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Tom77

Sinemet should be taken on an empty stomach

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Empty stomach meaning one hour prior to a meal or two hours after a meal.

 

This isn't always possible, especially when it is taken more than three times a day.

 

Also, should it (and other PD medications) be taken with no less than eight ounces of water to really work effectively?

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I didn't know about the empty stomach or water amount thing. Only the protein thing. No protein unless it is one hour before the pill or 2 1/2 hours after the pill.

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Funny. I was thinking about this exact thing yesterday. These folks that take levadopa 4 or 5 times a day....WHEN DO THEY EAT ANY PROTEIN?????  No wonder malnutrition is an issue for PWP.

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My stomach is never empty and I take my Sinemet 3X a day immediately after I eat.  8) I've heard that same suggestion previously on this forum. My neuro never gave me any "food" instructions when he first prescribed Sinemet and, if there were, my pharmacy would usually put a warning or suggestion label on my meds. They didn't. After nearly 3 years, no problems here.

 

Fred

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That is interesting Fred. Where mine instructs me how and when to take the meds is in prescription info sheet that comes with the meds. I admit I don't stick strictly to it and most days it's ok. But I've read where some people have difficulty unless they stick strictly to the schedule .

 

Teresa, I read where for every pill you should drink 8oz of water. I forget where I read that.

 

The prescription info sheet is pretty small print. Makes it hard to read.

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Merck's product info sheet on Sinemet can be found at:
https://www.merck.com/product/usa/pi_circulars/s/sinemet/sinemet_pi.pdf

 

Under the heading "Information for Patients" is the following statement:

The patient should be advised that a change in diet to foods that are high in protein may delay the
absorption of levodopa and may reduce the amount taken up in the circulation. Excessive acidity also
delays stomach emptying, thus delaying the absorption of levodopa. Iron salts (such as in multivitamin
tablets) may also reduce the amount of levodopa available to the body. The above factors may reduce
the clinical effectiveness of the levodopa or carbidopa levodopa therapy.

 

I didn't see any other "food" related guidance regarding the use of this product.

 

Fred

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Hey Fred, that's good news that it doesn't bother you. I believe that everything I've read says eating protein within 2 hours after taking Sinemet affects SOME people. It certainly doesn't say ALL people. There was This thread on our "ask the pharmacist" forum...   http://forum.parkinson.org/index.php?/topic/17727-sinemet-and-no-protein-please-simplify/

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It is mentioned several times in these forums.

 

I also saw one of the doctors state about drinking eight ounces of water with at least Sinemet for effectiveness.

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Bob,

 

Thanks. Interesting read. As it says, we're all different. I was never one to have a queasy stomach. But I did have my Gall Bladder removed maybe 10 or 12 years ago. Also, as I always say, I don't experience any downtime either due to my nature or the Ursodiol I take or some combination of my pills. Your guess is as good as mine.

 

BTW. I just bought a 1947 Baldwin Acrosonic 36" spinet. Not a great piano. But it fits in this house. All the felts and hammers are in great shape. I just finished tuning all 214 strings. Yup, I didn't realize that it was missing one of the G#2 strings. So I need to replace the pair. Of well. Still $500 for the piano + $200 for the move and add $40 for the strings. I think I got a good deal.

 

Fred

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The first seven years I never had to worry about taking sinemet with food. Then, boom, I was having off time and couldn't figure it out.

Overtime I figured it out on my own(that was 13 yrs ago). Google wasn't at my fingertips, docs never told me about protein until I mentioned it.

 

I think all pwp should be referred to a PD nutritionists at the time of dx. It is so important.

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The only time I take my meds on a empty stomach is the first time in the morning, my MDS even advised eating some crackers or a piece of toast when taking your meds  if they upset your stomach.  I think every thing that I take advises drinking water when taking them combine that with the need to stay hydrated because of constapation that is such a huge problem. Do you feel like alll you get done is take pills, drink water and  looking for a bathroom? That's rule # 1 incase you've watched the Bucket List. Rule #3 is also worth remembering too!   

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Actually, I've started to feel like Pavlov's dog, every time the cell-phone alarm goes off, I take more pills..........I swear, sometimes I think I rattle from all the bleeding pills I take now days..............BAH

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The trouble being that you can tell that it is working compared to the way you would be and/or feel if it wasn't working.....

 

There must be a reason why it is recommended otherwise.

Edited by Tom77

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The only time I take my meds on a empty stomach is the first time in the morning, my MDS even advised eating some crackers or a piece of toast when taking your meds  if they upset your stomach.  I think every thing that I take advises drinking water when taking them combine that with the need to stay hydrated because of constapation that is such a huge problem. Do you feel like alll you get done is take pills, drink water and  looking for a bathroom? That's rule # 1 incase you've watched the Bucket List. Rule #3 is also worth remembering too!   

 

It surely is a challenge to manage the timing of meds and meals.  It's mainly protein that is recommended not to be eaten when taking the pills, as it competes with Sinemet in crossing the blood brain barrier.  Taking the meds one hour before or two hours after a meal is best, but for people who take their meds every 2 hours or so, it's quite hard, I'm sure.  In that case, taking the bulk of any food with high protein would be better to do at night, as far as I understand from what I've read and heard.

 

Oh, and the other reason for drinking a full glass of water with any medicine is to help the liver process it with less chance of damage to the liver.

Edited by Linda Garren

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I wonder if the dopamine "pump" has the whole protein and eating issue???

 

That's a good question.  Maybe Dr. Okun might know something about that?  I know you are especially challenged in how to plan meals and protein around your eating pattern.  Would be great if the pump makes that not so much of a problem, wouldn't it.

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#2 Dr. Okun

Advanced Member

 

Ask the Doctor Moderators

 

4,783 posts

LocationUniversity of Florida

Posted Today, 06:06 AM

We have a great ask the dietician/nutritionist forum led by Kathyrn Holden. In general I recommend taking meds one hour before meals if you can, and if nausea is an issue I add Lodosyn or Domperidine. As for different proteins I will defer to our nutrition expert. I will say however that the majority of PD patients do not ever need to worry about proteins and therefore do not need radical diet changes. Hope that helps.

 

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Yay, yay...I am a closet protein craver.....I eat more protein than carbs...did not want to admit it on the forum or have to deal,with it. Also, I have never noticed anything different if I eat or not eat with my l dopa. Actually, I seem to have less nausea if I have it with a glass of fat free milk.

 

We learn something every day.

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