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Dear Mark, 

Doing a little reading and discovered "Pronoran" for Parkinson's disease helps with cognitive issues and more. 

My husband is pretty advanced now, after having Parkinson's for 15 years. Doctors think he's developing LBD too.

I'm looking to reduce Sinemet and stumbled upon Pronoran but never heard of this medicine before. 

Can you shine a light on this for me, please? 

Also, What do you think of the supplement "Prevagen" for cognitive issues? I'm hearing good things!!

Thanks for your time!!

Michelle

 

 

 

 

 

 

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Michellee,

I had a family emergency with my father out of town and I needed to be with him 24/7 since September 26th.

Everything came out good so I am now on my way home. I will be back on the Forum Wednesday answering questions. 

I apologize for the inconvenience and delay, but I really need to focus on my dad.

Thank you for understanding, 

~Mark

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Dear Mark, 

I'm terribly sorry, I meant this for the moderator as I felt they missed my question. It was showing "waiting for approval by a moderator"

or something like that. 

I feel terrible ... Please accept my apology and my best to you and your family.

Take care, 

Michelle

 

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Michelleee,

No problem. I am the moderator of the "Ask the Pharmacist" forum and have not had enough time due to my family issue. I am usually on top of these, but I promise I will take care of it Wednesday. 

There is also no reason to feel bad or terrible,  you could not have known. Plus, I should have put up a post concerning my time away from the Forum.

~Mark

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Michelleee,

Once again, I am truly sorry for not being able to answer these questions as quickly as I have been. I also want to thank you for understanding nature about my family issue. I truly appreciate it.

So, now on to everything you wanted to know, and some things you didn't want to, about Pronoran (generic name piribedil). Much of this information if from the manufacturer and Omedicine Journal.

Pronoran, when it enters the brain, binds to dopamine receptors which will allow for Dopamine to be stored up in the brain. The best part is that it has a specific affinity for certain Dopamine receptors that are affiliated with PD. It has been approval in other countries, but not the USA.

It can be used in patients as initial treatment and later stage treatment. Prolonged use of the medication can lead to less severe dyskensia and improved cognition than in Levodopa alone. It can also be used in conjunction with Levodopa, which would usually mean that as the Pronoran is added into the drug regime the amount of levodopa taken should be lowered.

There was a study that contained 1,103  patients in several stages of PD. Of this study, 543 PD patients were given 150mg to 300mg of Pronoran. It showed an increase in all patients motor symptoms with some improving 30% over 7 months with just Pronoran.

Pronoran is absorbed in the intestines, has a peak effect of 3-6 hours, and has a low risk of medication interactions. The dosing of Pronoran as monotherapy is 150mg to 250mg  taken daily (which is 3 to 5 tablet) depending on the severity of the patient. When used in combination with Levodopa the dose if usually 150mg (3 tablets) daily.

It must be taken after a meal with about 4 oz. of water.

The side effects are dose related, meaning the higher the dose the greater chance of side effects. Some of the side effects include: Digestive issues (less than 1 out of every 100 patients), Nervous system such as anxiety, dizziness, or hallucinations (less than 1 out of 100 patients), Cardiac System, such as low blood pressure, called orthostatic hypotension (less than 1 out of 10,000 patients), and allergic reaction to the medication itself or to the coating dye color of carmine (the chances of this are so small that they were not even posted because it did not happen in any of the patients in the study group.

The patient must be at least 18 years old and the only significant medication interaction is with neuroleptics (medications used for psychosis) except for Clozapine.

The old saying of, "You learn something new every day," is very true and i do find myself looking up different things throughout the day. No matter what the day, I may even learn more than one thing. I bring this up because I did not know that Pronoran contains a small amount of talc to aid as a filler in the medication production of it's sustained release tablet.

Now let's tackle Prevagen. It's football season so I had to throw in the "tackle" reference. When I start to look at a medication, the first thing I do is look for a study that was independently performed and not performed or paid for by the company who produces the produce the product. This way we know there is no bias in the study. The main study I found, which did not say who performed it or who paid for it, included only 218 people between the ages of 40 to 90 years old. The results of this limited size only showed a 2.3% increase in memory. This is not very good no matter who preformed or paid for the test.

Memory is very hard to gauge from one day to the next day. What I do find that many Neurologists, Psychiatrists, and Psychologists can do is called a Mini-Mental exam. This is a great tool in determining if a person does or does not have memory issues and how severe they might be. I would ask for one the next time you take your husband to the Dr.

I hope this helps and please keep me posted.

 

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Dear Mark, 

Hope all is well with your family, and that things turned out well for you all!  And I'm sorry I wrote twice about this question, I honestly thought it got passed over or I did something wrong. I didn't know that you are the moderator (I was thinking there's another person who reads questions first before passing on to you!)

I'm taking Prevagin off the list. Your answer was exactly what I thought it might be. Sounds like hype and lots of TV commercials!

Pronoran actually sounds great! But not being available in the US puts an end to that for my husband. 

He's been dx'd with Parkinson's dementia/Lewy Body at UCSF. He's going downhill very rapidly, and I'm always looking for a "cure" or at the very least, something to slow down the progression as he's only 63 ....... 64 this month. 

I do very much appreciate your time on this. And I'm so sorry that I seemed impatient. I'm actually not. Just misunderstood how this works.

Best to you.

Michelle

 

 

 

 

 

 

 

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Michelleee,

I am glad I could help in some way and thank you for your concern about my family.  My dad is doing great.

Thanks again.

If you ever have any other questions, feel free to let me know if I can help.

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