Basic Information
ID DDInter1631 and DDInter521
Interaction Coadministration of nonselective monoamine oxidase (MAO) inhibitors and sympathomimetic amines has been associated with severe hypertensive reactions. The mechanism involves a synergistic sympathomimetic effect due to enhanced norepinephrine storage in adrenergic neurons (MAOI activity) and increased liberation or decreased reuptake of catecholamines (sympathomimetic activity). Because safinamide is a selective MAO-B inhibitor, hypertensive reactions would not ordinarily be expected when used with sympathomimetic amines.
Management Coadministration of safinamide and sympathomimetic amines, such as methylphenidate, amphetamine, and their derivatives, is considered contraindicated.
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Alternative for Safinamide N04B
Ropinirole Opicapone Bromocriptine Apomorphine Tolcapone Levodopa
Entacapone Pramipexole Amantadine Rotigotine Pergolide Cabergoline
Alternative for Dexmethylphenidate N06B
Modafinil Pemoline Caffeine Citicoline Armodafinil
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.