Safinamide and Hydromorphone Rectal: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Safinamide
Hydromorphone Rectal
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of serotonin syndrome
Interaction Deep Dive
Concomitant use of safinamide (an MAO type B inhibitor) and an opioid is contraindicated due to the potential of life-threatening serotonin syndrome, which has been reported. Wait at least 14 days after discontinuation of safinamide before initiating an opioid1.
Why it happens (mechanism)
Additive serotonergic effects
Literature reports
1 report — tap to read
a) Cases of serotonin syndrome have been reported with the concomitant use of a MAOI (including selective MAOI type B) and opioids 1.
Common questions
Can I take Safinamide and Hydromorphone Rectal together?
Increased risk of serotonin syndrome Always confirm with your pharmacist or prescriber before making any change.
How serious is the Safinamide and Hydromorphone Rectal interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Safinamide or Hydromorphone Rectal need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XADAGO(R) oral tablets, safinamide oral tablets. US WorldMeds, LLC (per FDA), Louisville, KY, 2017. DailyMed
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