Nourianz vs. Xadago

Nourianz (istradefylline) and Xadago (safinamide) are indicated as adjunctive treatments to levodopa/carbidopa in adult patients with Parkinson's disease experiencing "off" episodes.

Nourianz and Xadago belong to different drug classes. Nourianz is an adenosine receptor antagonist and Xadago is a monoamine oxidase type B (MAO-B) inhibitor.

Side effects of Nourianz and Xadago that are similar include involuntary muscle movements, dizziness (including dizziness on standing), nausea, and sleep problems (insomnia).

Side effects of Nourianz that are different from Xadago include constipation and hallucinations.

Side effects of Xadago that are different from Nourianz include falls, anxiety, cough, indigestion, high blood pressure, and falling asleep during daily activities.

Both Nourianz and Xadago may interact with St. John's wort.

Nourianz may also interact with itraconazole, ketoconazole, clarithromycin, rifampin, midazolam, atorvastatin, seizure medications, and digoxin.

Xadago may also interact with other MAO inhibitors, isoniazid, opioids, triazolopyridine, antidepressants, cyclobenzaprine, dextromethorphan, sympathomimetics, tyramine, substrates of breast cancer resistance protein (BCRP), antipsychotics, and metoclopramide.

Nourianz may also interact with itraconazole, ketoconazole, clarithromycin, rifampin, St. John's wort, midazolam, atorvastatin, and digoxin.

Xadago may also interact with apomorphine, cholestyramine, dobutamine, epinephrine, isoniazid, isoproterenol, methyldopa, metoclopramide, papaverine, probenecid, antibiotics, blood pressure medication, antidepressants, medicines to treat psychiatric disorders, cold or allergy medicines, narcotics, sleeping pills, muscle relaxers, and anti-anxiety medications.

Common side effects of Nourianz include:

• involuntary muscle movements,
• dizziness,
• constipation,
• nausea,
• hallucinations, and
• insomnia

Common side effects of Xadago include:

• abnormal movements (dyskinesia),
• falls,
• nausea,
• insomnia,
• dizziness upon standing,
• anxiety,
• cough,
• indigestion,
• high blood pressure, or
• falling asleep during daily activities.

Nourianz (istradefylline) is an adenosine receptor antagonist indicated as adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson's disease (PD) experiencing "off" episodes.

Xadago (safinamide) is a monoamine oxidase type B (MAO-B) inhibitor indicated as adjunctive treatment to levodopa/carbidopa in patients with Parkinson's disease (PD) experiencing "off" episodes.

Nourianz may interact with itraconazole, ketoconazole, clarithromycin, carbamazepine, rifampin, phenytoin, St. John's wort, midazolam, atorvastatin, and digoxin. Nourianz is not recommended for use during pregnancy; it may harm a fetus. Women of childbearing potential are advised to use contraception during treatment with Nourianz. It is unknown if Nourianz passes into breast milk or how it would affect a nursing infant. Consult your doctor before breastfeeding.

Xadago may interact with other MAO inhibitors, isoniazid, opioids, serotonin-norepinephrine reuptake inhibitors (SNRIs), triazolopyridine, tricyclic or tetracyclic antidepressants, cyclobenzaprine, St. John's wort, dextromethorphan, sympathomimetics, tyramine, selective serotonin reuptake inhibitors (SSRIs), substrates of breast cancer resistance protein (BCRP), antipsychotics, or metoclopramide. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plant to become pregnant before using Xadago; it may harm a fetus. It is unknown if Xadago passes into breast milk. Because of the potential for adverse reactions in a nursing infant, breastfeeding while using Xadago is not recommended.

The recommended dosage of Nourianz is 20 mg orally once daily. The dosage may be increased to a maximum of 40 mg once daily.

The initial dose of Xadago is 50 mg administered orally once daily at the same time of day; after two weeks, the dose may be increased to 100 mg once daily, based on individual need and tolerability.