Levodopa - Parkinson's drug
Levodopa is one of the main drugs used to treat
Parkinson's symptoms. It can be used at
all stages of the condition.
Levodopa is a chemical building-block that your body converts
into dopamine. It replaces the
dopamine that is lost in Parkinson's.
There are branded and unbranded forms of levodopa available.
- co-beneldopa (Madopar, Madopar CR)
- co-careldopa (Caramet CR, Duodopa, Sinemet, Sinemet
Plus, Sinemet CR, Half Sinemet CR, Lecado, unbranded
- co-careldopa plus entacapone (Stalevo)
Levodopa is given with benserazide or carbidopa, to make sure it
can enter the brain more efficiently. Benserazide plus levodopa is
known as co-beneldopa. Carbidopa plus levodopa is known as
If you're having, or have had, treatment for melanoma, tell your
GP, specialist or Parkinson's nurse (if
you have one) if you're taking medication that contains
Madopar and Sinemet
Most people can take Madopar and Sinemet
without experiencing sickness or nausea.
Most people taking these drugs will experience considerable
long-term improvement, especially in stiffness and slowness of
Treatment will usually start on a low dose. This is gradually
increased until you and your GP, specialist or Parkinson's nurse
agree that your symptoms are under control.
Madopar is available in capsules, which should not be broken, or
dispersible tablets, which can be dissolved in water.
Sinemet can be taken in pill form.
Both Madopar and Sinemet come in different strengths, depending
on the dose your GP, specialist or Parkinson's nurse thinks you
Visit the Medicine Guides website for independent, up to date
information about these medicines:
From late 2012 you may notice changes to the packaging and
appearance of some Sinemet tablets. This is because of a change in
the production of the drug, and it will not affect the quality or
formulation of these tablets.
Our full news story: Changes to the
appearance of Parkinson's drug Sinemet
Controlled release Madopar and Sinemet
Controlled release preparations have the letters CR after the
These let the levodopa enter your body slowly instead of all at
once. They can increase the time between doses.
They may be used when the dose of standard levodopa starts to
wear off and the person taking it no longer feels the treatment is
Controlled release options can sometimes reduce involuntary
movements (dyskinesia). They can be taken before going to bed to
reduce stiffness during the night.
Madopar has a dispersible form that may be swallowed whole or
dissolved in water.
It takes effect more quickly because it doesn't need to be
broken down in your stomach to release the active ingredient. This
may be a good option if you have problems swallowing tablets or
Non-dispersible tablets or capsules should not be crushed and
put into water.
Duodopa is a gel that is pumped continuously through a tube that
is inserted into the intestine, where it is absorbed by the
This option is only suitable for a small number of people, whose
symptoms can’t be controlled with more common treatments.
Because it's given continuously, if you are prescribed duodopa
you are less likely to experience involuntary movements. You might
have fewer 'off' periods. And it may also help you control your
symptoms at night.
Stalevo combines levodopa with carbidopa and entacapone in
See the Stalevo
Medicine Guide for independent, up to date information about
Levodopa and protein
Taking levodopa with food can sometimes help to reduce feelings
of sickness. However, for some people, protein (found mainly in
meat, fish, eggs, cheese and beans) seems to interfere with how
well levodopa medication works, by stopping how well the drug is
absorbed by the body.
This may mean the drug is less effective if taken with, or
after, a protein-rich meal.
Some people may benefit from taking their medication at
least 30 minutes before they eat.
If this doesn't help, you may benefit from trying a protein
redistribution diet, where you take most of your daily protein in
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 you make any
changes you should speak to your your GP, specialist or Parkinson's
nurse. They can advise you on timing your dose and can help you to
get advice from a registered dietitian.
Side effects and problems with levodopa
In the early days of taking levodopa, you may feel sickness or
nausea. But in most people this is mild and will pass as your body
adjusts to the drug.
One of the main
problems with levodopa is a side effect called dyskinesia. These
are involuntary movements and can increase over time.
Over time, levodopa can become less effective. You may get 'off'
periods where you feel weak and can't move well. The effect of your
dose may wear off quickly.
Other side effects include:
Side effects of levodopa can sometimes be improved by changing
your dose, the form of the drug or how often you take it. If this
doesn't work, other types of drug may be combined with
Speak to your GP, specialist or Parkinson's nurse about the
right treatment for you.
Impulsive and compulsive behaviour
Some people taking levodopa have problems controlling impulsive
and compulsive behaviour.
More drug treatments for Parkinson's
In this section
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