Last time, I wrote about how protein affects the uptake of levodopa (the main ingredient in Madopar, Sinemet and Stalevo). This time I want to focus on the importance of taking levodopa at the right times.
Why is timing so important? Levodopa has a very short life in the body. If you are erratic with your tablet times, your symptom control will fluctuate. Levodopa passes into the brain and the remaining dopamine-producing cells convert it into dopamine. When you first take levodopa, the brain can still store dopamine and release it later. Over time, the brain loses this ability. If you are late with a dose, the levels of dopamine fall and you will experience “wearing off” or a return of symptoms, ie stiffness, slowness and tremor.
Levodopa is initially given three times daily, usually every five hours from waking and at least 30 minutes before meals. If you sleep well, there is usually no need to take any at bedtime. In time you may notice that the dose wears off about 45 minutes before the next one is due, so the next step is to take four doses per day at 4-hourly intervals. It’s about determining how long each dose lasts and taking the next one before the previous dose wears off. This will keep your Parkinson’s optimally controlled.
Of course taking tablets on time, every time, is difficult. Life has a tendency to get in the way. This is where timers, alarms and other gadgets can prove useful. Keying in your tablet times into a mobile phone is great if you always carry it with you. A vibrating watch is good if you do not want everyone around you to hear the alarm or if you are hard of hearing. There are tablet containers that will fit into your pocket or handbag and alarm or vibrate to remind you. Check out shop.parkinsons.org.uk or 0844 415 7863 for more details. Put vibrating watch into your internet search engine and you will get a lot of hits.
If you think you need to adjust your times or dosages, please contact me first for advice