Safinamide

What is Safinamide

Safinamide is a selective and reversible inhibitor of monoamine oxidase (MAO) Type B. MAO exists as two catabolic isoenzymes, MAO-A and MAO-B.

The neurotransmitters serotonin and norepinephrine are primarily catabolized by MAO-A and dopamine is primarily catabolized by MAO-B.

MAO in the gastrointestinal tract is primarily type A, and provides protection from systemic absorption of exogenous amines with vasopressor actions, such as tyramine, which can cause hypertensive crisis if absorbed intact. 

Brand Name

XADAGO

Indications

  • Parkinson’s disease

Side Effects

  • anxiety
  • cataracts
  • cough
  • drowsiness
  • dyskinesia
  • dyspepsia
  • dyspnea
  • edema
  • elevated hepatic enzymes
  • hallucinations
  • hypertension
  • hypertensive crisis
  • impulse control symptoms
  • insomnia
  • nausea
  • neuroleptic malignant syndrome-like symptoms
  • orthostatic hypotension
  • psychosis
  • rash
  • retinopathy
  • serotonin syndrome
  • sudden sleep onset

Monitoring Parameters

  • laboratory monitoring not necessary
  • LFTs

Contraindications

  • abrupt discontinuation
  • albinism
  • alcoholism
  • breast-feeding
  • cataracts
  • children
  • coadministration with other CNS depressants
  • dental work
  • diabetic retinopathy
  • driving or operating machinery
  • ethanol ingestion
  • geriatric
  • hepatic disease
  • hypertension
  • hypertensive crisis
  • impulse control symptoms
  • infants
  • MAOI therapy
  • orthostatic hypotension
  • pregnancy
  • psychosis
  • retinitis pigmentosa
  • schizophrenia
  • surgery
  • uveitis

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Alpelisib
  • Alprazolam
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amoxapine
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amphetamines
  • Anxiolytics; Sedatives; and Hypnotics
  • Aripiprazole
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • atypical antipsychotic
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Brexpiprazole
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Butabarbital
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Cenobamate
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloral Hydrate
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Citalopram
  • Clemastine
  • Clomipramine
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Cyclizine
  • Cyclobenzaprine
  • Cyproheptadine
  • Desipramine
  • Desloratadine; Pseudoephedrine
  • Desvenlafaxine
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diazepam
  • Diethylpropion
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dobutamine
  • Dopamine
  • Doxepin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Droperidol
  • Duloxetine
  • Ephedrine
  • Epinephrine
  • Escitalopram
  • Esketamine
  • Estazolam
  • Eszopiclone
  • Ethanol
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Fluvoxamine
  • food
  • Gabapentin
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydroxyzine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Pseudoephedrine
  • Iloperidone
  • Imatinib
  • Imipramine
  • Isocarboxazid
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isoproterenol
  • Lasmiditan
  • Lemborexant
  • Levocetirizine
  • Levodopa
  • Levomilnacipran
  • Linezolid
  • Lisdexamfetamine
  • Loratadine; Pseudoephedrine
  • Lorazepam
  • Loxapine
  • Lumateperone
  • Lurasidone
  • Maprotiline
  • Meclizine
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Meprobamate
  • Mesoridazine
  • Methadone
  • Methamphetamine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methohexital
  • Methotrexate
  • Methylene Blue
  • Methylphenidate
  • Metoclopramide
  • Midazolam
  • Midodrine
  • Milnacipran
  • Mitoxantrone
  • Molindone
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Naproxen; Pseudoephedrine
  • Norepinephrine
  • Nortriptyline
  • Olanzapine
  • Oxazepam
  • Ozanimod
  • Paliperidone
  • Paroxetine
  • Pentobarbital
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phendimetrazine
  • Phenelzine
  • Phenobarbital
  • Phenothiazines
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Pimozide
  • Pregabalin
  • Prilocaine; Epinephrine
  • Primidone
  • Prochlorperazine
  • Promethazine
  • Propoxyphene
  • Protriptyline
  • Pseudoephedrine
  • Quazepam
  • Quetiapine
  • Racepinephrine
  • Ramelteon
  • Rasagiline
  • Rimegepant
  • Risperidone
  • Rosuvastatin
  • Secobarbital
  • Sedating H1-blockers
  • Selective serotonin reuptake inhibitors
  • Selegiline
  • Serotonin norepinephrine reuptake inhibitors
  • Sertraline
  • Solriamfetol
  • St. John’s Wort, Hypericum perforatum
  • Sulfasalazine
  • Suvorexant
  • Talazoparib
  • Tapentadol
  • Tasimelteon
  • Temazepam
  • Tetrabenazine
  • Thiethylperazine
  • Thiopental
  • Thioridazine
  • Topotecan
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triprolidine
  • Ubrogepant
  • Valbenazine
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Zaleplon
  • Ziprasidone
  • Zolpidem