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PD Meds and food: To eat or not to eat


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#1 OneWingedVictory

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Posted 08 April 2013 - 03:13 PM

Hello Mark

I am trying to figure out which of my PD meds should be taken with food and which without for maximum effectiveness and minimum gastric upset.

I am a YOPD person and still work. So my med regime needs to be pretty simple. Ideally I would like to get to the point where I have a generally smooth ride throughout the day. I'm not there yet, however. Sometimes I feel like a rusty old jalopy and other times I feel like a brand-new Audi A8 -- sometimes all in the same day!

I'm taking--

Neupro patch 2mg (I put it on in the morning)
Sinemet 100/25 1.5 tabs every 4 hours until bedtime (eg 7 am, 11 am, 3 pm, 7pm)
Comtan x3 a day (I take it with sinemet at 7, 11, 3)
Amantadine 100 mg twice a day (I take it at 7 and 3)
Sinemet CR 200/50 (at bedtime)

Thanks much.

OneWingedVictory
The One Winged Victory of Samothrace is a metaphor for our struggles, despite the odds, to keep steady and accept grace in the face of punishing adversity.

#2 MComes RPH

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Posted 10 April 2013 - 11:51 AM

Hopefully and easy answer.
1- sinemet- without food ( 1 hour before or 2 hours after meals)
2- amantadine- with food or milk
3- neupro and comtan- with or without food.
Hope that helps.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#3 OneWingedVictory

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Posted 10 April 2013 - 12:12 PM

Yes, thanks. Very much appreciate it!


The One Winged Victory of Samothrace is a metaphor for our struggles, despite the odds, to keep steady and accept grace in the face of punishing adversity.

#4 MComes RPH

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Posted 11 April 2013 - 11:43 PM

Any time. It was funny, ironic, somewhat chilling, that while I was reading you're "thank you," (you are welcome) I always click to the profile to get a better perspective as to whom I am giving advise to. As I was looking at you're profile I say a picture of Van Morrison popped up, and oddly enough... I was listening to Van Morrison's Greatest Hits. Very odd, but a good odd. Also a great choice of music.
Sit back, take some sinemet, throw on some Van Morrison, have a cup of tea, listen to the rain as it taps out it's own beat on the roof of my house, and watch the storm come over the lake behind my house.
Now that, my friend, is almost better than a "moon dance."
Take care and keep me updated.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#5 Island Woman

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Posted 12 April 2013 - 06:16 AM

My info from pharmacy say with food for sinemet cr...yes or no... plus another Van Morrison fan here.

Patricia

#6 Island Woman

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Posted 15 April 2013 - 06:42 AM

I just started sinemet cr 25/100 instead of regular also taking azilect...can they be taken together or stagger them? Thanks

Patricia

#7 MComes RPH

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Posted 15 April 2013 - 07:32 AM

Patricia,
Sinemet Cr- preferably empty stomach, but if it causes upset stomach, then a little bit of food (no protein!) is ok.
Also mo problem yalimg Azilect with sinemet
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#8 MComes RPH

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Posted 15 April 2013 - 07:39 AM

Pat,
No problem taking the Azilect with the sinemet. If you do experience some stomach upset, take the Azilect about 30 minutes before sinemet with some crackers or somethon
Rock on Van Morrison.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#9 Island Woman

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Posted 15 April 2013 - 08:07 AM

Thanks and a MoonDance to you...already had breakfast so I screwed up todays meds. been on the azilect for a yr. no problem...started the sinemet cr this past friday and feel worse but going to try and stick with it before making the dr. call.

Pat

#10 MComes RPH

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Posted 15 April 2013 - 08:19 AM

Pat,:PD meds are like a good dance, " They startled and go slow."
Hang in theere my friend.
Keep me updated.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#11 jbollinger

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Posted 13 June 2013 - 10:42 AM

Another question about meds, timing and food. I've been on Azilect and Ropinirole for about a year and a half. Last winter I had to start omeprazole because the meds gave me so much nausea I developed GERD. I'm currently taking the omeprazole in the morning a half hour before eating and taking AM meds when I finish eating. I've heard that taking PD meds an hour or so before or after eating is better so I wonder if I can take the omeprazole at bedtime and the AM PD meds about 30 minutes before I eat breakfast? Thanks for the information.

#12 MComes RPH

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Posted 13 June 2013 - 11:15 AM

You can try that. With a lot of people that does work if you are unable to take the meds 1 hour before or 2 hours after eating.
The omeprazole will limit the stomach acid and, when taken too close to the other meds, will slow down the breakdown of the med in the stomach.
It may lower the omeprazole effectiveness probably mid-day the next day, but depending on how bad the gerd is, it may have no affect at all.
Give it a shot and see what happens. Try it for a week. If it does nor seem to help, try to find a time around lunch, where you can take the omeprazole 30 minutes before lunch and also make sure it is seperated from the other meds by at least 1 hour prior to omep or to houta after omep.
Hope this helps.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#13 flowerlover

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Posted 31 July 2013 - 02:26 PM

Hello. Recently started Sinemet 3x/day, was told to take it at least 1/2 hr. before meals, which I've been doing, approx. every 4-4/12 hrs. Problem is that sometimes I need a mid-aft snack and I'm confused as to how to time my 3rd dose so I have an empty stomach and can still eat dinner at a reasonable hour, and now your advice to member above to take Sinemet 1 hr. before or 2 hrs. after meals has me even more confused. (Perhaps I should chane my user name to "easily confused".) Thanks for any advice you can give.

#14 MComes RPH

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Posted 04 August 2013 - 02:08 PM

When it comes to PD meds, I think we should all be given an extra 4 hours in our day so that we can take or meds and get a little extra sleep. That would be great with my beautiful "Brown Eyed" wife.
Anyway, it does seem confusing. In the "perfect world," an empty stomach is 1 hour prior to a MEAL or 2 hours after a MEAL. If you need a snack, eat it. Try not to live by your meds, I know , easier said than done.
Sinemet is best on an empty stomach, but if you really think about it, you're stomach is never really completely empty and also, most meds are absorbed in the small intestine. That is why the 1hour before or 2 hours after. That is how long yo clear the food from the small intestine. So, a little snack, with no protein, will be fine. If you notice you are starting to go "off" a bit, then take a 1/4 to 1/2 tab. Then remember that when you have that next snack to take that 1/4-1/2 tab of sinemet an enjoy the snack.
As far as AZILECT, with or without food is ok. I tell people to try it first without food, if it causes some upset stomach, then take it with some food.
My best advice is this: PD is one of the very few diseases that tells your body when it needs it's medicine. Our bodies are an amazing machine. We listen to it when we are hungry, we listen when we are thirsty, we listen when we are tired, so, I guess we are lucky to have a disease that tells us when we need our medicine. So let's not ignore it. Let's listen to that too. Plus, when we are off, put on the dancing shoes and you're favorite music, and "dance till the dose kicks in."
Hope that helps all of you.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#15 flowerlover

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Posted 05 August 2013 - 09:04 AM

Thank you. This is very helpful. (And dancing is one of my favorite things!)

#16 MComes RPH

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Posted 05 August 2013 - 10:12 PM

I also like "dancing in the dark." But my favorite is "Born to Run"
Thanks,:glad I could help. Keep me posted.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




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