Drug interactions
Safinamide + St john's wort
Severity: Contraindicated
Safinamide and St john's wort: contraindicated 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
St John's wort has serotonergic activity and weak MAO and reuptake inhibition. With safinamide it can lead to serotonin syndrome.
What this interaction means in plain words
Safinamide and St john's wort are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Serotonin reuptake inhibition from St John's wort combined with MAO inhibition increases synaptic serotonin.
What to do
Avoid the combination and advise patients to stop St John's wort before starting safinamide. Monitor for serotonin toxicity if overlap occurs.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Safinamide with St john's wort?
MediHelp rates the interaction as contraindicated. Safinamide and St john's wort are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. St John's wort has serotonergic activity and weak MAO and reuptake inhibition. With safinamide it can lead to serotonin syndrome.
How serious is the interaction between Safinamide and St john's wort?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and advise patients to stop St John's wort before starting safinamide. Monitor for serotonin toxicity if overlap occurs.
What other medicines interact with Safinamide?
MediHelp also lists interactions of Safinamide with, for example, Amitriptyline, Amoxapine, Amphetamine polistirex. The full list is on the Safinamide page.
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