Drug interactions
Escitalopram + Safinamide
Severity: Major
Escitalopram and Safinamide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Safinamide is a reversible MAO-B inhibitor, and combining it with an SSRI may increase serotonergic activity and the risk of serotonin syndrome. Labeling advises caution, and cases are uncommon at recommended doses.
What this interaction means in plain words
Escitalopram and Safinamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Escitalopram belongs to Central Nervous System; Safinamide belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from reduced monoamine breakdown by MAO-B inhibition and serotonin reuptake inhibition.
What to do
Use only if clearly needed, at the lowest effective doses, and monitor for agitation, tremor, hyperreflexia, sweating and fever. Stop one or both drugs if serotonin syndrome is suspected.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Other interactions of Safinamide
- Amitriptyline + Safinamide Contraindicated
- Amoxapine + Safinamide Contraindicated
- Amphetamine polistirex + Safinamide Contraindicated
- Clomipramine + Safinamide Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Desipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Escitalopram with Safinamide?
MediHelp rates the interaction as major. Escitalopram and Safinamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Safinamide is a reversible MAO-B inhibitor, and combining it with an SSRI may increase serotonergic activity and the risk of serotonin syndrome. Labeling advises caution, and cases are uncommon at recommended doses.
How serious is the interaction between Escitalopram and Safinamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only if clearly needed, at the lowest effective doses, and monitor for agitation, tremor, hyperreflexia, sweating and fever. Stop one or both drugs if serotonin syndrome is suspected.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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