Generic Name: safinamide

Brand Name: Xadago

Drug Class: Antiparkinson Agents, Adjunct; Antiparkinson Agents, MAO Type B Inhibitors

Safinamide

Safinamide is a prescribed medication designed for the treatment of Parkinson’s disease (PD). PD is characterized by the degeneration of nerve cells in the brain that produce dopamine, a neurotransmitter essential for various brain functions. Safinamide serves as an additional therapy, alleviating symptoms during “off” episodes when the effects of primary PD treatments diminish.

Mechanism of Action of Safinamide

This medication works by preventing the breakdown of dopamine in the brain. Safinamide selectively inhibits monoamine oxidase type B (MAOB), an enzyme responsible for breaking down dopamine. By inhibiting MAOB, safinamide helps maintain dopamine levels between doses of primary PD therapy.

Warnings and Precautions

• Contraindications: Safinamide is not suitable for those with a history of hypersensitivity reactions to safinamide or severe liver impairment.
• Drug Interactions: Concurrent use with certain medications, such as other MAO inhibitors, dextromethorphan, opioids, and serotonin-norepinephrine reuptake inhibitors, is cautioned due to potential adverse effects.
• Blood Pressure Monitoring: Safinamide may induce or exacerbate hypertension. Regular blood pressure monitoring is advised, especially when used with sympathetic nervous system stimulants.
• Impulse Control Issues: Patients may experience intense urges for gambling, spending, and other impulsive behaviors. Careful monitoring and potential dosage adjustments are recommended.

Side Effects of Safinamide

Common side effects include dyskinesia, falling, insomnia, anxiety, nausea, dyspepsia, elevated liver enzymes, hypertension, orthostatic hypotension, cough, impulse control disorders, sudden onset of sleep, and headaches. Severe symptoms like serious heart or nervous system reactions and eye issues should be reported promptly.

Safinamide Dosages

The recommended adult dose involves an initial 50 mg orally once daily, potentially increased to 100 mg after two weeks based on individual response and tolerability. Higher doses have not shown additional benefits.

Pregnancy and Breastfeeding

Safinamide’s safety during pregnancy is uncertain, and it may cause developmental toxicity. Breastfeeding while using safinamide should be decided carefully, weighing potential risks to the infant against treatment benefits.

Additional Considerations

• Adherence: Safinamide should be taken exactly as prescribed, and abrupt discontinuation is discouraged.
• Driving and Machinery Operation: Caution is advised due to the potential for sudden onset of drowsiness and sleep.
• Overdose: No specific treatment for overdose is known. Restricted intake of tyramine-containing foods is suggested for several weeks.

Conclusion

Safinamide plays a crucial role in managing Parkinson’s disease symptoms during “off” episodes. However, its usage requires careful consideration of potential interactions, side effects, and adherence to prescribed doses. Patients must promptly report any unusual symptoms or severe reactions to ensure safe and effective treatment.