Xadago (safinamide)

What is Xadago?

Xadago is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to treat Parkinson’s disease (PD) in adults. PD is a condition that affects the nervous system.

Xadago is approved for use in adults who have a sudden return of PD symptoms while taking levodopa/carbidopa, another medication commonly prescribed for PD. This sudden return of symptoms is known as an “off period.”

Off periods occur when the effects of levodopa/carbidopa wear off between doses. Xadago can help reduce both the symptoms of off periods and the length of time off periods last.

Drug details

Xadago contains the active drug safinamide, which belongs to a drug class called monoamine oxidase-B inhibitors. A drug class is a group of medications that work in a similar way.

Xadago comes as a tablet that you swallow. You’ll likely take this medication once per day.

Xadago comes in two strengths: 50 milligrams (mg) and 100 mg.

FDA approval

Xadago (safinamide) was approved by the FDA in 2017.

Effectiveness

For information about the effectiveness of Xadago, see the “Xadago for Parkinson’s disease” section below.

Xadago generic

Xadago is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Xadago side effects

Xadago can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Xadago. These lists do not include all possible side effects.

For more information about the possible side effects of Xadago, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Xadago, you can do so through MedWatch.

It’s also important to note that Xadago is only FDA-approved when taken with levodopa/carbidopa, which is another drug taken to treat Parkinson’s disease (PD). So keep in mind that the side effects of taking Xadago by itself aren’t known. All the side effects in the lists below were reported in adults who were also taking levodopa/carbidopa to treat their PD.

Mild side effects

Mild side effects* that have been reported with Xadago include:

• nausea
• insomnia (trouble sleeping)†

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Xadago. To learn about other mild side effects, talk with your doctor or pharmacist, or view Xadago’s patient information.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Xadago aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms that have been reported with Xadago use include:

• Hypertension (high blood pressure).*
• Problems related to sleep.*
• Dyskinesia (uncontrolled and sudden body movements).*
• Serotonin syndrome (high levels of serotonin, which is a brain chemical).† Symptoms can include:
  • confusion
  • excess sweating
  • dilated pupils
  • blood pressure changes
  • fast heartbeat
  • muscle spasms or stiffness
  • diarrhea
  • very high fever
• Hallucinations (seeing or hearing something that’s not really there) or psychosis (loss of contact with reality).
• Allergic reaction.*
• Unusual urges, such as excessive gambling, spending, or binge eating.
• Increased risk of falling.
• Vision problems due to changes in your retina (layer of tissue at the back of your eyes).

* For more information about this side effect, see “Side effect details” below.
† This side effect is more likely to occur in people who are also taking certain antidepressants, decongestants, or pain medications.

Side effect details

Learn some details about certain side effects this drug may cause.

Hypertension

Xadago can cause hypertension (high blood pressure) in some people. This side effect was seen in clinical studies of the drug.

Hypertension typically doesn’t cause any symptoms. But very high blood pressure can cause symptoms, such as:

• severe headache
• blurry vision
• confusion
• trouble breathing
• severe anxiety
• nausea or vomiting

If these symptoms occur, you should call your doctor or seek emergency medical care as soon as possible.

Talk with your doctor about a plan for monitoring your blood pressure while taking Xadago. Your doctor may recommend taking your blood pressure with a home monitor. This is especially important if you already take medications to treat hypertension.

If your blood pressure increases while you’re taking Xadago, talk with your doctor. They may want to discuss changes to your treatment plan.

Taking certain medications with Xadago may raise your risk for this side effect. For more information, see the “Xadago interactions” section below. To learn about how often this side effect occurred in clinical studies, see Xadago’s prescribing information.

If you have questions about your risk for hypertension with Xadago, talk with your doctor or pharmacist.

Dyskinesia

Dyskinesia can occur with Xadago use. With dyskinesia, you have sudden muscle movements that you can’t control. New or worsened dyskinesia was a common side effect in people who took Xadago in clinical studies.

It’s important to note that Xadago is FDA-approved to treat Parkinson’s disease along with another drug: levodopa/carbidopa. Dyskinesia is also a very common side effect of levodopa/carbidopa.

If you were already experiencing dyskinesia from taking levodopa/carbidopa before starting Xadago, adding Xadago to your treatment plan could worsen this side effect. Your dyskinesia may become more severe or may occur more often.

Common dyskinesia symptoms may include:

• tremor (shaking) in your hands or feet
• sudden jerky movements of your arms, legs, head, or face
• head bobbing
• fidgeting
• swaying or rocking

If you notice new or more severe involuntary movements after starting Xadago, talk with your doctor. They may lower your dosage of levodopa/carbidopa. (But you shouldn’t stop or change your dose unless your doctor recommends it.)

Rarely in the clinical studies, dyskinesia as a side effect was severe enough that some people stopped using Xadago because of it.

For more details about how often this side effect occurred in clinical studies, see Xadago’s prescribing information. If you have questions about your risk for dyskinesia with Xadago, talk with your doctor or pharmacist.

Problems related to sleep

Some people using Xadago may experience sleep problems. This was a common side effect reported in clinical studies of Xadago. These sleep problems were mild in some people and severe in others. Examples of sleep problems include:

• insomnia (trouble falling asleep or staying asleep)
• sleepiness, including falling asleep during daily activities

Insomnia

Insomnia was a common side effect in people who took Xadago in clinical studies. With insomnia, you may have trouble falling asleep or staying asleep.

For some people, insomnia is mild or occasional. Developing good sleep hygiene is usually helpful in these cases. Sleep hygiene refers to habits that help your body get better sleep. A few examples of healthy sleep hygiene habits include the following:

• Wake up and go to bed around the same time each day, including weekends. This helps your body get into a consistent routine.
• Avoid having caffeine later in the day, as it can keep you awake.
• Engage in relaxing activities for about 30 to 60 minutes before bedtime. Try making these activities screen-free, as blue light from mobile devices can contribute to sleep problems. Some ideas for your pre-bedtime routine include taking a warm bath or shower or listening to soothing music.

If these tips don’t help your insomnia, talk with your doctor. They may suggest ways to relieve this side effect or recommend changes to your treatment plan.

Sleepiness

Xadago may cause sleepiness in some people. It’s been reported that people taking Xadago may suddenly fall asleep during their daily activities. Reports have included falling asleep while having conversations, eating a meal, and while driving. This has led to automobile accidents in some cases.

In a clinical study, sudden sleepiness occurred in some people taking a daily dosage of 100 milligrams (mg) of Xadago. It isn’t known how often this side effect occurred in the study.

It’s possible that your risk for falling asleep during daily activities may be higher if you take other medications with Xadago that cause drowsiness. For more information, see the “Xadago interactions” section below.

You may not notice any warning signs before feeling suddenly sleepy. For this reason, it may not be safe for you to drive during your Xadago treatment.

If you notice sudden sleepiness or that you are falling asleep during routine activities after starting this drug, talk with your doctor. They may advise you to stop driving, or they may make changes to your treatment plan.

If you have questions about sleepiness with Xadago, talk with your doctor. They’ll discuss the risks and benefits of this medication with you.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Xadago. It isn’t known how often allergic reactions occur with this drug. Symptoms of a mild allergic reaction can include:

• rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, gums, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Xadago, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Xadago cost

As with all medications, the cost of Xadago can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Xadago. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

Before approving coverage for Xadago, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Xadago, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Xadago, or if you need help understanding your insurance coverage, help is available.

Supernus Pharmaceuticals Inc., the manufacturer of Xadago, offers a savings program that may lower the cost of its drug. For more information and to find out if you’re eligible for support, call 888-4XADAGO (888-492-3246) or visit the program website.

Mail-order pharmacies

Xadago may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Xadago, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Xadago is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Xadago dosage

The Xadago dosage that your doctor prescribes may depend on several factors. These include:

• other medical conditions you may have, including liver disease
• other medications that you take

Typically, your doctor will start you taking a low dosage. Then they may increase your Xadago dosage to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Xadago comes as a tablet that you take by mouth. It comes in two strengths: 50 milligrams (mg) and 100 mg.

Dosage for Parkinson’s disease

Your doctor will likely have you start by taking one 50-mg tablet of Xadago once daily. Then you and your doctor will see how well the medication works and whether you have any side effects.

If you have no issues after 2 weeks of taking Xadago, your doctor may increase your dosage to 100 mg taken once daily.

If you have liver problems, such as hepatitis, your doctor may not increase your dose above 50 mg per day.

What if I miss a dose?

If you miss a dose, just skip the missed dose and take Xadago at your usual time the next day. You shouldn’t take two doses at once to make up for a missed dose. Doing so could raise your risk for serious side effects.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

Will I need to use this drug long term?

Xadago is meant to be used as a long-term treatment. If you and your doctor determine that Xadago is safe and effective for you, you’ll likely take it long term.

Xadago for Parkinson’s disease

The Food and Drug Administration (FDA) approves prescription drugs such as Xadago to treat certain conditions. Xadago is FDA-approved to treat Parkinson’s disease (PD) in adults.

About PD

PD is a neurological condition that affects your muscle control, movements, and balance. The most noticeable symptom is usually a tremor (shaking) in one hand or foot. PD usually affects older adults, and symptoms can get worse over time.

It causes tremors (shaking) that you can’t control, usually in the hands or feet. Over time, PD can also cause symptoms not related to movement. Some examples include urination problems, constipation, depression, and dementia.

There’s currently no cure for PD, but treatments can help ease symptoms and slow the disease’s progression.

One of the most effective medications used to treat PD is levodopa/carbidopa. It can greatly reduce your PD symptoms.

But a common problem with levodopa/carbidopa is that this medication can become less effective over time. As PD worsens, the effects of levodopa/carbidopa can wear off between doses. As the medication wears off, you can experience “off” periods. During an off period, you may have a sudden return of PD symptoms.

Symptoms that may worsen during off periods include:

• muscle stiffness or cramping
• tremor (shaking)
• trouble moving
• trouble speaking
• loss of facial expressions

Effectiveness for Parkinson’s disease

Xadago contains the active drug safinamide. This drug has been shown to be effective in clinical studies for reducing off periods of PD in people who are also taking levodopa/carbidopa.

For more details on how Xadago performed in clinical studies, read this patient brochure.

It’s important to note that Xadago isn’t approved for use as a single treatment for PD. It’s only been tested in people who are also taking levodopa/carbidopa to treat PD. It isn’t known if Xadago is effective if it’s taken as monotherapy (by itself, with no other drugs) to reduce PD symptoms.

Xadago and children

Xadago isn’t approved for use in children. Parkinson’s disease doesn’t affect children, so this drug hasn’t been studied in that age group.

Xadago use with other drugs

Xadago is approved by the Food and Drug Administration (FDA) to treat Parkinson’s disease (PD) in adults who have a sudden return of PD symptoms while taking levodopa/carbidopa. (This sudden return of symptoms is called an “off period.”)

Xadago is not approved for use by itself. It’s only used with levodopa/carbidopa.

About levodopa/carbidopa

Levodopa/carbidopa is a common medication prescribed for PD. It can greatly reduce your PD symptoms. Brand-name versions of levodopa/carbidopa include Atamet, Parcopa, Rytary, Sinemet, and Sinemet CR.

A problem with levodopa/carbidopa is that this medication can become less effective with long-term use. And because PD worsens over time, the effects of levodopa/carbidopa can wear off between doses. As the medication wears off, you can experience off periods.

During off episodes, your tremor and other PD symptoms can often be at their worst. Xadago is prescribed as an adjunct (add-on) treatment to levodopa/carbidopa. It helps reduce the symptoms of off periods in people with PD.

Alternatives to Xadago

Other drugs are available that can treat Parkinson’s disease (PD). Some may be a better fit for you than others. If you’re interested in finding an alternative to Xadago, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug approved by the Food and Drug Administration (FDA) is used for a purpose other than what it’s approved for.

Examples of other drugs that may be used to treat “off periods” of PD include:

• apomorphine (Apokyn)
• inhaled levodopa (Inbrija)
• istradefylline (Nourianz)
• opicapone (Ongentys)

Examples of other drugs that may be used to treat symptoms of PD include:

• amantadine (Gocovri)
• benztropine (Cogentin)
• entacapone (Comtan)
• levodopa/carbidopa*
• pramipexole (Mirapex)
• rasagiline (Azilect)
• ropinirole (Requip)
• rotigotine (Neupro)
• selegiline
• tolcapone (Tasmar)

Your doctor will discuss the best treatment options with you. They may adjust your treatment plan over time. This may depend on how well the medications help your symptoms and if you develop any bothersome or serious side effects.

* For more information, see the “Xadago use with other drugs” section above.

Xadago and alcohol

Drinking alcohol is not recommended during your Xadago treatment.

Some alcoholic beverages can interact with Xadago. This interaction can be dangerous and may lead to a sudden, severe increase in your blood pressure.

In addition to this interaction, alcohol could worsen certain side effects of Xadago, including:

• sleepiness
• increased risk of falling
• nausea
• unusual urges, such as excessive gambling, spending, or binge eating

Alcohol may also worsen some symptoms of Parkinson’s disease. If you have questions about alcohol use with your condition, talk with your doctor.

Xadago interactions

Xadago can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Xadago and other medications

Below is a list of medications that can interact with Xadago. This list does not contain all drugs that may interact with Xadago.

Before taking Xadago, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Types of drugs that you should not take with Xadago include:

• Other monoamine oxidase inhibitors (MAOIs). Xadago is an MAOI. Taking more than one MAOI could cause serotonin syndrome or a hypertensive crisis (a sudden and dangerous increase in blood pressure). Examples of other MAOIs include:
  • linezolid (Zyvox)
  • phenelzine (Nardil)
• Opioid drugs. Opioids are strong pain medications. These drugs can cause drowsiness and could raise your risk for falling asleep while doing daily activities during your Xadago treatment. Examples of opioids include:
  • meperidine (Demerol)
  • methadone
  • tramadol (Ultram)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs are prescription medications used to treat depression or anxiety disorders. Taking Xadago with SNRIs could raise your risk for a life threatening condition called serotonin syndrome. Some common SNRIs include:
  • desvenlafaxine (Pristiq)
  • duloxetine (Cymbalta)
  • venlafaxine (Effexor XR)
• Cyclobenzaprine (Flexeril), a muscle relaxer. Taking this drug with Xadago could raise your risk for serotonin syndrome.
• Certain antidepressants that raise your level of serotonin. Taking these drugs with Xadago could raise your risk for serotonin syndrome. Examples of these antidepressants include:
  • amitriptyline (Elavil)
  • mirtazapine (Remeron)
  • nortriptyline (Pamelor)
  • trazodone (Desyrel)
• Certain stimulants prescribed for attention deficit hyperactivity disorder (ADHD). Taking these drugs with Xadago could increase your risk for serotonin syndrome. Examples of these stimulants include:
  • amphetamine (Adderall)
  • methylphenidate (Ritalin)
• Dextromethorphan (Delsym). Dextromethorphan is a cough suppressant found in several prescription and over-the-counter cold medications. Taking Xadago with dextromethorphan may raise your risk for episodes of psychosis (loss of touch with reality) or other unusual behavior.

Types of drugs that can cause an interaction with Xadago include:

• Selective serotonin reuptake inhibitors (SSRIs). SSRIs are prescription medications used to treat depression or anxiety disorders. If you’re taking an SSRI, your doctor will monitor you for serotonin syndrome while you’re taking Xadago. Examples of common SSRIs include:
  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)
  • sertraline (Zoloft)
• Certain eye and nasal decongestants that can raise your blood pressure. Using these drugs with Xadago could cause your blood pressure to increase too much. Some examples of nasal decongestants include:
  • phenylephrine (Neo-Synephrine, Sudafed PE, Altafrin)
  • pseudoephedrine (Sudafed)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Xadago and herbs and supplements

If you’re taking Xadago, you shouldn’t use St. John’s wort. St. John’s wort is an herbal supplement that some people take for depression. It’s thought to work similarly to an antidepressant and may increase your levels of serotonin. Using St. John’s wort with Xadago could raise your risk for serotonin syndrome, a serious condition that can be life threatening.

It’s possible that other herbs or supplements could interact with Xadago. So it’s important to always check with your doctor or pharmacist before using any herbs or supplements during your Xadago treatment.

Xadago and foods

During your Xadago treatment, you should avoid certain foods that are high in a substance called tyramine. This is because Xadago interacts with tyramine. This interaction could cause hypertensive crisis (a sudden and dangerous increase in blood pressure).

To avoid this interaction, you shouldn’t eat foods that contain more than 150 milligrams (mg) of tyramine while taking Xadago. Tyramine-rich foods usually include foods that are aged, fermented, smoked, cured, or pickled. Here are a few examples:

• aged cheeses
• pickled herring
• overripe fruits
• sauerkraut

For more examples of high-tyramine foods, see this article. If you accidentally eat a tyramine-rich food, call your doctor right away. They may advise you to seek emergency medical care to monitor you for, or treat, high blood pressure.

How to take Xadago

You should take Xadago according to your doctor’s or a healthcare professional’s instructions.

Xadago comes as a tablet that you take by mouth.

When to take

You’ll take Xadago once daily. It’s recommended to take your dose at the same time each day. There’s no best time of day to take this medication. But it’s important to take it at the same time each day to keep a consistent level of the drug in your body.

Consider pairing your daily dose of Xadago with something in your regular routine. For example, you could take it every morning after you eat breakfast.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

Taking Xadago with food

You can choose to take your Xadago dose with or without food.

During your Xadago treatment you should avoid certain foods that are high in a substance called tyramine. This is because Xadago interacts with tyramine. This interaction could cause hypertensive crisis (a sudden and dangerous increase in blood pressure).

For more details about foods to avoid with Xadago, see the “Xadago interactions” section above.

Can Xadago be crushed, split, or chewed?

Xadago comes as a tablet that you take by mouth. The manufacturer of Xadago hasn’t stated whether the tablets can be crushed, split, or chewed. If you have trouble swallowing tablets, talk with your doctor or pharmacist.

How Xadago works

Parkinson’s disease (PD) is thought to occur due to damage to brain cells that produce dopamine. Dopamine is a substance that sends messages between your brain and your body. Dopamine levels affect many brain functions, including muscle control, memory, and mood.

When dopamine levels drop, PD symptoms can develop. Symptoms often begin with a tremor (shaking) in one hand or foot. The disease tends to get worse over time, and tremors can spread to other areas. Over time, PD can also cause symptoms not related to movement. Some examples include urination problems, constipation, depression, and dementia.

Xadago contains the active drug safinamide. Safinamide works by blocking the action of an enzyme called monoamine oxidase (MAO). This enzyme breaks down certain brain chemicals, including dopamine.

When MAO is blocked, the levels of dopamine in the brain increase. Raised dopamine levels are thought to ease the movement-related symptoms of PD.

How long does it take to work?

In clinical studies of Xadago, some people reported improved movement within 2 to 4 weeks of starting treatment.

If you’ve been taking Xadago for more than a month and haven’t noticed any improvement, talk with your doctor. They may want you to give the medication more time to work. Or they may recommend changes to your treatment plan.

Xadago and pregnancy

It isn’t known if it’s safe to take Xadago while pregnant. This drug hasn’t been studied during pregnancy.

When Xadago was given to pregnant animals in studies, harmful effects were observed in the fetuses. Animal studies don’t always reflect what can happen in humans. But based on the available information, your doctor may suggest a different treatment for you if you’re pregnant.

If you’re pregnant or planning a pregnancy, talk with your doctor before using Xadago.

Xadago and birth control

It’s not known if Xadago is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Xadago.

For more information about taking Xadago during pregnancy, see the “Xadago and pregnancy” section above.

Xadago and breastfeeding

It’s not known if it’s safe to breastfeed while using Xadago. This is because it’s unknown whether Xadago passes into breast milk or if the drug could affect a child who is breastfed. If you’re currently breastfeeding or plan to breastfeed, talk with your doctor before using Xadago.

Common questions about Xadago

Here are answers to some frequently asked questions about Xadago.

Can I take Xadago if I have liver problems?

It depends on how severe your condition is. If you have severe liver disease, you shouldn’t take Xadago. If you have mild or moderate liver disease, your doctor may prescribe Xadago for you. But you’ll likely take a lower dosage.

If you currently have liver problems or have had them in the past, talk with your doctor. They’ll likely check your liver function with a blood test before starting your Xadago treatment. They’ll decide if Xadago is safe for you based on the results of your liver function test. If you do use Xadago, your doctor will monitor your liver with follow-up blood tests during your treatment.

Do I need to have lab tests or other health assessments done while I’m taking Xadago?

Possibly. Your doctor will likely suggest that you get your eyes checked more often during your Xadago treatment.

This is because in animal studies of long-term Xadago use, damage to animals’ retinas were observed. (Your retinas are the back layer of your eyes, and retina damage can cause vision loss.)

It’s important to note that retina damage hasn’t been reported in humans who took Xadago, and animal studies don’t always predict what will happen in humans.

If you notice any vision changes during your Xadago treatment, talk with your doctor. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

In addition, if you have a history of liver problems, you may need to have liver function tests during your treatment. To learn more, see the “Can I take Xadago if I have liver problems?” question above.

Does Xadago cure Parkinson’s disease?

No, Xadago doesn’t cure Parkinson’s disease (PD). There’s currently no cure for PD.

Xadago can help reduce both the symptoms of “off periods”* and the length of time off periods last in people using levodopa/carbidopa for PD.

If you have questions about what to expect from your Xadago treatment, talk with your doctor.

* During an off period, you may have a sudden return of PD symptoms.

Xadago precautions

Before taking Xadago, talk with your doctor about your health history. Xadago may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Hypertension. Xadago can cause hypertension (high blood pressure). If you already have hypertension, taking Xadago could worsen your condition. Before using Xadago, talk with your doctor about your hypertension. They may monitor your blood pressure more closely during your treatment. Or they may recommend that you monitor your blood pressure yourself at home. If your blood pressure increases while you’re taking Xadago, your doctor may suggest changes to your treatment plan.
• Dyskinesia. Xadago may cause dyskinesia (uncontrolled and sudden body movements) in some people. If you already have dyskinesia, taking Xadago may make the condition worse. If you notice your dyskinesia worsening after starting Xadago, talk with your doctor. They may recommend changes to your treatment plan, such as adjusting your dosage of levodopa/carbidopa (a drug that’s used with Xadago).
• Liver problems. If you’ve had any conditions that affect your liver, such as hepatitis, be sure to tell your doctor before taking Xadago. This medication isn’t safe for people with severe liver damage. If you have less-severe liver damage, your doctor may suggest a lower dosage of Xadago for you. And if so, your doctor will monitor your liver function with blood tests during your Xadago treatment.
• Allergic reaction. If you’ve had an allergic reaction to Xadago or any of its ingredients, you shouldn’t take Xadago. Ask your doctor what other medications are better options for you.
• Pregnancy. It’s unknown whether Xadago is safe to use during pregnancy. For more information, see the “Xadago and pregnancy” section above.
• Breastfeeding. It’s unknown whether Xadago is safe to use while breastfeeding. For more information, see the “Xadago and breastfeeding” section above.

Note: For more information about the potential negative effects of Xadago, see the “Xadago side effects” section above.

Xadago overdose

Using more than the recommended dosage of Xadago can lead to serious side effects.

Do not use more Xadago than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Xadago

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Xadago withdrawal and dependence

There haven’t been studies on whether Xadago can cause drug dependence.

To avoid withdrawal symptoms, it’s important that you don’t stop taking Xadago suddenly. (You should always talk with your doctor before stopping any prescribed medication.) If you and your doctor decide that it’s best for you to stop using Xadago, your doctor will taper (slowly reduce) your dose. This tapering is usually done over a period of at least 1 week.

Examples of withdrawal symptoms that could occur from suddenly stopping Xadago include:

• high fever
• confusion
• muscle stiffness
• blood pressure changes

If you have questions about safely stopping your Xadago treatment, talk with your doctor.