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.
The generic drug name is levodopa. Brand names are:
- Madopar®, Madopar® CR (co-beneldopa)
- Sinemet®, Sinemet® CR, Half Sinemet® CR (co-careldopa)
- Duodopa® (co-careldopa)
- Stalevo® (co-careldopa plus entacapone)
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
co-careldopa.
If you’re having, or have had, treatment for melanoma, tell your
GP, specialist or Parkinson's nurse if
you're taking medication that contains levodopa.
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 movement.
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
need.
Visit the Medicine Guides website for independent, up to date
information about these medicines:
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 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
Controlled release Madopar and Sinemet
Controlled release preparations have the letters CR after the
drug name.
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
effective.
Controlled release options can sometimes reduce involuntary
movements (dyskinesia). They can be taken before going to bed to
reduce stiffness during the night.
Dispersible Madopar
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
capsules.
Non-dispersible tablets or capsules should not be crushed and
put into water.
Duodopa
Duodopa is a gel that is pumped continuously through a tube that
is inserted into the intestine, where it is absorbed by the
blood.
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
Stalevo combines levodopa with carbidopa and entacapone in
one tablet.
See the Stalevo
Medicine Guide for independent, up to date information about
this medicine.
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 45
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
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 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
levodopa.
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
Return to the drug treatments for
Parkinson's main page
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