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Amir

interaction between levodopa and anti-inflammatory drugs

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Amir    0

Hi everyone, 

My mother has Parkinson's disease, and has been taking levodopa medication for around 15 years now. Recently, she discovered she has a gastro inflammation that must be taken care of. However, the pills fighting the inflamation distrub her L-dopa medication, resulting in many more off periods than usual. She had tried numerous pills (including Omeprazole, Famotidine, Nexium (Esomeprazole) and Dexilant (Dexlansoprazole)), and while some were better than others, all hurt the affect of her L-dopa medication. 

We have discussed this with doctors and searched the web independently, but found no mention of this problem. I assume many people had this combination of drugs, though, because acidic reflux (a possible cause of the inflammation) is common in Parkinson's.

Had someone here perhaps had this experience, or taken these pills with no such problem? Does someone perhaps know of an MD that specializes in gastro-related issues in Parkinson's, or can refer us to another good source of information?

 

Thanks very much in advance, and good health to everyone, 

Amir

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Linda Garren    751

Hello, Amir.  Yes, I deal with the same problem and had recently asked Dr. Okun about it.  You can look it up on his site.

How often does your mom take carbidopa/levodopa?  I take it every 4 hours, 5 times a day.  I try to take Prilosec (recommended by my gastro doc at Johns Hopkins) at least 2 hours after a dose of sinemet and 2 hours before  What I've found works best for me is taking Prilosec around 6:00 a.m., usually go back to bed until 8:00, at which time I take the first dose of Sinemet for the day.

Be sure she takes her sinemet with orange juice (never grapefruit juice), which will provide the acid she needs to help the sinemet work.

So far, this schedule has worked for me.  I hope it can work out for your mom.  Please keep us updated.

Edited by Linda Garren

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MusicMan    771

The only problem with this is that OJ has a LOT of acid in it, which can cause distress by itself.

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Linda Garren    751

Hmmmmm....  I wonder if Dr. Okun or Mark could comment on this for you?  My situation is a little different since I take Prilosec which lowers stomach acid all day, so the small bit of orange juice I drink isn't a problem for me.

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Amir    0

Thanks very very much! 

I shared your answers with my mother and she asked to thank you very much, and also to say that it's a good idea taking the gastro medication straight in the morning and only then L-dopa a bit later. She had 2 issues with this though: 

  • As Bob mentioned, she refrains from orange juice entirely these days. It could be insignificant given the pills, we'll check this with doctors. 
  • She was told that both medication types should be taken on an empty stomach, and so putting them always 2 hours apart wouldn't leave her much time she can eat :). When do you usually take the 2nd round of Prilosec?

From what you say it sounds that sinemet requires certain acidity to work properly? That's something we don't remember anyone mentioning to us. 

Edited by Amir

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Dancing Bear    80

Best to ask these questions on the other forums (Doctor and Pharmacy) to start with or search the other forums as Linda suggested for past postings.

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Linda Garren    751

Hi, Amir. 

I take Prilosec somewhere around 5:30 or 6:00 a.m..  Two hours later I take Sinemet with maybe 4 oz. orange juice.   The Prilosec by then will handle the little bit of orange juice she takes. 

The Prilosec I take is a 24-hour one, so I take it only once a day.  You'll find the lowest prices at stores like Walmart and Target. And they sometimes have special offers on it.

If she eats a saltine or two before taking Sinemet, it will help with any nausea she might have otherwise from the Sinemet. 

She need only wait about an our after taking the SInemet to eat breakfast.  Hopefully the saltine and the orange juice will give her just enough to be able to wait the hour until breakfast. 

And yes--I found the same thing about orange juice not having been mentioned.  You'll find that you'll pick up little tips and information here and there.  I have yet to see any publication that includes a complete listing of all of the possible ways our body can be affected by Parkinson's.  I've had it for two years and am still learning things it has affected in my body that I didn't know where due to Parkinson's.  Information and research has been exploding in the last few years, and it's hard even for the MDS's to keep up with it all. It has been only in the last few years that the need for MDS's has been realized, and there has been a scramble for medical students being trained for it.  Many patients have had to wait months before an MDS has had availability for them.

Please be sure to keep up with the information in our Forum and also check often in the Ask the Doctors section where you'll find helpful information and answers to your questions.  In addition, you may find it helpful to subscribe to Neurology Now, a free magazine and on-line resource re: neurological issues.  The Michael J. Fox online site is another very  very good source of information.  Both of these will keep you up to date on the research that is going on re Parkinson's.

And you'll find a lot of caring support in this forum, and excellent tips and information.  Welcome!

 

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