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FDA Approves Xadago- From FDA Website

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FDA Approves Xadago

FDA Approves Xadago (safinamide) as an Add-On Treatment for Patients with Parkinson’s Disease

March 21, 2017 -- The U.S. Food and Drug Administration today approved Xadago (safinamide) tablets as an add-on treatment for patients with Parkinson’s disease who are currently taking levodopa/carbidopa and experiencing “off” episodes. An “off” episode is a time when a patient’s medications are not working well, causing an increase in Parkinson’s symptoms, such as tremor and difficulty walking.

“Parkinson’s is a relentless disease without a cure,” said Eric Bastings, M.D., deputy director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research. “We are committed to helping make additional treatments for Parkinson’s disease available to patients.”

An estimated 50,000 Americans are diagnosed with Parkinson’s disease each year, according to the National Institutes of Health, and about one million Americans have the condition. The neurological disorder typically occurs in people over age 60, though it can occur earlier, when cells in the brain that produce a chemical called dopamine become impaired or die. Dopamine helps transmit signals between the areas of the brain that produce smooth, purposeful movement – such as eating, writing, and shaving. Early symptoms of the disease are subtle and occur gradually. In some people, Parkinson’s disease progresses more quickly than in others.

The efficacy of Xadago in treating Parkinson’s disease was shown in a clinical trial of 645 participants who were also taking levodopa and were experiencing “off” time. Those receiving Xadago experienced more beneficial “on” time, a time when Parkinson’s symptoms are reduced, without troublesome uncontrolled involuntary movement (dyskinesia), compared to those receiving a placebo. The increase in “on” time was accompanied by a reduction in “off” time and better scores on a measure of motor function assessed during “on” time than before treatment.

In another clinical trial of 549 participants, the participants adding Xadago to their levodopa treatment had more “on” time without troublesome uncontrolled involuntary movement compared to those taking a placebo, and also had better scores on a measure of motor function assessed during “on” time than before treatment.

Certain patients should not take Xadago. These include patients who have severe liver problems, or who take a medicine used to treat a cough or cold called dextromethorphan. It also should not be taken by patients who take another medicine called a monoamine oxidase inhibitor (MAOI) because it may cause a sudden severe increase in blood pressure, or by those who take an opioid drug, St. John’s wort, certain antidepressants (such as serotonin-norepinephrine reuptake inhibitors, tricyclics, tetracyclics, and triazolopyridines), or cyclobenzaprine, because it may cause a life-threatening reaction called serotonin syndrome.

The most common adverse reactions observed in patients taking Xadago were uncontrolled involuntary movement, falls, nausea, and trouble sleeping or falling asleep (insomnia).

Serious, but less common, risks include the following: exacerbated high blood pressure (hypertension); serotonin syndrome when used with MAOIs, antidepressants, or opioid drugs; falling asleep during activities of daily living; hallucinations and psychotic behavior; problems with impulse control/compulsive behaviors; withdrawal-emergent hyperpyrexia (fever) and confusion; and retinal pathology.

The FDA granted approval of Xadago to Newron Pharmaceuticals.

Source: FDA

Posted: March 2017

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This is such good news.  I worry about when my husband reaches this stage where his Sinemet fails to work and he is freezing a lot.  What additional information can you give us about this newly approved drug?  

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Here is what else I know about Xadago (Safinamide). It is:

1- A Monoamine Oxidase type B Inhibitor (better known as an MAO-B Inhibitor).

2- The Mechanism of Action, Side Effects, Adverse Effects, and Drug Interactions resemble another MAOI-B specific Inhibitor, Azilect (Rasagiline)

3- At this point, only to be used in conjunction with Levodopa/Carbidopa therapy and has not shown to effective for single use therapy.

4- Being marketed for people with PD who are having issues with "off" periods.

5- To be taken only once a day at approximately the same time every day

6- Can be taken with or with out food. There is no food contraindication (ie. Tyramine reaction) as there is with Rasagiline or Selegiline. There is arning about consuming foods "high" in Tyramine which could result in Severe hypertension (blood pressure).

7- Comes in two strengths: 50mg and 100mg.  A patient will start on the 50mg dose and is able to increase, if need, to 100mg after 2 weeks of being on the 50mg.

8- Side effects from Most common to Least common: ( uncontrolled muscle movements (ie.Dyskensia), nausea, tiredness, increase in blood pressure, unusual urges.

9- Drug Interactions: Antidepressants listed as SNRI's, Tricyclic, or Tetracyclic, muscle relaxer Cyclobenzaprine, Amphetamine, Methylphenidate, Metoclopramide, cough suppressant Dextromethorphan, and St. John's Wort.

*Some of this information was retrieved from the Xadago website.

I hope this helps and please keep me posted.


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