Safinamid Teva: Uses, Dosage & Side Effects
A generic selective, reversible MAO-B inhibitor used as add-on therapy to levodopa for the treatment of mid-to-late stage Parkinson’s disease with motor fluctuations
Safinamid Teva is a generic prescription medicine containing safinamide 50 mg as its active ingredient. It belongs to the class of selective and reversible monoamine oxidase type B (MAO-B) inhibitors and is used as add-on treatment to levodopa in adults with Parkinson’s disease who experience motor fluctuations. As a generic equivalent to the originator medicine Xadago, Safinamid Teva delivers the same therapeutic action – increasing dopamine availability in the brain and modulating glutamate release – to help extend “on” time and reduce “off” periods. It is taken once daily as a film-coated tablet and requires a prescription from a qualified healthcare professional.
Quick Facts: Safinamid Teva
Key Takeaways
- Safinamid Teva is a generic version of Xadago containing safinamide 50 mg; both medicines deliver the same therapeutic effect as selective, reversible MAO-B inhibitors in Parkinson’s disease.
- It is used exclusively as an add-on therapy to a stable dose of levodopa (alone or with other anti-Parkinson medications) in adults with mid-to-late stage disease experiencing “on-off” motor fluctuations.
- Safinamid Teva must never be combined with other MAO inhibitors (selegiline, rasagiline, moclobemide, phenelzine, isocarboxazid, tranylcypromine) or with pethidine; a 7-day washout is required between discontinuation and starting these drugs.
- The recommended starting dose is 50 mg once daily; the dose may be increased to 100 mg once daily based on clinical response (using a different strength formulation), while patients with moderate hepatic impairment must not exceed 50 mg daily.
- Patients with certain retinal conditions (including albinism, retinal degeneration, uveitis, inherited retinopathy, or severe progressive diabetic retinopathy) must not take Safinamid Teva due to potential risk of retinal damage.
What Is Safinamid Teva and What Is It Used For?
Safinamid Teva is a generic medicinal product manufactured by Teva Pharmaceutical Industries, one of the largest generic pharmaceutical companies in the world. It contains the active substance safinamide, which belongs to a class of medications known as monoamine oxidase type B (MAO-B) inhibitors. As a generic medicine, Safinamid Teva is bioequivalent to the originator brand Xadago – meaning it contains the same active ingredient at the same strength, has been demonstrated to be absorbed and distributed in the body in the same way, and produces the same therapeutic effect. Generic medicines typically become available after the patent and regulatory exclusivity periods on the originator product expire, and they generally offer the same clinical benefits at a lower cost.
Parkinson’s disease is a progressive neurodegenerative disorder characterized by the gradual loss of dopamine-producing neurons in the substantia nigra, a region deep within the brain that plays a critical role in coordinating voluntary movement. As dopamine levels decline, patients develop the cardinal motor symptoms of the disease: a tremor that is typically present at rest, bradykinesia (slowness of movement), muscular rigidity, and postural instability. Non-motor symptoms such as sleep disturbance, cognitive changes, mood disorders, and autonomic dysfunction are also common and can significantly affect quality of life.
Levodopa remains the most effective symptomatic treatment for Parkinson’s disease because it is converted to dopamine in the brain and directly replaces what is being lost. However, as the disease progresses and dopaminergic neurons continue to degenerate, the body’s capacity to buffer the fluctuating levels of levodopa diminishes. Patients increasingly experience motor fluctuations – periods where levodopa’s effect wears off (“off” periods with poor mobility and symptom re-emergence) alternating with periods of good symptom control (“on” periods). Some patients also develop dyskinesia: involuntary, often writhing movements that appear when dopamine levels in the brain are at their peak.
Safinamide works through a distinctive dual mechanism of action that differentiates it from other MAO-B inhibitors. Its primary action is the highly selective and reversible inhibition of MAO-B, the enzyme responsible for the metabolic breakdown of dopamine in the brain. By blocking this enzyme, safinamide reduces dopamine degradation and increases its availability in the striatum, thereby enhancing and smoothing out the effect of levodopa. Unlike selegiline and rasagiline, which are irreversible MAO-B inhibitors, safinamide’s inhibition of MAO-B is reversible – meaning that enzyme function recovers once the drug is cleared from the body.
The secondary mechanism involves state-dependent blockade of voltage-gated sodium channels. At therapeutic doses, safinamide selectively blocks sodium channels in their inactivated state, which inhibits pathological glutamate release from overactive neurons. Excessive glutamatergic activity has been implicated in both the pathophysiology of Parkinson’s disease and the development of levodopa-induced dyskinesia. This anti-glutamatergic action may contribute to the clinical benefit of safinamide in managing motor complications without worsening troublesome dyskinesia – a potential advantage over purely dopaminergic add-on therapies.
Safinamid Teva is indicated for the treatment of adult patients with idiopathic Parkinson’s disease as add-on therapy to a stable dose of levodopa, either alone or in combination with other anti-Parkinson medications, in mid-to-late stage fluctuating patients. The clinical evidence supporting this indication comes from pivotal randomized controlled trials of safinamide (SETTLE and Study 016/018), which demonstrated significantly increased daily “on” time without troublesome dyskinesia and reduced “off” time compared with placebo when added to optimized levodopa therapy.
A generic medicine contains the same active ingredient, at the same dose, in the same dosage form, and is intended for the same route of administration as the originator brand. Before approval, generics must demonstrate bioequivalence to the reference product through pharmacokinetic studies. Safinamid Teva is therapeutically equivalent to Xadago and can be used interchangeably under medical supervision. The excipients (inactive ingredients) and tablet appearance may differ, but the clinical effect is the same.
Unlike other MAO-B inhibitors, safinamide combines dopaminergic enhancement (through MAO-B inhibition) with non-dopaminergic glutamate modulation (through sodium channel blockade). This dual approach may help control motor symptoms while potentially reducing the risk of worsening levodopa-induced dyskinesia, offering a differentiated therapeutic profile for patients with motor fluctuations.
What Should You Know Before Taking Safinamid Teva?
Before starting treatment with Safinamid Teva, your doctor will review your full medical history and current medications to confirm the medicine is appropriate and safe for you. Because safinamide interacts with several medications and can pose risks to patients with specific comorbidities, a careful pre-treatment evaluation is essential. Inform your prescriber of every prescription medicine, over-the-counter product, herbal supplement, and recreational substance you use.
Contraindications
There are several important situations in which Safinamid Teva must not be used. Understanding these absolute contraindications is essential for patient safety and for preventing potentially serious or life-threatening adverse reactions.
- Hypersensitivity: Do not take Safinamid Teva if you are allergic to safinamide or to any of the excipients used in the film-coated tablets. Excipients may include microcrystalline cellulose, crospovidone, magnesium stearate, colloidal anhydrous silica, hypromellose, and coating agents – the exact list is detailed in the patient information leaflet provided with your pack.
- Other MAO inhibitors: You must not take Safinamid Teva if you are currently using any other monoamine oxidase inhibitor, including selegiline, rasagiline, moclobemide, phenelzine, isocarboxazid, or tranylcypromine (whether prescribed for Parkinson’s disease, depression, or any other condition). A washout period of at least 7 days is required after stopping Safinamid Teva before starting any MAO inhibitor, and vice versa.
- Pethidine (meperidine): Concurrent use of pethidine, a potent opioid analgesic, is strictly contraindicated due to the risk of serotonin syndrome and other serious adverse reactions. A 7-day washout between discontinuation of safinamide and initiation of pethidine is required.
- Severe hepatic impairment: Safinamid Teva must not be used in patients with severe liver disease (Child-Pugh Class C), as safinamide is extensively metabolized in the liver and its clearance is significantly reduced in these patients. Drug accumulation in the body could increase the risk of adverse effects.
- Retinal conditions: Patients with eye conditions that pose a risk of potential retinal damage must not take Safinamid Teva. These include albinism (lack of pigment in the skin and eyes), retinal degeneration (progressive cell loss from the light-sensitive layer at the back of the eye), uveitis (inflammation inside the eye), inherited retinopathy (hereditary eye diseases), or severe progressive diabetic retinopathy (progressive vision loss caused by diabetes). This precaution is based on animal studies showing retinal changes at high doses.
Combining Safinamid Teva with another MAO inhibitor can lead to a hypertensive crisis (dangerously high blood pressure) or serotonin syndrome – a potentially life-threatening condition characterized by confusion, high blood pressure, muscle rigidity, fever, and agitation. You must wait at least 7 days after stopping Safinamid Teva before starting any other MAO inhibitor or pethidine, and the same washout period applies in the reverse direction.
Warnings and Precautions
Before and during treatment with Safinamid Teva, speak to your doctor if any of the following apply to you:
- Liver problems: If you have any degree of hepatic impairment, your doctor should be informed before starting treatment. Patients with moderate hepatic impairment (Child-Pugh Class B) should not exceed 50 mg per day. Regular liver function monitoring may be recommended, and if your liver function deteriorates while on treatment the dose may need to be reduced or the medicine discontinued.
- Impulse control disorders: Patients and caregivers should be aware that compulsive behaviors have been reported with dopaminergic medications used in Parkinson’s disease. These may include pathological gambling, increased sexual urges, hypersexuality, compulsive spending or buying, binge eating, and obsessive-compulsive behaviors. If you or your caregiver notice any of these changes, inform your doctor promptly, as dose adjustment or treatment discontinuation may be necessary. Patients with a personal or family history of such disorders should be monitored particularly carefully.
- Involuntary movements (dyskinesia): Dyskinesia may occur or worsen when Safinamid Teva is taken together with levodopa. Your doctor may need to adjust the dose of levodopa or other Parkinson’s medications to manage these movements. It is unusual for the dose of safinamide itself to require adjustment purely because of dyskinesia.
- Serotonin syndrome: Although safinamide is a selective MAO-B inhibitor, caution is advised when combining it with serotonergic drugs (selective serotonin reuptake inhibitors, serotonin-noradrenaline reuptake inhibitors, tricyclic antidepressants, or dextromethorphan). Watch for symptoms such as confusion, agitation, rapid heartbeat, high blood pressure, hyperthermia, muscle rigidity, and myoclonus.
- Sudden sleep onset: Dopaminergic therapies, including safinamide when used with levodopa, may be associated with somnolence and rarely with sudden onset of sleep during activities of daily living. Caution is advised when driving or operating machinery.
- Eye health: Although the retinal risk signal was identified in animal models, periodic ophthalmological examination may be advisable in patients with pre-existing macular or retinal conditions who start safinamide.
Pregnancy and Breastfeeding
Safinamid Teva should not be used during pregnancy. There are limited data on the use of safinamide in pregnant women, and animal studies are insufficient to rule out potential harm to the developing fetus, including reproductive toxicity. Women of childbearing potential must use effective contraception during treatment and for a period afterwards as advised by their doctor. If you are pregnant, think you may be pregnant, or are planning to become pregnant, speak with your doctor before using this medicine so that alternative treatment options can be considered.
Safinamide is likely excreted in breast milk based on its pharmacological properties and its physicochemical characteristics. A risk to the breastfed infant cannot be excluded. Therefore, Safinamid Teva should not be used during breastfeeding. Your doctor will help you decide whether to discontinue breastfeeding or to discontinue treatment with safinamide, taking into account the benefit of therapy for you and the benefit of breastfeeding for your child.
Driving and Operating Machinery
Drowsiness and dizziness may occur during treatment with safinamide. You should exercise caution when driving, operating dangerous machinery, or performing other hazardous activities until you are reasonably certain that Safinamid Teva does not adversely affect your alertness or coordination. Parkinson’s disease itself can also impair driving ability, and the combination of the disease and its treatments may have additive effects on reaction time, attention, and visual processing. Consult your doctor before driving if you are uncertain.
Children and Adolescents
Safinamid Teva is not recommended for use in children and adolescents under 18 years of age. There are no data on the safety and efficacy of safinamide in this population, and Parkinson’s disease does not typically occur in pediatric patients.
Use in Elderly Patients
No dose adjustment is required based on age alone. However, elderly patients are often more susceptible to medication-related adverse effects, and they frequently have co-existing health conditions and concomitant medications. Safinamid Teva should be used with usual caution in this group, with particular attention to the risk of orthostatic hypotension, falls, and drug interactions.
How Does Safinamid Teva Interact with Other Drugs?
Drug interactions with Safinamid Teva fall into several categories: absolute contraindications involving serotonergic and MAO-related drugs, precautionary interactions with sympathomimetic agents and antidepressants, and pharmacokinetic interactions through drug transporter proteins. It is essential to tell your doctor and pharmacist about all medications, supplements, and herbal products you are taking before starting Safinamid Teva. Do not start any new medicine without first checking compatibility with your healthcare provider.
Major Interactions
| Interacting Drug | Effect | Clinical Significance |
|---|---|---|
| MAO inhibitors (selegiline, rasagiline, moclobemide, phenelzine, tranylcypromine) | Risk of hypertensive crisis and serotonin syndrome | Absolute contraindication – never combine; 7-day washout required |
| Pethidine (meperidine) | Risk of serotonin syndrome and severe adverse reactions | Absolute contraindication – never combine; 7-day washout required |
| Dextromethorphan (found in many cough medicines) | Potential risk of serotonergic toxicity and psychosis | Avoid combination; use alternative cough treatments |
| Ephedrine / Pseudoephedrine (decongestants) | Potential risk of elevated blood pressure | Avoid combination; use alternative decongestants |
| Tramadol, methadone, propoxyphene | Potential risk of serotonin syndrome | Avoid combination; close monitoring if essential |
Precautionary Interactions
| Interacting Drug | Effect | Clinical Significance |
|---|---|---|
| SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram, fluvoxamine) | Theoretical risk of serotonin syndrome | Use lowest effective dose; avoid fluoxetine & fluvoxamine when possible |
| SNRIs (venlafaxine, duloxetine) | Theoretical risk of serotonin syndrome | Use with caution; monitor for symptoms |
| Tricyclic antidepressants (amitriptyline, nortriptyline) | Theoretical serotonergic risk | Use with caution at low doses |
| Tyramine-rich foods (aged cheese, cured meats, fermented products) | Theoretical risk of blood pressure elevation | Dietary restriction not routinely required due to MAO-B selectivity |
| BCRP substrates (rosuvastatin, sulfasalazine, methotrexate) | Safinamide may inhibit BCRP transporter – potentially increased plasma levels | Monitor for increased drug effects; consider dose adjustment |
| Ciprofloxacin and other strong CYP3A4 inhibitors | Modest increase in safinamide exposure | Usually clinically insignificant; monitor |
Because safinamide is highly selective for MAO-B, the strict dietary tyramine restriction required with non-selective MAO inhibitors generally does not apply at recommended therapeutic doses. However, individual sensitivity varies and patients should report any symptoms such as severe headache, flushing, or palpitations after consuming tyramine-rich foods.
Minor Interactions
At therapeutic doses, safinamide has minimal interaction with most commonly prescribed medicines such as antihypertensives, oral contraceptives, proton pump inhibitors, and most antibiotics. In vitro studies have shown weak inhibition of some CYP enzymes, but these have not translated into clinically meaningful interactions in published studies. Nonetheless, always inform your prescriber and pharmacist of all medicines you take, so that individual risks can be assessed.
What Is the Correct Dosage of Safinamid Teva?
The following dosing information is based on the approved EMA and FDA labelling for safinamide. Always follow your prescriber’s instructions, which may vary based on your individual medical situation.
| Patient Group | Starting Dose | Maintenance Dose | Administration |
|---|---|---|---|
| Adults (18+) | 50 mg once daily | 50–100 mg once daily | Oral, same time each day |
| Elderly (≥65 years) | 50 mg once daily | 50–100 mg once daily | No dose adjustment based on age |
| Mild hepatic impairment (Child-Pugh A) | 50 mg once daily | Up to 100 mg once daily | Use with caution |
| Moderate hepatic impairment (Child-Pugh B) | 50 mg once daily | Maximum 50 mg once daily | Do not increase above 50 mg |
| Severe hepatic impairment (Child-Pugh C) | Contraindicated | Do not use | Not recommended |
| Renal impairment | 50 mg once daily | 50–100 mg once daily | No dose adjustment required |
| Children / adolescents (<18) | Not recommended | Not recommended | No safety/efficacy data |
Adults
Standard Adult Dosing
Treatment should begin at 50 mg of safinamide once daily. This starting dose can be increased to 100 mg once daily based on clinical response, no sooner than 2 weeks after starting. Because Safinamid Teva is currently available in 50 mg strength in this guide, increasing to 100 mg would typically require using the corresponding 100 mg strength of safinamide from the originator brand or another generic, or taking two 50 mg tablets together only if explicitly directed by the prescriber.
The tablet should be taken by mouth at approximately the same time each day, swallowed whole with a glass of water. It may be taken with or without food. Safinamid Teva is always used alongside levodopa-containing therapy (such as levodopa/carbidopa or levodopa/benserazide), which is continued at the patient’s established dose. Your doctor may adjust the dose of levodopa as safinamide’s effects become apparent.
Elderly
Patients Aged 65 Years and Over
No dose adjustment is required based on age alone. Elderly patients should start at 50 mg once daily with careful monitoring for side effects that are more common in this age group, including orthostatic hypotension, dizziness, confusion, and falls. The dose may be increased to 100 mg once daily where indicated, with the same precautions as in younger adults.
Children and Adolescents
Patients Under 18 Years
The safety and efficacy of safinamide in children and adolescents have not been established. Safinamid Teva is not recommended in this age group. Parkinson’s disease is extremely rare in children, and when it does occur, treatment should be guided by a specialist with expertise in pediatric movement disorders.
Missed Dose
If You Forget to Take Safinamid Teva
If you forget to take a dose, take it as soon as you remember on the same day. If you do not remember until the following day, skip the missed dose and take the next dose at the usual time on that day. Do not take a double dose to make up for a forgotten dose. Continued adherence to once-daily dosing is important for maintaining consistent drug levels and clinical effect.
Overdose
If You Take Too Much Safinamid Teva
If you take more Safinamid Teva than prescribed, contact your doctor or the nearest hospital emergency department immediately. Symptoms of overdose may include elevated blood pressure, orthostatic hypotension, euphoria, mood changes, hallucinations, insomnia, nausea, vomiting, dizziness, sweating, tachycardia, and possibly chest pain. There is no specific antidote; management is supportive and may include monitoring of vital signs, activated charcoal if recent ingestion, and symptomatic treatment. Bring the medicine pack to the hospital so staff can identify the product and dose.
Do not stop taking Safinamid Teva without first consulting your doctor. Abrupt discontinuation of dopaminergic therapies in Parkinson’s disease can worsen motor symptoms and, very rarely, precipitate a neuroleptic malignant syndrome-like reaction. If discontinuation is needed, your doctor will provide guidance on tapering or switching to an alternative therapy.
What Are the Side Effects of Safinamid Teva?
Like all medicines, Safinamid Teva can cause side effects, although not everybody gets them. The following list describes the adverse reactions that have been reported in clinical trials and in post-marketing surveillance of safinamide. Frequencies are defined according to the European Medicines Agency convention: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), and very rare (<1/10,000).
Very Common
- Worsening of dyskinesia (involuntary movements), particularly during initial titration or when added to optimized levodopa
Common
- Insomnia (difficulty sleeping)
- Somnolence (drowsiness) or sedation
- Dizziness or lightheadedness
- Headache
- Worsening of Parkinson’s disease symptoms
- Cataract (clouding of the lens of the eye)
- Orthostatic hypotension (drop in blood pressure on standing)
- Nausea
- Falls
- Constipation
- Dyspepsia (indigestion)
Uncommon
- Urinary tract infection
- Skin cancer (basal cell or squamous cell)
- Anaemia or low white blood cell count
- Decreased appetite, elevated blood triglycerides
- Hallucinations, compulsive behaviors (gambling, shopping, eating, hypersexuality)
- Abnormal dreams, anxiety, confusion
- Restless legs syndrome
- Blurred vision, retinal disorder, eye pain
- Palpitations, tachycardia, bradycardia, atrial fibrillation
- Hypertension, flushing, varicose veins
- Cough, dyspnea, rhinorrhea
- Dry mouth, flatulence, vomiting, abdominal pain
- Hyperhidrosis (excessive sweating), generalized itching
- Back pain, arthralgia, muscle spasm
- Increased blood creatine kinase
Rare or Very Rare
- Pneumonia, bronchospasm
- Eosinophilia
- Photophobia
- Suicidal ideation or behavior
- Hypersensitivity reactions (angioedema, urticaria, anaphylaxis)
- Serotonin syndrome (when combined with other serotonergic drugs)
- Hypertensive crisis (when combined with other MAO inhibitors)
- Hepatic enzyme elevations
When to Seek Urgent Medical Attention
Contact your doctor or seek emergency care immediately if you experience any of the following while taking Safinamid Teva:
- Signs of an allergic reaction (swelling of the face, lips, tongue, or throat; difficulty breathing; severe rash or hives)
- Signs of serotonin syndrome (confusion, agitation, rapid heartbeat, fever, sweating, shivering, muscle rigidity or twitching, seizures)
- Severe headache with high blood pressure, nausea or vomiting, chest pain, or vision changes
- Thoughts of self-harm or suicide
- Sudden vision loss or severe eye pain
- Chest pain, irregular heartbeat, or fainting
- New or worsening compulsive behaviors
Reporting Side Effects
If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in the patient information leaflet. You can also report side effects directly via your national reporting system – this is an important way to improve knowledge of medicine safety. By reporting adverse reactions, you help to ensure that medicines remain safe and effective for everyone.
How Should You Store Safinamid Teva?
Proper storage of medicines is essential to preserve their potency, safety, and quality. Safinamid Teva should be handled with the same care as any other prescription medicine.
- Temperature: Store the tablets below 30°C (86°F). Do not refrigerate or freeze the tablets unless explicitly instructed by the pharmacist. Excessive heat can degrade the active ingredient and excipients.
- Humidity: Store in a dry place away from sources of moisture such as bathrooms or kitchen sinks. The blister packaging protects against moisture but is most effective when the pack is kept in its original carton.
- Light: Keep the tablets in the original blister packaging until the moment of use to protect them from light exposure.
- Out of reach of children: Store Safinamid Teva in a location that is inaccessible to children and pets. Accidental ingestion of adult prescription medicines is a leading cause of poisoning in children.
- Expiry date: Do not use Safinamid Teva after the expiry date printed on the blister and carton. The expiry date refers to the last day of that month. Expired medicines may be less effective and occasionally harmful.
- Inspecting the tablets: Before taking a tablet, look at it. Do not use a tablet that is broken, discolored, crumbling, or otherwise damaged. Contact your pharmacy for replacement.
- Travel: When travelling, carry Safinamid Teva in your hand luggage in its original packaging along with your prescription, especially for international travel. Avoid exposing tablets to extreme temperatures (e.g. in a hot car or unheated cargo hold).
Safe Disposal
Do not throw away medicines via wastewater or household waste. Return unused or expired Safinamid Teva tablets to your pharmacy for environmentally sound disposal. Many countries operate take-back schemes that ensure medicines are incinerated at high temperatures to prevent environmental contamination and to protect wildlife and water supplies. Do not flush tablets down the toilet. These measures help to protect the environment and prevent accidental exposure.
What Does Safinamid Teva Contain?
Active Ingredient
Each film-coated tablet of Safinamid Teva 50 mg contains 50 mg of safinamide, provided as safinamide methanesulfonate (also known as safinamide mesylate). Safinamide is a chemical entity with the formula C17H19FN2O2. It is a chiral molecule, and only the pharmacologically active (S)-enantiomer is used therapeutically. In the body, safinamide is converted from its mesylate salt form and released from the tablet to act on MAO-B and voltage-gated sodium channels.
Excipients (Inactive Ingredients)
The tablet contains inactive ingredients that help with tablet formation, disintegration, stability, and appearance. Typical excipients used in safinamide film-coated tablets include:
- Tablet core: microcrystalline cellulose, crospovidone (type A), magnesium stearate, and colloidal anhydrous silica
- Film coating: hypromellose, polyethylene glycol (macrogol 6000), titanium dioxide (E171), iron oxide red (E172), and potentially mica-based pearlescent pigment (potassium aluminium silicate, E555)
The specific excipient list for Safinamid Teva may differ from the originator product and from other generic versions. Always consult the patient information leaflet in your pack for the exact list. This is particularly important if you have known allergies or intolerances to specific excipients.
Appearance and Packaging
Safinamid Teva 50 mg tablets are typically supplied as round or oval film-coated tablets, often orange to reddish in color, and sometimes embossed with a specific marking. The exact shape, color, and markings may differ between batches and countries but are detailed in the patient information leaflet supplied with your pack. The tablets are commonly provided in blister strips of aluminum-PVC or aluminum-aluminum, and the pack sizes may include 7, 14, 28, 30, 90, or 100 tablets, depending on market and prescription.
Allergen and Dietary Information
Safinamid Teva 50 mg tablets are generally considered suitable for people following most common dietary regimens. They do not contain gluten, lactose (in typical generic formulations), or animal-derived ingredients in amounts that would be relevant to most patients. However, anyone with a known allergy to safinamide or to specific excipients should carefully review the patient information leaflet. The titanium dioxide used in film coatings has been the subject of ongoing European regulatory reviews; your pharmacist can confirm the current formulation status.
Frequently Asked Questions
Safinamid Teva is a generic medicine containing safinamide 50 mg, used to treat Parkinson’s disease in adults. It is specifically prescribed as an add-on therapy to a stable dose of levodopa (alone or in combination with other Parkinson’s medications) in patients with mid-to-late stage Parkinson’s disease who experience motor fluctuations, including “on” periods (when they can move) and “off” periods (when they have difficulty moving). It is not used as a first-line, single-agent therapy for Parkinson’s disease and is not indicated for early, non-fluctuating disease.
Safinamid Teva is a generic version of the originator brand Xadago. Both medicines contain the same active ingredient (safinamide), have the same mechanism of action, the same clinical efficacy, and the same safety profile. Generic medicines must demonstrate bioequivalence to the originator product to receive regulatory approval, meaning they deliver the active ingredient to the bloodstream in the same amount and at the same rate within accepted limits. The main differences are the manufacturer, the tablet appearance (shape, color, markings), the specific excipients used in the formulation, and typically a lower price.
Yes, switching from Xadago to Safinamid Teva is generally straightforward because both contain the same active ingredient at the same strength. Your doctor or pharmacist can advise on the switch and confirm any local regulatory considerations regarding generic substitution. Because generic products must demonstrate bioequivalence, therapeutic response should remain consistent. However, notify your healthcare provider of any new symptoms, unexpected side effects, or perceived loss of efficacy after switching, as some patients may be sensitive to changes in excipients or may experience variability in absorption. Continued monitoring by your movement disorder specialist is recommended.
Safinamid Teva works through a dual mechanism of action. First, it is a highly selective and reversible inhibitor of monoamine oxidase type B (MAO-B), the enzyme responsible for breaking down dopamine in the brain. By blocking MAO-B, safinamide increases the availability of dopamine, which is deficient in Parkinson’s disease. Second, safinamide modulates glutamate release through state-dependent sodium channel blockade, an effect that may reduce pathological glutamatergic signaling implicated in motor complications, including levodopa-induced dyskinesia. This combination of dopaminergic and non-dopaminergic actions distinguishes safinamide from other MAO-B inhibitors.
Caution is needed when combining Safinamid Teva with certain antidepressants. SSRIs (such as fluoxetine or fluvoxamine) and SNRIs (such as venlafaxine) should be used with care and at the lowest effective dose due to the theoretical risk of serotonin syndrome. Fluoxetine and fluvoxamine are generally avoided when alternatives exist. Tricyclic antidepressants may be used with caution at low doses. However, other MAO inhibitors such as selegiline, rasagiline, moclobemide, or tranylcypromine must NOT be taken with Safinamid Teva – this combination is strictly contraindicated. Always consult your doctor before combining any antidepressant with this medicine, and watch for symptoms of serotonin syndrome such as agitation, tremor, sweating, or rapid heartbeat.
The most common side effects of Safinamid Teva (affecting up to 1 in 10 patients) include insomnia, dyskinesia (involuntary movements), drowsiness, dizziness, headache, worsening of Parkinson’s symptoms, cataract (clouding of the eye lens), orthostatic hypotension (drop in blood pressure on standing), nausea, falls, and constipation. Most adverse effects are mild to moderate in intensity and may settle as your body adjusts to the medicine. Very common (in more than 1 in 10 patients) is worsening of dyskinesia, particularly during the first weeks of treatment or when safinamide is added to an already optimized levodopa regimen.
Yes, impulse control disorders have been reported with Parkinson’s disease medications, including when used alongside safinamide. These may include compulsive gambling, increased sexual urges, hypersexuality, compulsive spending or shopping, binge eating, and obsessive behaviors. The risk appears higher in patients taking dopamine agonists, but can occur with any dopaminergic therapy. Patients and caregivers should be aware of these potential behavioral changes and report them to their doctor promptly if they occur. Early recognition allows for dose adjustment or medication change before significant harm is done to the patient’s finances, relationships, or wellbeing.
Safinamid Teva should not be used during pregnancy. Women of childbearing potential must use effective contraception while taking this medicine. Animal studies have shown reproductive toxicity at high doses, and data in humans are limited. The drug is likely excreted in breast milk, so breastfeeding is not recommended during treatment and for a short period afterward as advised by your doctor. If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor before taking Safinamid Teva so that alternative treatment options can be considered.
Because safinamide is highly selective for MAO-B at therapeutic doses, the strict dietary tyramine restrictions required with non-selective MAO inhibitors generally do not apply. You do not usually need to avoid aged cheeses, cured meats, or fermented foods. However, individual sensitivity varies, and you should contact your doctor if you experience severe headache, flushing, sweating, or palpitations after eating tyramine-rich foods. No special diet is otherwise required. Safinamid Teva can be taken with or without food.
If you forget to take a dose of Safinamid Teva, take it as soon as you remember on the same day. If you do not remember until the following day, skip the missed dose and take the next dose at the usual time on that day. Do not take a double dose to make up for a missed one, as this could increase the risk of side effects. Set a daily reminder, use a pill organizer, or link dosing to a routine activity (such as breakfast) to improve adherence and keep your dopamine levels stable.
References
- European Medicines Agency (EMA). Xadago (safinamide) – Summary of Product Characteristics. EMA, 2025. Available at: https://www.ema.europa.eu/
- U.S. Food and Drug Administration (FDA). Xadago (safinamide) – Prescribing Information. FDA Center for Drug Evaluation and Research, 2024.
- Borgohain R, Szasz J, Stanzione P, et al. Two-year, randomized, controlled study of safinamide as add-on to levodopa in mid to late Parkinson’s disease. Movement Disorders. 2014;29(10):1273-1280. DOI: 10.1002/mds.25961
- Schapira AH, Fox SH, Hauser RA, et al. Assessment of safety and efficacy of safinamide as a levodopa adjunct in patients with Parkinson disease and motor fluctuations: a randomized clinical trial. JAMA Neurology. 2017;74(2):216-224. DOI: 10.1001/jamaneurol.2016.4467
- Fox SH, Katzenschlager R, Lim SY, et al. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson’s disease. Movement Disorders. 2018;33(8):1248-1266.
- Cattaneo C, La Ferla R, Bonizzoni E, Sardina M. Long-term effects of safinamide on dyskinesia in mid- to late-stage Parkinson’s disease: a post-hoc analysis. Journal of Parkinson’s Disease. 2015;5(3):475-481.
- National Institute for Health and Care Excellence (NICE). Parkinson’s disease in adults (NG71). NICE Guideline, London, 2017 (last updated 2024).
- Joint Formulary Committee. British National Formulary (BNF). London: BMJ Group and Pharmaceutical Press; current edition. Available at: https://bnf.nice.org.uk/
- World Health Organization. ATC/DDD Index 2025 – N04BD03 Safinamide. WHO Collaborating Centre for Drug Statistics Methodology. Available at: https://www.whocc.no/atc_ddd_index/
- Muller T. Pharmacokinetics and pharmacodynamic evaluation of safinamide for the treatment of Parkinson’s disease. Expert Opinion on Drug Metabolism & Toxicology. 2017;13(6):693-699.
- Bianchi MLE, Riboldazzi G, Mauri M, Versino M. Efficacy of safinamide on non-motor symptoms in a cohort of patients affected by idiopathic Parkinson’s disease. Neurological Sciences. 2019;40(2):275-279.
About Our Medical Team
This article was written and reviewed by iMedic’s medical editorial team according to our editorial standards. All content is based on peer-reviewed evidence and current clinical guidelines from the European Medicines Agency (EMA), U.S. Food and Drug Administration (FDA), Movement Disorder Society (MDS), and National Institute for Health and Care Excellence (NICE).
Medical Review Board
Board-certified specialists in neurology, movement disorders, and clinical pharmacology with extensive experience in Parkinson’s disease management.
Editorial Process
All medicine articles undergo rigorous peer review, fact-checking, and annual updates to reflect the latest clinical evidence and regulatory changes.
Evidence Framework
We use the GRADE evidence framework and prioritize systematic reviews, meta-analyses, and randomized controlled trials (Evidence Level 1A).
Conflicts of Interest
iMedic has no financial relationships with pharmaceutical manufacturers. We do not accept sponsorship, advertising, or funding from drug companies.
Last medical review: December 29, 2025 | Next scheduled review: December 2026
Questions or concerns about this article? Contact our medical team.