Levodopa

(Brand names: Sinemet, Syndopa, Syndopa plus, Syndopa CR, Tidomet etc)

Levodopa is the MOST POWERFUL, POSSIBLY BEST medication for Parkinson’s disease.

If Parkinson’s was a jungle, Levodopa would be an Elephant. It is the Optimus Prime of Transformers, the Mount Everest of mountains… I could go on…

Levodopa is the best medication for Parkinson's disease, for most people
Levodopa is the best medication for Parkinson’s disease, for most people

How does levodopa work?

In a very simple fashion! Levodopa travels inside the brain, and is converted into Dopamine! As described here, low levels of dopamine in the brain is the main problem in Parkinson’s disease. So, levodopa directly addresses the basic problem.

LevodopaToDopamine
Once it enters the brain, Levdoopa is converted into Dopamine.

Use/Advantages:

  1. It is one of the strongest medications for Parkinson’s disease. It has a very marked effect on relieving the movement and many of the non-movement problems associated with Parkinson’s disease.

Disadvantages / Side-effects of levodopa:

  1. Absorption:
    The absorption of levodopa is decreased if you have food in your stomach at the same time.
    The absorption of levodopa is decreased if you have food in your stomach at the same time.

    Ideally, levodopa should be taken on an empty stomach. You should not eat at least 30 minutes (and if possible one hour) before and after taking levodopa. It is mainly protein in the food that hampers the absorption of levodopa. But, you should drink a glass of water with each dose to help the tablet dissolve.

  2. Logistics: Levodopa needs to be taken multiple times in a day. In the initial stages, it has to be taken 3 times a day, but in the later stages, it may need to be taken 5 or more times per day. It is sometimes difficult to remember to take each dose on time!
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    It is somewhat inconvenient to take Levodopa.
  3. Nasuea: Some patients complain of nausea after taking levodopa. Carbidopa, which is always given with levodopa, does decrease nausea somewhat.
    High doses of levodopa can cause some people to become nauseous.
    High doses of levodopa can cause some people to become nauseous.

    Usually, levodopa should be taken on an empty stomach because food decreases its absorption. But If the nausea is so very severe, then taking levodopa with a small piece of bread can be permitted. It is mainly protein that hampers the absorption of levodopa, and bread does not contain a lot of protein. Sometimes, your doctor may prescribe medications such as domperidone for this problem.

  4. Lightheadedness: Some people may complain that when they take levodopa, they feel lightheaded. This feeling usually goes away. Sometimes, it is caused by a drop in blood pressure when standing up. In this case, drinking enough water (7-8 glasses/day if okay with your cardiologist/nephrologist), and getting up gradually helps a lot.
    This often is worst in the morning or night. When you get up from bed in the morning, first sit by the side of the bed for some time. Then stand up gradually and stand by the side of the bed for some time. And only after you spend some time standing and feel stable, start walking (after 30 seconds – 1 minute).
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    Some people may feel a bit lightheaded after taking levodopa.

    Rarely, medications (e.g. fludrocortisone or Pyridostigmine) may need to be given for this problem. Fludrocortisone increases the amount of fluid in the body. No one completely understands how Pyridostigmine works in this scenario. But it is a safe and very effective medication to prevent this kind of drop in blood pressure.

  5. “Dyskinesias”: Earlier, some doctors used to believe that levodopa should be avoided in very early Parkinson’s disease. They were concerned that the early use of levodopa leads to the early development of abnormal movements called dyskinesias. However, most recent research shows that this is not a very valid concern. These movements are now believed to be due to the disease itself, rather than any particular medication. In very young patients, below 45 years of age, it may be reasonable to consider using drugs other than levodopa because of this concern.
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    Dyskinesias are extra dance-like movements. Earlier, it was feared that levodopa worsens dyskinesias. However, this does not seem to be the case.
  6. Other side-effects: Since this book cannot be comprehensive, it is impossible to cover all side effects here. However, some patients report disturbed sleep etc. with levodopa – if you have any of these relatively rare side-effects you should make sure to talk about them with your doctor.

Bottom-line:

Since it is a potent, safe medication with minimal side-effects, levodopa is the most frequently prescribed medication for Parkinson’s disease.

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

4.6 87 reviews

  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ 8 months ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ 8 months ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ 6 months ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ 8 months ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ 10 months ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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