Xadago, A Drug For Parkinson’s

Xadago is a medicine whose active substance is safinamide. This drug s It is used as a complementary therapy for the treatment of Parkinson’s disease, being used for episodes of difficulty in movement, known as off episodes .

Xadago works by increasing the level of the neurotransmitter dopamine in the brain. Dopamine is a substance that is involved in the control of movement. In Parkinson’s patients, dopamine is at lower levels than in unaffected people.

How does Xadago work?

Safinamide reversibly and specifically inhibits MAO-B. Although Xadago also has other mechanisms of action such as the following:

  • It is a calcium channel antagonist.
  • Inhibits dopamine reuptake.
  • It works as an antagonist in the release of glutamate.

This drug is the only one with a dual mechanism of action for Parkinson’s disease. For this reason, it influences the control of symptoms and motor alterations when the pathology is in the middle or advanced stages. It is in those periods that there are fluctuations of movement.

Currently there are other MAO-B inhibitors for the treatment of Parkinson’s, however, they do not have the other mechanisms of action that safinamide possesses.

What is it for?

tremors in Parkinson's

This medicine is indicated for the treatment of Parkinson’s disease as a complementary therapy. It is added at a stable dose of levodopa alone or in combination with other antiparkinson drugs .

Its ideal use is among patients who are going through middle or advanced stages of the disease, and who experience fluctuations in movement. Beyond Xadago, the pharmacological options for these people today are:

  • MAO-B inhibitors, such as selegiline or rasagiline.
  • Levodopa with a LAAD inhibitor.
  • COMT inhibitors, such as entacapone.

    How is Xadago taken?

    The recommended starting dose of Xadago is one 50 milligram tablet, however this dose can be increased up to one 100 milligram tablet once a day.

    It is not necessary to take safinamide separately from food, and its effect is experienced after two or three weeks from the start of therapy.

    When you are being treated with Xadago, you should consult a specialist before starting to take any other drug, especially if it is one of the following groups of drugs:

    • Other MAO inhibitors.
    • Influenza that contain dextromethorphan, ephedrine or pseudoephedrine.
    • Selective serotonin reuptake inhibitors (SSRIs) used for anxiety disorders. 
    • Serotonin and norepinephrine reuptake inhibitor (SNRI) drugs, used for depression.

    Possible side effects

    insomnia as a side effect of Xadago

    In several studies carried out in patients with middle or advanced stage Parkinson’s disease, taking safinamide as an adjunct to levodopa, the following side effects were observed as common:

    • Insomnia
    • Difficulty in controlling the execution of voluntary movements
    • Sleepy feeling
    • Dizziness and headache

    Uncommon adverse effects included urinary tract infections, anemia, low white blood cell count, red blood cell abnormalities, poor appetite, elevated cholesterol and blood sugar levels. There were also hallucinations and dreams with nightmares or feelings of fear.

    Finally, rare, low-frequency adverse effects may appear, such as nasal allergy, oral infections, striking weight loss, increased potassium level in the blood, disorientation situations or vision disturbances.

    A pathology of difficult approach

    Parkinson’s disease is a difficult disease to deal with. For patients, daily life is complicated, and for the health team the accessibility to the therapies that the patient really requires is a problem.

    Xadago may be a therapeutic alternative in patients with pathology that are in middle or advanced stages and that are affected by motor fluctuations. It is not used alone, but in combination with levodopa or other dopaminergics.

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