Rilutek (Riluzole) - Oral

What Is Rilutek?

Rilutek is a prescription medication used to slow the progression of amyotrophic lateral sclerosis (ALS). It's in the central nervous system agent drug class. Rilutek is prescribed for long-term use. It’s available as a tablet that’s taken by mouth on a twice a day schedule. 

Rilutek slows the breakdown of nerve cells. It blocks the release of glutamate, a neurotransmitter that’s released by nerve cells. Glutamate plays an important role in nerve function and promotes the breakdown of nerve cells.

Drug Facts

  • Generic Name: Riluzole
  • Brand Name: Rilutek
  • Drug Availability: Prescription
  • Therapeutic Classification: Central Nervous System Agent
  • Available Generically: Yes
  • Controlled Substance: N/A
  • Administration Route: Oral
  • Active Ingredient: Riluzole
  • Dosage Form: Tablet


What Is Rilutek Used For?

Rilutek is approved for treating amyotrophic lateral sclerosis (ALS), a progressively worsening condition that affects the nervous system. In 2015, there were 16,583 people with ALS in the United States (5.2 people per 100,000 people).

This condition causes profound weakness of the muscles of the arms, legs, chest, throat, and face. It impairs movements such as using the arms and walking, as well as swallowing and breathing. It is considered a fatal disease.

ALS can be hereditary, but often occurs without a known genetic or environmental cause. ALS causes symptoms due to the breakdown of lateral motor neurons located in the spinal cord. Rilutek may slow the breakdown of motor neurons, delaying disease progression and helping people live longer.

How to Take Rilutek

For treatment of ALS, your healthcare provider would prescribe Rilutek tablets for you on a twice a day schedule. Rilutek should not be taken with food, so it’s recommended that you time your doses at least one hour before a meal or two hours after a meal.

Storage

Keep your tablets in their original container and away from the reach of children or pets. 

The container should be stored away from bright light and kept at a temperature of 20 to 25 degrees Celsius (C), 68 to 77 degrees Fahrenheit (F).

Off-Label Uses

Rilutek has been used off-label for the treatment of several conditions. Research studies have shown that Rilutek can have beneficial effects on these conditions. 

Off label uses of Rilutek include:

  • Spinal cord injury: It is used for nerve protection to prevent worsening and to minimize injury. The dose for this condition has not been well established. 
  • Bipolar disorder: It is prescribed with lithium for treating symptoms of depression in bipolar disorder. It has not been found to be effective on its own for this condition.
  • Alzheimer’s disease: Rilutek has been evaluated and used as a treatment for Alzheimer’s disease. It hasn’t shown strong benefits, but it has shown promising effects on biochemical markers of Alzheimer’s disease.

How Long Does Rilutek Take?

The effects of Rilutek on the body take months to reach a stage of being measurable.

What Are the Side Effects of Rilutek?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Rilutek can cause side effects. Your healthcare provider may monitor you for side effects and may change or stop your medication if the side effects become severe or intolerable.

Common Side Effects

According to the manufacturer, the most common side effects of Rilutek include:

  • Severe weakness and lack of energy
  • Nausea
  • Dizziness
  • Decreased lung function
  • Abdominal pain

Be sure to talk to your healthcare provider about any side effects that you experience. Your healthcare provider may give you treatment to help manage your symptoms.

Severe Side Effects

Rilutek can also cause severe adverse effects, although these are not common. 

Severe side effects of Rilutek can include:

  • Liver damage: Symptoms include nausea, vomiting, yellowish discoloration of the skin and eyes, dark urine. 
  • Neutropenia: Low blood cells can cause frequent infections. 
  • Interstitial lung disease: Can cause shortness of breath, fatigue, coughing up phlegm or blood.

Get prompt medical attention if you experience any of these side effects because they can be dangerous.

Long-Term Side Effects

If you stop taking Rilutek, you should expect to stop experiencing the medication side effects within a few weeks. However, severe liver damage or lung damage may be irreversible.

Report Side Effects

Rilutek may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Rilutek Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (film, suspension, tablets):
    • For ALS:
      • Adults—50 milligrams (mg) (10 milliliters [mL]) 2 times a day (every 12 hours).
      • Children—Use and dose must be determined by your doctor.

Modifications

Take Rilutek as prescribed by your healthcare provider. Ask your healthcare provider or pharmacist for tips on how to manage taking your medicine.

Missed Dose

If you miss a dose of Rilutek, take it as soon as you can. If it's almost time for your next dose, skip the dose that you missed and go back to your normal medication schedule. Avoid doubling up on doses.

Overdose: What Happens If I Take Too Much Rilutek?

This medication can cause adverse effects if you take too much. 

Effects of an overdose may include:

  • Drowsiness 
  • Memory loss 
  • Methemoglobinemia (increased hemoglobin in the blood) can cause dizziness, headaches, nausea, or shortness of breath 
  • Acute encephalopathy (rapid brain dysfunction) possibly with behavioral changes, confusion, or seizures
  • Coma

There is no specific treatment for managing an overdose, and your healthcare providers would monitor you until the effects of overdose wear off. You may need urgent treatment for symptoms of an overdose.

Overdose: What Happens If I Take Too Much Rilutek?

If you think you or someone else may have overdosed on Rilutek, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Rilutek, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Check with your doctor right away if you have a rash, stomach pain, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Riluzole can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection or if you have a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Check with your doctor right away if you start having breathing problems, dry cough, chest pain, fever, or chills. These could be symptoms of a serious lung problem.

Tell your doctor if you have Japanese ancestry. You may need a lower dose of this medicine to avoid unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Rilutek?

In studies of pregnant animals, riluzole caused developmental toxicity (it damaged the fetus). Speak with your healthcare provider if you are or intend to become pregnant.

In studies of nursing animals, riluzole was detected in the milk. Serious adverse effects could happen to infants exposed to riluzole. Speak with your healthcare provider if you are or intend to breastfeed.

Rilutek should not be used in patients with severe liver disease.

What Other Medications Interact With Rilutek?

This medication can interact with several medications.

Interactions include:

  • Strong to moderate CYP1A2 inhibitors: These medications include ciprofloxacin, enoxacin, fluvoxamine, methoxsalen, mexiletine, oral contraceptives, thiabendazole, vemurafenib, zileuton, and more. Taking them with Rilutek can increase the risk of Rilutek side effects.
  • Medications that can harm the liver: These include allopurinol, methyldopa, sulfasalazine, and more. When taken with Rilutek, there is an increased risk of liver damage.

What Medications Are Similar?

Riluzole is available as Tiglutik in a liquid form, as well as Exservan, an oral disintegrating form. These formulations are approved for treating ALS. 

Radicava (edaravone) is another medication that is used for treatment of ALS, and it can be taken with Rilutek or other forms of riluzole. Like Rilutek, Radicava is considered neuroprotective. However, Radicava works differently than Rilutek. It is an antioxidant that is believed to prevent nerve cell damage. Radicava is administered over the course of an hour intravenously (IV) through a vein. It is taken every day for approximately two weeks, with a two-week break in between, for a total of 10 cycles.

Frequently Asked Questions

  • What is Rilutek used for?

    Rilutek is indicated for chronic treatment of amyotrophic lateral sclerosis (ALS). It is also prescribed off label for treatment of spinal cord injury, Alzheimer’s disease, and bipolar depression.

  • How does Rilutek work?

    This medication prevents nerve damage by interfering with glutamate release from nerves.

  • What drugs should not be taken with Rilutek?

    Medications that have a risk of liver damage can be dangerous when taken with Rilutek. Discuss the risks and benefits with your healthcare provider and pharmacist.

  • How long does it take for Rilutek to work?

    The effects of Rilutek on the body take months to reach a stage of being measurable.

  • What are the side effects of Rilutek?

    This medication can cause a number of common side effects, including nausea, dizziness, abdominal pain, and lung problems. Severe side effects of Rilutek include liver damage, lung disease, and neutropenia (low blood cells).

  • How to stop taking Rilutek?

    Don’t stop taking Rilutek on your own. You should follow your healthcare provider’s instructions when it’s time to stop taking this medication.

How to Stay Healthy While Taking Rilutek

Rilutek is used for treating ALS and other serious neurological or psychiatric conditions. Follow instructions carefully and don’t skip your doses. 

Important considerations when taking Rilutek:

  • You will have blood tests that measure serum aminotransferases (a liver function test) before and during your treatment. 
  • Watch for signs of liver disease (yellow skin and eyes, nausea, vomiting) and contact your healthcare provider if you experience any of these. 
  • Make sure that you are getting adequate nutrition because ALS can cause difficulty eating. 
  • Participate in physical therapy and respiratory therapy to help your body function the best it can. 
  • Get help for managing your day-to-day activities. 
  • Consider joining a support group for people who are living with ALS.
  • Seek psychological support for managing your emotions and expectations of living with ALS.


Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Centers for Disease Control and Prevention. Prevalence of ALS.

  3. Food and Drug Administration. Rilutek label.

  4. Nguyen A, Chow DS, Wu L, et al. Longitudinal impact of acute spinal cord injury on clinical pharmacokinetics of riluzole, a potential neuroprotective agent. J Clin Pharmacol. 2021;61(9):1232-1242. doi:10.1002/jcph.1876

  5. Park LT, Lener MS, Hopkins M, et al. A double-blind, placebo-controlled, pilot study of riluzole monotherapy for acute bipolar depression. J Clin Psychopharmacol. 2017;37(3):355-358. doi:10.1097/JCP.0000000000000693

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  7. Food and Drug Administration. Exservan label.