[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Neuroprotective agents for ALS](https://durgical.com/en/pharmacology/classes/neuroprotective-agents-for-als/) › Riluzole

[Pharmacology](https://durgical.com/en/pharmacology/) · [Neuroprotective agents for ALS](https://durgical.com/en/pharmacology/classes/neuroprotective-agents-for-als/)

# Riluzole

The first drug shown to prolong life in ALS, by a few months. It reduces glutamate signalling; liver tests are checked.

Updated 2026-11-01

- Class: [Neuroprotective agents for ALS](https://durgical.com/en/pharmacology/classes/neuroprotective-agents-for-als/)
- Ion channel: Voltage-gated sodium channels and glutamate signalling
- ATC code: N07XX02

## Mechanism of action

Riluzole is a benzothiazole with several actions: it inhibits glutamate release, blocks NMDA- and kainate-type glutamate receptors and inhibits voltage-gated sodium channels. Reducing glutamate excitotoxicity is thought to slow motor neuron death, but the exact mechanism of benefit in ALS is unknown.

- Riluzole blocks sodium channels on nerve terminals
- Glutamate release falls; glutamate receptors are partly blocked
- Motor neurons face less excitotoxic stress
- Survival is extended by a few months

## Pharmacokinetics

**Absorption**
Absorbed by mouth; a high-fat meal lowers absorption, so it is given apart from meals

**Distribution**
Highly protein bound

**Metabolism**
Extensive liver metabolism, mainly CYP1A2, then glucuronidation

**Half-life**
About 12 hours

## Indications

- Amyotrophic lateral sclerosis [Amyotrophic lateral sclerosis →](https://durgical.com/en/conditions/amyotrophic-lateral-sclerosis/)

## Adverse effects

### Common

- Weakness and fatigue
- Nausea, diarrhoea, abdominal pain
- Dizziness and somnolence

### Serious (rare, important)

- Liver injury with raised aminotransferases
- Neutropenia (fever needs prompt review)
- Interstitial lung disease
- Severe hypersensitivity, including anaphylaxis

## Contraindications

- History of severe hypersensitivity to riluzole

## Key interactions

**Ciprofloxacin and other strong or moderate CYP1A2 inhibitors**
More riluzole adverse effects

**Strong or moderate CYP1A2 inducers**
Lower levels and possibly less effect

**Other liver-toxic drugs**
Added risk of liver injury

## What is monitored

- Serum aminotransferases before and regularly during treatment; it is stopped if liver dysfunction appears
- Blood count if fever occurs (neutropenia)
- Cough or breathlessness (interstitial lung disease)

## Administration and safety

- Given at least an hour before or two hours after a meal
- Tablets, oral suspension and oral film exist; the suspension is shaken well; the film dissolves on the tongue
- Liquid forms help patients with swallowing problems

## Nursing care

- Check that liver tests are scheduled
- Teach to report fever, jaundice, dark urine or cough
- Assess swallowing and choose the right formulation
- Explain that it slows ALS but does not reverse weakness

## Pregnancy and breastfeeding

There are no studies in pregnant women and the risk is not known.

## Memory aid

«RiLUzole for Lou Gehrig, watch the LIVER»: ALS drug with liver monitoring.

## Test yourself

Think of the answer, then tap the question to see it.

## Which disease is riluzole used for, and what benefit has it shown?

Amyotrophic lateral sclerosis; it prolongs survival by a few months.

## Which neurotransmitter does riluzole reduce?

Glutamate (it inhibits release, blocks glutamate receptors and sodium channels).

## Which laboratory tests are followed with riluzole?

Liver aminotransferases; and a blood count if fever suggests neutropenia.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/riluzole/)

## Related drugs

- [Edaravone](https://durgical.com/en/pharmacology/edaravone/)

## Related conditions

- [Amyotrophic lateral sclerosis](https://durgical.com/en/conditions/amyotrophic-lateral-sclerosis/)

[← Back to the class: Neuroprotective agents for ALS](https://durgical.com/en/pharmacology/classes/neuroprotective-agents-for-als/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - RILUZOLE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dd432c13-389e-46b3-8891-0cf1a58800ff) (DailyMed (U.S. National Library of Medicine), 2026); [Riluzole: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a696013.html) (MedlinePlus (U.S. National Library of Medicine), 2022); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/riluzole/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/riluzole/