Pharm

Safinamide

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Safinamide, Xadago

  • Indications
  1. Parkinsonism (adjunctive therapy)
    1. May reduce "off" time in mid to late Parkinsonism without increasing Dyskinesia
  1. Start 50 mg orally daily
  2. May be increased to 100 mg orally daily after 2 weeks
  3. On discontinuation, taper to 50 mg orally daily for one week before stopping
  • Metabolism
  1. Hepatic metabolism
  2. Avoid in moderate to severe hepatic Impairment
  • Mechanism
  1. Reversible MAO Inhibitor (Type B)
    1. Inhibits intracerebral Dopamine metabolism
    2. Contrast with Rasagiline and Selegiline which irreversibly inhibit MAO B
  • Adverse Effects
  1. See MAO Inhibitor
  2. Retinopathy
    1. Based on animal studies
    2. Periodic Retinal Exams is recommended
  3. Skin Discoloration, Hyperbilirubinemia
    1. Seen in animal studies
  • Drug Interactions
  1. See MAO Inhibitors
  2. Risk of life threatening interactions (Hypertensive Crisis, Serotonin Syndrome)
  3. Tyramine Containing Food
    1. Significant tyramine restriction is not typically needed at typical doses of Type B MAO Inhibitors
    2. Avoid foods with high tyramine concentrations
  • References
  1. (2021) Med Lett Drugs Ther 63(1618): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 46-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia