Riluzole is an anti-glutamate medication manufactured by Sanofi-Aventis under the name Rilutek™. Riluzole appears to block the release of glutamate from nerve cells (neurones).
Riluzole is safe and effective for slowing disease progression to a modest degree in ALS (Miller and others 2009a). It helps people remain in the milder or moderately affected stages of the disease for longer than those not taking riluzole, if they start on the medication early in the disease progression (Miller and others 2007).
In Australia riluzole is available for eligible people at a subsidised price on the Pharmaceutical Benefits Scheme (PBS) under an authority prescription.
Miller and others 2009a
Riluzole has a modest beneficial effect in slowing disease progression (prolonged survival of 2–3 months) based on 4 Class I trials. The number needed to treat to delay 1 death until after 12 months was 11.
Chio and others 2009
Riluzole may improve mortality rate by 23% and 15% at 6 and 12 months, respectively.
Miller and others 2007
Adverse effects from riluzole are relatively minor and, for the most part, reversible after stopping the drug. The most common adverse effects are fatigue and nausea. Riluzole affects liver function and should be prescribed with care in people who have pre-existing problems with liver function.
National Institute for Health and Clinical Excellence 2001
Regular blood testing to monitor liver function (every month for three months, then every three months for a further nine months and annually thereafter) is recommended for people taking riluzole.
