Xadago interactions: Alcohol, medications, and other factors

Before you start treatment with Xadago, tell your doctor and pharmacist which prescription, over-the-counter (OTC), and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Xadago interacts with supplements, herbs, or vitamins, see the “Xadago and other interactions” section below.)

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

Here’s a table of drugs that can interact with Xadago. Keep in mind that this table doesn’t include all drugs that may interact with Xadago. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn more about interactions with these drugs and possible alternative treatment options, see the section below called “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Xadago due to the risk of harm. These are known as contraindications. The contraindications of Xadago include:

Having severe liver problems

Doctors typically won’t prescribe Xadago for people with severe liver problems, such as severe cirrhosis. This is because Xadago is broken down by your liver. If you have severe liver problems, the drug could build up in your body. This could raise your risk of serious side effects.

If you have liver problems, talk with your doctor before taking Xadago. If the problem is severe, they’ll likely prescribe a treatment other than Xadago for your condition.

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Xadago in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI). And they typically won’t prescribe Xadago with other drugs that are MAOIs.

This is because taking Xadago with an MAOI can cause a dangerous increase in blood pressure, called a hypertensive crisis. It can also increase your risk of serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, diarrhea, nausea, or vomiting. Serotonin syndrome can be life threatening for some people.

Below are a few examples of MAOIs that can interact with Xadago:

• methylene blue (ProvayBlue)
• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Emsam, Zelapar)
• isocarboxazid (Marplan)

Before you start treatment with Xadago, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with Xadago. Likewise, after you stop taking Xadago, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Taking certain other drugs

Doctors typically won’t prescribe Xadago in combination with the following drugs:

• serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants, such as:
  • desvenlafaxine (Pristiq)
  • duloxetine (Cymbalta)
  • venlafaxine (Effexor XR)
• tricyclic and related antidepressants, such as:
  • amitriptyline
  • mirtazapine (Remeron)
  • trazodone
• stimulants for attention deficit hyperactivity disorder (ADHD), such as:
  • amphetamine (Adzenys XR-ODT)
  • amphetamine/dextroamphetamine (Adderall)
  • methylphenidate (Ritalin, others)
• the muscle relaxant cyclobenzaprine (Amrix)
• the cough suppressant dextromethorphan* (Delsym)
• opioids,* such as:
  • morphine (MS Contin, others)
  • oxycodone (OxyContin, others)
  • tramadol (Ultram, ConZip)

Taking Xadago with one of these drugs can increase your risk of serotonin syndrome (a dangerous condition caused by a buildup of serotonin in your body).

Taking Xadago with an opioid can increase your risk of suddenly falling asleep during your daily activities, which is a side effect of Xadago. Taking Xadago with a stimulant can also increase your risk of high blood pressure, which is a side effect of both drugs. And taking Xadago with dextromethorphan can increase your risk of psychosis (loss of touch with reality) or abnormal behavior.

Before you start treatment with Xadago, it’s important to tell your doctor if you take any of the drugs listed above. They may prescribe a treatment other than Xadago for your condition. Or they may have you stop taking the drug and wait at least 2 weeks before starting treatment with Xadago.

After you stop taking Xadago, your doctor will typically have you wait at least 2 weeks before starting treatment with any of the drugs listed above.

* To learn more about interactions with these drugs and possible alternative treatment options, see the section below called “Drug interactions in depth.”

Having had an allergic reaction to Xadago or any of its ingredients

If you’ve had an allergic reaction to Xadago or any of its ingredients, your doctor will likely not prescribe Xadago. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better for you.

Note: Before you start treatment with Xadago, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Xadago.

If you drink alcohol, your doctor will likely recommend that you do not drink it while taking Xadago. They’ll also usually advise you not to take any prescription or OTC drugs that contain alcohol during Xadago treatment.

Consuming alcohol while taking Xadago may cause sleepiness. It can increase your risk of suddenly falling asleep without warning during daily activities such as driving, talking, or eating. This is a serious side effect of Xadago.

Drinking certain types of alcohol with Xadago can also increase your risk of high blood pressure with Xadago. Alcoholic beverages that contain high amounts of a substance called tyramine, such as tap beers, can have this effect.

If you have concerns about avoiding alcohol while you’re taking Xadago, talk with your doctor before starting treatment.

Here’s a closer look at certain drug interactions of Xadago.

Nasal decongestants

Xadago can interact with nasal decongestants, which are used to help treat a blocked or stuffy nose.

Interaction result: Taking Xadago with nasal decongestants can increase your blood pressure. It can also raise your risk of hypertensive crisis (sudden, dangerous increase in blood pressure).

Interaction explained: Xadago and nasal decongestants can both increase your blood pressure. So taking them together could cause a bigger increase in your blood pressure.

Examples of nasal decongestant drugs: Here are some nasal decongestant drugs that may interact with Xadago:

• phenylephrine
• pseudoephedrine (Sudafed)

These nasal decongestants are ingredients in many OTC cold, flu, and allergy medications.

Steps you or your doctor may take: Be sure to check the ingredients of any cough, cold, or allergy medications you buy without a prescription before taking them with Xadago. Talk with your doctor before taking any medications that contain nasal decongestants with Xadago. If your doctor recommends taking a nasal decongestant during your treatment with Xadago, they may want to monitor your blood pressure.

Opioids

Xadago can interact with opioids, which are strong pain relievers. Some are also prescribed to treat opioid use disorder.

Interaction result: Taking Xadago with opioids can increase your risk of serotonin syndrome (a dangerous condition caused by a buildup of serotonin in your body).

Taking Xadago with an opioid can also increase your risk of suddenly falling asleep during daily activities such as driving, talking, or eating.

Interaction explained: Xadago and opioids can both increase levels of a chemical called serotonin in your body. So taking them together may make your serotonin levels too high. Opioids can also cause sleepiness, while Xadago can increase your risk of falling asleep without warning. So taking these drugs together can raise your risk of suddenly falling asleep.

Examples of opioid drugs: Here are some opioid drugs that may interact with Xadago:

• codeine
• hydrocodone (Hysingla ER)
• morphine (MS Contin, others)
• oxycodone (OxyContin, others)
• tramadol (ConZip)

Opioids can also be found in certain combination pain-relieving medications.

Steps you or your doctor may take: Your doctor will likely avoid prescribing opioid pain relievers with Xadago. If you need a pain reliever while taking Xadago, talk with your doctor about other pain relievers that may be safer options for you.

For example, while taking Xadago, it’s usually safe to take acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin).

Dextromethorphan

Xadago can interact with dextromethorphan (Delsym), which is a cough suppressant. It’s used to help relieve coughs related to colds or minor throat irritations.

Dextromethorphan is an ingredient in many OTC cough, cold, and flu medications.

Interaction result: Taking Xadago with dextromethorphan can increase your risk of serotonin syndrome (a dangerous condition caused by a buildup of serotonin in your body). It can also increase your risk of psychosis (loss of touch with reality) or abnormal behavior.

Interaction explained: Xadago and dextromethorphan can both increase levels of a chemical called serotonin in your body. So taking them together may make your serotonin levels too high.

Steps you or your doctor may take: While taking Xadago, you should not take cough, cold, or flu medications that contain dextromethorphan. Be sure to check the ingredients of OTC medications before taking them with Xadago, or ask your pharmacist for advice. You can also ask your pharmacist to recommend other cough medications that may be safer options for you.

Xadago may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Xadago.

Xadago interactions with supplements

Before you start treatment with Xadago, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Doctors will typically recommend you avoid taking tryptophan or 5-HTP supplements with Xadago. These supplements may be used to treat mood and sleep disorders, and other conditions.

Taking Xadago with tryptophan or 5-HTP can cause a chemical called serotonin to build up in your body. This can increase your risk of a dangerous condition called serotonin syndrome.

Your doctor may be able to suggest a supplement other than tryptophan or 5-HTP for your condition.

If you have questions about other interactions that may affect you, talk with your doctor or pharmacist.

Xadago interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Xadago. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

Taking St. John’s wort with Xadago can cause a chemical called serotonin to build up in your body. This can increase your risk of a dangerous condition called serotonin syndrome.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Xadago interactions with vitamins

There are no specific reports of vitamins interacting with Xadago. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Xadago.

Xadago interactions with food

Xadago may interact with foods that contain a substance called tyramine. Consuming foods that are high in tyramine during Xadago treatment may increase your risk of a hypertensive crisis (sudden, dangerous increase in blood pressure).

While taking Xadago, your doctor may recommend avoiding foods that contain more than 150 milligrams (mg) of tyramine. Examples of these foods include:

• sauerkraut
• concentrated yeast products such as spreads (Marmite, Vegemite)
• cured or smoked meats or fish
• pickled herring
• aged cheeses, such as cheddar or stilton

If you have questions about foods to avoid while taking Xadago, talk with your doctor.

Xadago interactions with vaccines

There aren’t any known interactions between Xadago and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Xadago interactions with lab tests

Xadago isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

X DRUG INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Xadago.

Using cannabis may cause sleepiness. Using cannabis while taking Xadago may increase your risk of suddenly falling asleep without warning during daily activities such as driving, talking, or eating. This is a serious side effect of Xadago.

Before you start treatment with Xadago, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Xadago. Before you take this drug, be sure to talk with your doctor about your health history. Xadago may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Xadago include:

• Liver problems: If you have liver problems, your doctor may prescribe a Xadago dosage that’s lower than usual. But if you have severe liver problems, they’ll likely not prescribe this medication. For more information, see the “When to avoid Xadago” section above.
• High blood pressure: If you have high blood pressure, taking Xadago may make it worse. Your doctor will usually monitor your blood pressure during Xadago treatment. If needed, they may adjust your dosage of Xadago or blood pressure medication.
• Dyskinesia: If you have dyskinesia (abnormal body movements you can’t control), taking Xadago can make this worse. Talk with your doctor about whether Xadago is right for you.
• Mental health condition: If you have a mental health condition, such as schizophrenia, taking Xadago may worsen your symptoms. Doctors may not prescribe Xadago if you have certain mental health conditions, because the drug could worsen your symptoms. And you may be at higher risk for new symptoms caused by Xadago, such as hallucinations.
• Eye condition: If you have an eye condition, such as diabetic eye disease, your doctor may closely monitor your vision for changes if you take Xadago. The drug caused eye-related side effects in animal studies. It’s not known if these side effects also happen in humans.
• Allergic reaction: If you’ve had an allergic reaction to Xadago or any of its ingredients, your doctor will likely not prescribe Xadago. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better for you.
• Breastfeeding: It’s not known whether it’s safe to take Xadago while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Xadago may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Xadago. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Xadago is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Xadago. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Xadago. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Xadago label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Xadago doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Xadago by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Xadago. These resources might help:

• Overview of Xadago: For a general overview of Xadago, you can see this article.
• Facts about your condition: To learn more about Parkinson’s disease, see our Parkinson’s disease hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.