{"id":59182,"date":"2024-02-28T05:45:17","date_gmt":"2024-02-28T05:45:17","guid":{"rendered":"https:\/\/medsname.com\/xafinact\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"xafinact","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/xafinact\/","title":{"rendered":"Xafinact"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Xafinact<\/strong> je peror\u00e1ln\u00ed safinamid<\/strong> (50 mg nebo 100 mg) tableta \u2014 selektivn\u00ed inhibitor monoaminooxid\u00e1zy typu B (MAO-B)<\/strong> pou\u017e\u00edvan\u00e1 k l\u00e9\u010db\u011b Parkinsonova choroba<\/strong>. Blokov\u00e1n\u00edm MAO-B v mozku zpomaluje rozklad dopaminu a prodlu\u017euje dobu, po kterou levodopa \u00fa\u010dinkuje mezi d\u00e1vkami (sni\u017euje \u201coff\u201d \u010das). Safinamid nav\u00edc p\u0159in\u00e1\u0161\u00ed glutam\u00e1t-moduluj\u00edc\u00ed \u00fa\u010dinek<\/strong> nad r\u00e1mec inhibice MAO-B \u2014 blokuje nap\u011b\u0165ov\u011b z\u00e1visl\u00e9 sod\u00edkov\u00e9 kan\u00e1ly a sni\u017euje stimulovan\u00e9 uvol\u0148ov\u00e1n\u00ed glutam\u00e1tu v baz\u00e1ln\u00edch gangli\u00edch. Schv\u00e1len pouze jako dopl\u0148kov\u00e1 l\u00e9\u010dba k levodop\u011b<\/strong>, nikoli jako monoterapie. \u010cast\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: nespavost, bolest hlavy, dyskineze, sucho v \u00fastech, ortostatick\u00e1 hypotenze. Vyhn\u011bte se kombinaci s v\u011bt\u0161inou antidepresiv (SSRI, SNRI, TCA), opioidy jako je petidin a tramadol, a dextromethorfanem \u2014 riziko. D\u016fle\u017eit\u00e9:<\/strong> Co je Xafinact? serotoninov\u00fd syndrom<\/em>.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Xafinact jsou peror\u00e1ln\u00ed tablety obsahuj\u00edc\u00ed<\/h2>\n

safinamid 50 mg nebo 100 mg . Safinamid je selektivn\u00ed<\/strong>. p\u016fvodn\u011b uveden\u00fd jako inhibitor monoaminooxid\u00e1zy typu B (MAO-B)<\/strong> Xadago . Xafinact je vyr\u00e1b\u011bn ve v\u00fdrobn\u00edm za\u0159\u00edzen\u00ed certifikovan\u00e9m WHO-GMP a je bioekvivalentn\u00ed origin\u00e1ln\u00ed zna\u010dce ve stejn\u00e9 s\u00edle.<\/strong>. Safinamid je nejnov\u011bj\u0161\u00ed inhibitor MAO-B (schv\u00e1len\u00fd EMA v roce 2015 a FDA v roce 2017). Jeho du\u00e1ln\u00ed mechanismus \u2014 reverzibiln\u00ed inhibice MAO-B.<\/p>\n

Safinamide is the newest MAO-B inhibitor (approved by the EMA in 2015 and FDA in 2017). Its dual mechanism \u2014 reversible MAO-B inhibition plus<\/em> modulaci sod\u00edkov\u00fdch kan\u00e1l\u016f a glutam\u00e1tu \u2014 byl speci\u00e1ln\u011b navr\u017een pro \u0159e\u0161en\u00ed levodopa-indukovan\u00e9 dyskineze a fenom\u00e9nu wearing-off u pacient\u016f s kol\u00edsav\u00fdm pr\u016fb\u011bhem Parkinsonovy choroby. Na rozd\u00edl od selegilinu a rasagilinu je schv\u00e1len pouze jako dopln\u011bk k levodop\u011b<\/strong>, nikdy jako monoterapie.<\/p>\n

Jak funguje p\u0159\u00edpravek Xafinact (safinamid)?<\/h2>\n

Safinamid p\u016fsob\u00ed prost\u0159ednictv\u00edm dvou paraleln\u00edch mechanism\u016f. Dopaminergn\u00ed \u00fa\u010dinek<\/strong> \u2014 reverzibiln\u00ed, vysoce selektivn\u00ed inhibice MAO-B \u2014 zvy\u0161uje hladinu dopaminu v mozku a prodlu\u017euje \u00fa\u010dinek ka\u017ed\u00e9 d\u00e1vky levodopy. Nedopaminergn\u00ed \u00fa\u010dinek<\/strong> \u2014 blok\u00e1da nap\u011b\u0165ov\u011b z\u00e1visl\u00fdch sod\u00edkov\u00fdch kan\u00e1l\u016f a sn\u00ed\u017een\u00e9 uvol\u0148ov\u00e1n\u00ed stimulovan\u00e9ho glutam\u00e1tu \u2014 tlum\u00ed abnorm\u00e1ln\u00ed glutam\u00e1tergn\u00ed signalizaci v baz\u00e1ln\u00edch gangli\u00edch, kter\u00e1 p\u0159isp\u00edv\u00e1 k levodopou indukovan\u00e9 dyskineze<\/em>. Tato kombinace vysv\u011btluje, pro\u010d safinamid redukuje dyskinezi, zat\u00edmco v\u011bt\u0161ina ostatn\u00edch dopaminergn\u00edch l\u00e1tek by ji zhor\u0161ila.<\/p>\n

Srovn\u00e1n\u00ed inhibitor\u016f MAO-B<\/h2>\n

T\u0159i inhibitory MAO-B pou\u017e\u00edvan\u00e9 u Parkinsonovy choroby \u2014 selegilin, rasagilin a safinamid \u2014 sd\u00edlej\u00ed spole\u010dn\u00fd mechanismus \u00fa\u010dinku, ale v\u00fdznamn\u011b se li\u0161\u00ed v metabolitech, d\u00e1vkov\u00e1n\u00ed a klinick\u00e9m vyu\u017eit\u00ed:<\/p>\n\n\n\n\n\n\n\n\n\n
Vlastnost<\/th>\nSelegilin<\/th>\nRasagilin<\/th>\nSafinamid<\/th>\n<\/tr>\n<\/thead>\n
Typick\u00e1 d\u00e1vka<\/td>\n5\u201310 mg\/den<\/td>\n0,5\u20131 mg\/den<\/td>\n50\u2013100 mg\/den<\/td>\n<\/tr>\n
Aktivn\u00ed metabolity<\/td>\nAmphetamin + methamphetamin<\/td>\nAminoindan (neamfetaminov\u00fd)<\/td>\n\u017d\u00e1dn\u00fd stimula\u010dn\u00ed metabolit<\/td>\n<\/tr>\n
\u00da\u010dinek na glutam\u00e1t<\/td>\nNe<\/td>\nNe<\/td>\nAno<\/strong> \u2014 modulace sod\u00edkov\u00fdch kan\u00e1l\u016f\/uvol\u0148ov\u00e1n\u00ed glutam\u00e1tu<\/td>\n<\/tr>\n
Indikace<\/td>\nMonoterapie nebo dopln\u011bk<\/td>\nMonoterapie nebo dopln\u011bk<\/td>\nPouze jako dopln\u011bk<\/strong> \u2014 pro kol\u00edsav\u00fd pr\u016fb\u011bh Parkinsonovy choroby p\u0159i l\u00e9\u010db\u011b levodopou<\/td>\n<\/tr>\n
Riziko nespavosti<\/td>\nVy\u0161\u0161\u00ed (metabolity amfetaminu)<\/td>\nN\u00edzk\u00e1<\/td>\nN\u00edzk\u00e1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Pro koho je Xafinact ur\u010den?<\/h2>\n

Xafinact je vhodn\u00fd pro dosp\u011bl\u00e9 s pokro\u010dil\u00fdm stadiem Parkinsonovy choroby na stabiln\u00ed terapii levodopou, u kter\u00fdch se vyskytuj\u00ed motorick\u00e9 fluktuace (tzv. wearing-off efekt). Je ne<\/strong> schv\u00e1len pro \u010dasnou monoterapii \u2014 rasagilin nebo selegilin jsou vhodn\u00e9 inhibitory MAO-B pro tuto indikaci. Pacienti s t\u011b\u017ek\u00fdm po\u0161kozen\u00edm jater, o\u010dn\u00edm onemocn\u011bn\u00edm (zejm\u00e9na albinismem, retinitis pigmentosa, degenerac\u00ed s\u00edtnice, t\u011b\u017ekou diabetickou retinopati\u00ed nebo uveitidou) by safinamid u\u017e\u00edvat nem\u011bli.<\/p>\n

D\u00e1vkov\u00e1n\u00ed a pod\u00e1v\u00e1n\u00ed<\/h2>\n

Standardn\u00ed re\u017eim je 50 mg jednou denn\u011b po dobu 2 t\u00fddn\u016f<\/strong> jako po\u010d\u00e1te\u010dn\u00ed d\u00e1vka, pot\u00e9 zv\u00fd\u0161ena na 100 mg jednou denn\u011b<\/strong> pokud je dob\u0159e sn\u00e1\u0161en. Vy\u0161\u0161\u00ed d\u00e1vky nep\u0159in\u00e1\u0161ej\u00ed benefit; nad 100 mg\/den se ztr\u00e1c\u00ed selektivita k MAO-B. U\u017e\u00edvejte r\u00e1no s j\u00eddlem nebo nala\u010dno. Lze kombinovat s jak\u00fdmkoli standardn\u00edm re\u017eimem levodopy; d\u00e1vka levodopy m\u016f\u017ee vy\u017eadovat m\u00edrn\u00e9 sn\u00ed\u017een\u00ed (10\u201330 %), pokud se zhor\u0161\u00ed dyskineze.<\/p>\n\n\n\n\n\n\n\n
F\u00e1ze<\/th>\nD\u00e1vka<\/th>\n<\/tr>\n<\/thead>\n
T\u00fddny 1\u20132<\/td>\n50 mg jednou denn\u011b, r\u00e1no<\/td>\n<\/tr>\n
Udr\u017eovac\u00ed d\u00e1vka (pokud 50 mg nesta\u010d\u00ed)<\/td>\n100 mg jednou denn\u011b<\/td>\n<\/tr>\n
T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed<\/td>\nVyhnout se<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\u26a0 Tyramin a \u201cs\u00fdrov\u00fd efekt\u201d<\/strong> P\u0159i standardn\u00edch d\u00e1vk\u00e1ch selektivn\u00edch k MAO-B nen\u00ed obvykle nutn\u00e1 dietn\u00ed restrikce tyraminu. ne<\/em> Nutn\u00e9. Selektivita MAO-B je v\u0161ak z\u00e1visl\u00e1 na d\u00e1vce \u2014 selegilin nad 10 mg\/den, rasagilin nad 1 mg\/den a safinamid nad 100 mg\/den ztr\u00e1cej\u00ed selektivitu a inhibuj\u00ed tak\u00e9 perifern\u00ed MAO-A. P\u0159i t\u011bchto d\u00e1vk\u00e1ch mohou potraviny bohat\u00e9 na tyramin (zraj\u00edc\u00ed s\u00fdry, uzen\u00e9 maso, bobovit\u00e9 rostliny, fermentovan\u00e1 s\u00f3ja, to\u010den\u00e9 pivo) vyvolat hypertenzn\u00ed krizi. Dodr\u017eujte p\u0159edepsan\u00e9 d\u00e1vkov\u00e1n\u00ed, abyste se tomuto riziku vyhnuli.<\/div>\n

B\u011b\u017en\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n

Dyskineze (paradoxn\u00ed \u010dasn\u00fd \u00fa\u010dinek \u2014 safinamid zpo\u010d\u00e1tku zesiluje \u00fa\u010dinek levodopy, tak\u017ee dyskineze se mohou zv\u00fd\u0161it<\/em> v prvn\u00edch t\u00fddnech p\u0159ed ust\u00e1len\u00edm), nevolnost, nespavost, ortostatick\u00e1 hypotenze, riziko p\u00e1d\u016f. M\u00e9n\u011b \u010dast\u00e9: vizu\u00e1ln\u00ed halucinace, \u00fazkost, \u00fabytek hmotnosti. Retin\u00e1ln\u00ed toxicita<\/strong> byla probl\u00e9mem v pokusech na zv\u00ed\u0159atech, ale u lid\u00ed nebyla pozorov\u00e1na v \u017e\u00e1dn\u00e9 v\u00fdznamn\u00e9 m\u00ed\u0159e \u2014 p\u0159esto se doporu\u010duje o\u010dn\u00ed vy\u0161et\u0159en\u00ed p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby a pravideln\u011b u pacient\u016f s p\u0159edchoz\u00edm onemocn\u011bn\u00edm s\u00edtnice.<\/p>\n

\u26a0 Serotoninov\u00fd syndrom \u2014 nebezpe\u010dn\u00e9 interakce<\/strong> Kombinace inhibitoru MAO-B se serotonergn\u00edmi l\u00e9ky m\u016f\u017ee zp\u016fsobit serotoninov\u00fd syndrom<\/em>: neklid, pocen\u00ed, t\u0159es, hyperreflexie, hore\u010dka, pr\u016fjem, v t\u011b\u017ek\u00fdch p\u0159\u00edpadech z\u00e1chvaty a smrt. Vyvarujte se:<\/strong> SSRI (fluoxetin, sertralin, paroxetin, citalopram, escitalopram), SNRI (venlafaxin, duloxetin), tricyklick\u00e1 antidepresiva (amitriptylin, imipramin), pethidin (meperidin), tramadol, dextromethorfan, methadon, t\u0159ezalka te\u010dkovan\u00e1, MDMA. Vylu\u010dovac\u00ed obdob\u00ed:<\/strong> p\u0159eru\u0161it u\u017e\u00edv\u00e1n\u00ed fluoxetinu 5 t\u00fddn\u016f p\u0159ed zah\u00e1jen\u00edm inhibitoru MAO-B; ostatn\u00ed SSRI\/SNRI p\u0159eru\u0161it alespo\u0148 2 t\u00fddny p\u0159edem; neza\u010d\u00ednat s fluoxetinem d\u0159\u00edve ne\u017e 2 t\u00fddny po ukon\u010den\u00ed inhibitoru MAO-B.<\/div>\n

Interakce s l\u00e9ky a potravinami<\/h2>\n