication primarily used in the treatment of amyotrophic lateral sclerosis (ALS). The different names for riluzole correspond to the brand-name versions and their specific formulations. Understanding these names is crucial for both patients and caregivers, particularly when discussing treatment options with a healthcare provider. The most prominent brand names are Rilutek, Tiglutik, and Exservan. The choice of which formulation to use is often based on the patient's ability to swallow, as ALS can cause progressive dysphagia (difficulty swallowing).
The primary brand names and their forms
Rilutek (Tablets)
Rilutek was the first FDA-approved medication containing riluzole, receiving approval in 1995. It is available as a 50 mg oral tablet. For many years, this was the only available form of riluzole. However, for patients who find swallowing tablets difficult, newer formulations have since been introduced to offer more convenient administration. Crushing tablets was a common practice, but this carried a risk of incomplete dosage or potential clogging of feeding tubes.
Tiglutik (Oral Suspension)
Tiglutik is a thickened, liquid oral suspension form of riluzole. It was developed to make administration easier for patients with dysphagia. Tiglutik can be taken orally or administered through a feeding tube, providing a safer and more reliable option than crushing tablets. This formulation is dosed via an oral syringe, ensuring accurate and consistent administration.
Exservan (Oral Film)
Exservan is an oral film formulation of riluzole that dissolves on the tongue without the need for water. Approved by the FDA in 2019, it was another advancement aimed at simplifying the medication process for ALS patients. The film adheres to the tongue and dissolves, after which the patient swallows their saliva normally. This bypasses the need to swallow a tablet or liquid and can be a significant benefit for those with severe swallowing difficulties.
Mechanism of action: What makes riluzole effective?
Riluzole's mechanism of action is primarily centered on its role as a glutamate inhibitor. It is thought to exert a neuroprotective effect by interfering with the brain's glutamatergic system. Here is a more detailed breakdown:
- Inhibition of glutamate release: Riluzole helps to reduce the amount of glutamate released from nerve endings.
- Neuroprotection from excitotoxicity: Excessive glutamate levels can lead to a phenomenon known as excitotoxicity, where neurons are overstimulated and damaged. By reducing glutamate activity, riluzole helps protect motor neurons from this damage, thereby slowing disease progression.
- Voltage-dependent sodium channel inactivation: Some research also suggests that riluzole may inactivate voltage-dependent sodium channels, which can further dampen neuronal excitability.
Riluzole formulations and administration
Choosing the correct riluzole formulation depends on a patient's specific needs and symptoms. Here is a quick breakdown of the different forms:
- Rilutek (Tablets): Taken orally, 50 mg twice daily. Must be taken on an empty stomach, at least one hour before or two hours after a meal, as food can reduce its effectiveness.
- Tiglutik (Oral Suspension): Taken orally or via feeding tube, 50 mg (10 mL) twice daily. Also taken on an empty stomach, and the bottle must be shaken well before each use.
- Exservan (Oral Film): Placed on the top of the tongue, 50 mg twice daily. Dissolves completely without water. As with other forms, it should be taken on an empty stomach.
Comparison of Riluzole Formulations
| Feature | Rilutek (Tablet) | Tiglutik (Oral Suspension) | Exservan (Oral Film) |
|---|---|---|---|
| Formulation | Oral Tablet (50 mg) | Thickened Liquid (50 mg/10 mL) | Oral Film (50 mg) |
| Administration | Swallow tablet with water | Administer orally or via feeding tube | Place on tongue to dissolve |
| Swallowing | Requires swallowing | Designed for easy swallowing or feeding tube use | Dissolves on tongue; no swallowing required |
| Timing | Empty stomach | Empty stomach | Empty stomach |
| Key Benefit | Original formulation; generally available as a generic | Ideal for patients with moderate dysphagia or feeding tubes | Best for patients with severe dysphagia; requires no water |
| Risk of Issue | Potential swallowing difficulties; risks with crushing tablets | Requires careful measurement; some risk of incomplete dose if administered improperly | Requires careful handling and placement |
Why is finding the right name important?
For many patients with ALS, especially those navigating the challenges of progressive motor neuron disease, communication about medication can become difficult. Using the correct name for the specific formulation being used ensures clarity during medical appointments, prescription refills, and when consulting with pharmacists or other caregivers. Furthermore, it helps avoid confusion between the original tablet and the newer, specialized forms, which can be critical for maintaining consistent and effective treatment.
Monitoring and side effects
While riluzole is generally well-tolerated, monitoring is essential. The most significant risks include liver injury and low white blood cell counts (neutropenia). Regular blood tests are necessary, especially during the first few months of treatment, to monitor liver function. Common, milder side effects can include weakness, nausea, dizziness, and stomach pain. Any signs of liver problems, such as jaundice, dark urine, or abdominal pain, should be reported to a healthcare provider immediately.
Conclusion
While riluzole is the generic name for the active drug, its other names—Rilutek, Tiglutik, and Exservan—are just as important. These brand names represent different, specialized formulations designed to address the specific needs of patients with amyotrophic lateral sclerosis. Riluzole is believed to work by inhibiting glutamate activity in the nervous system, thereby slowing disease progression and extending survival for ALS patients. As research continues to explore new treatments for ALS, including other potential uses for riluzole, patients can benefit from clear communication with their healthcare team about which formulation best suits their current condition. For more in-depth information about riluzole and ALS, authoritative sources like the ALS Association are invaluable.
Visit The ALS Association for more information about medications for treating ALS.
