Levodopa - Parkinson's drugs
Levodopa is one of the main drugs used to treat the symptoms of Parkinson's
It's a natural amino acid that the brain converts
into dopamine. It replaces the loss of
the chemical caused by Parkinson's.
The generic drug name is levodopa. Brand names are:
- Madopar (co-beneldopa®)
- Sinemet (co-careldopa®)
- Stalevo®
- Duodopa®
If you are having, or have had, treatment for melanoma, please
be sure to inform your medical team if you're taking medication
that contains levodopa.
Madopar and Sinemet
Most people can take Madopar and Sinemet without experiencing
sickness or nausea and experience considerable long term
improvement, especially in stiffness and slowness of movement.
People with Parkinson's are usually started on a low dose,
gradually increasing until they and their GP/consultant feel that
there has been a good response.
Madopar and Sinemet can be taken in pill form, either whole or
crushed and dissolved in water or added to food.
Visit the Medicine Guides website for independent, up to date
information about these medicines:
Controlled release preparations of Madopar and Sinemet
Controlled release preparations have the letters CR after the
drug name.
With controlled release preparations the time between doses
can sometimes be prolonged by 30-50%.
They may be used when the dose of standard levodopa begins to
wear off and the person taking them no longer feels the
effectiveness of the treatment.
Controlled release preparations can also be taken before going
to bed to reduce stiffness and immobility during the night.
Global shortage of Sinemet
You may be aware that there is a global shortage of the
Parkinson's drug Sinemet due to a new supply process. It is now
expected that full stock levels will not be available until some
time in 2011.
If you will be affected by this shortage, try not to worry.
There are alternatives available. We advise you to contact your GP,
neurologist or specialist Parkinson's nurse as soon as possible to
discuss the alternatives that are available.
Find out more: Shortage of Parkinson's
drug Sinemet
Take action: Campaign to end Sinemet
shortage
Dispersible Madopar
Madopar has a dispersible form that may be swallowed whole or
dissolved in water.
Absorption of the dispersible form is quicker and it can be used
to quickly control Parkinson's symptoms.
People who have difficulty swallowing tablets or capsules may
also find this beneficial.
Duodopa
Duodopa is administered directly to the upper part of the small
intestine via a permanent tube, where it is absorbed into the
blood.
Because it is administered continuously, people on this
treatment are less likely to experience unwanted involuntary
movements (dyskinesias) and some may experience fewer 'off'
periods.
It may also improve symptoms during the night (even though the
pump is turned off) in some cases.
Stalevo
Stalevo is a combination drug to treat Parkinson's, which
contains levodopa, carbidopa and entacapone in one tablet.
See the
Stalevo Medicine Guide for independent, up to date information
about this medicine.
The role of protein
In some people, protein (which is found mainly in meat, fish,
eggs, cheese, beans and pulses) seems to interfere with the
effectiveness of levodopa medication.
Protein can interfere with the absorption of levodopa from the
gut, since both levodopa and protein are made up of amino
acids.
This may result in less of the drug reaching the brain. This
means the drug may be less effective if taken with or after a
protein-rich meal.
It can be beneficial to take levodopa 45 minutes before meals,
ideally with a carbohydrate food like a cracker or biscuit.
If this doesn't help, you may benefit from trying a protein
redistribution diet, where you take most of your daily protein in
the evening.
This can help the levodopa treatment to be more effective in the
daytime, when you are likely to need it more.
As protein is essential for a healthy diet, before making any
dietary changes you should consult your GP or consultant and
preferably do this under the supervision of a registered
dietician.
Some side effects and problems of levodopa
In the early days of taking levodopa tablets, some feelings of
sickness and nausea are common. However, in most people, they are
usually mild and pass as the body adjusts to the drug.
A small percentage of people cannot tolerate these drugs at all
because of severe sickness or other side effects, such as
confusion, hallucinations, mood swings or psychological
changes.
In the longer term, the response to these drugs can become
less reliable. You may find the effect of the most recent dose
wears off before the next one is due or has begun to work.
Dyskinesias (uncontrolled voluntary movements) may also appear
in the longer term.
Side effects of levodopa can sometimes be improved by altering
the type or amount of Sinemet or Madopar, or how often the drug is
taken.
If this is not satisfactory, other types of drug can be combined
with levodopa.
Speak to your GP or consultant about the appropriate treatment
for you.
More drug treatments of Parkinson's
Return to the drug treament of
Parkinson's main page
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