Selective MAO-B inhibitor + glutamate modulation
Safinamide
Brand names: Xadago
Adult dose
Dose: Initial 50mg PO OD, may increase to 100mg OD
Route: PO
Frequency: OD
Clinical pearls
- Adjunct to levodopa in mid-late stage Parkinson's with motor fluctuations
- Avoid tyramine-rich foods at high doses
Contraindications
- Severe hepatic impairment
- Concurrent MAOIs
- Pethidine
- Albinism / retinopathy
- Pregnancy/breastfeeding
Side effects
- Dyskinesia
- Insomnia
- Hypertension
- Hallucinations
- Impulse control disorders
- Ophthalmic events
Interactions
- MAOIs
- Pethidine
- SSRIs (caution)
- Sympathomimetics
- Dextromethorphan
Monitoring
- BP
- Eye exam
Reference: BNF; NICE NG71; https://bnf.nice.org.uk/drugs/safinamide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS