Rasagiline may cause hallucinations. Signs of severe CNS toxicity (some fatal), including hyperpyrexia, hyperthermia, rigidity, altered mental status, seizure and coma reported in combination with antidepressants. Risk of melanoma may be increased with rasagiline, although increased risk associated with Parkinson’s disease itself. May cause orthostatic hypotension, particularly in combination with levodopa (use with caution in cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). Use with caution in mild hepatic impairment; avoid with moderate to severe impairment. Use of rasagiline with tricyclic antidepressants and SSRIs also associated with rare reactions and should generally be avoided. Do not use within 5 weeks of fluoxetine discontinuation. Do not initiate tricyclic, SSRI or SNRI therapy within 2 weeks of discontinuing rasagiline. Addition of oral selegiline to levodopa therapy may result in exacerbation of levodopa adverse effects. Due to potential for hemodynamic instability, patients should not undergo elective surgery requiring general anesthesia and should avoid local anesthesia containing sympathomimetic vasoconstrictors within 14 days of discontinuing rasagiline. Use caution with foods high in tyramine content, supplements containing tyrosine, phenylalanine, tryptophan, or caffeine. Hypertensive crisis may occur.