At present there is no cure for Parkinson's disease. Drugs are used to try to control and treat the symptoms of Parkinson's. No one drug is perfect, but there are many developments in treatments all the time.
The main aims of drug used for Parkinson's are:
- replace dopamine that has been reduced in the brain due to Parkinson's
- stimulate the the brain where dopamine works
- block the action of other chemicals that affect dopamine, such as acetylcholine as well as other enzymes that reduce dopamine's effect.
Often newly diagnosed people can have considerable improvements by careful introduction of the appropriatedrugs.
When somebody only has mild symptoms, they may decide, together with their doctor, to postpone drug treatment until it is required.
As Parkinsons disease is an individual condition all drugs prescribed may need to be changed to suit individual needs.
Responses to the drugs used to treat the symptoms of Parkinson's varies from person to person not all drugs will suit everyone.
It is important you know as much about the drugs prescribed for you as possible and it may be worth asking for leaflets about the specfic drugs from your PDNS or doctor or from the Parkinson's disease society, whoose details you can find on the links page.
Specific Drug Information
Levodopa
About Levodopa
This belongs to the group of medicines known as dopaminergic drugs.
Levodopa is used to relieve the symptoms of Parkinson's disease. The common brand names of drugs containing Levodopa are: Sinemet, Madopar and Stalevo. Levodopa is converted into dopamine and so increases the level of dopamine in the brain, relieving these symptoms. Levodopa is available in tablet form.
Before Taking Levodopa
Before taking levodopa make sure your doctor or pharmacist knows:
- if you are pregnant, trying for a baby or breast-feeding
- if you suffer from kidney, liver, heart or lung problems
- if you suffer from glaucoma, diabetes or acromegaly (a growth disorder), osteomalacia (weakening of the bones) or psychoses (severe mental problems)
- if you have ever had a stomach ulcer or skin cancer
- if you have ever had an allergic reaction to this or any other medicine
- if you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines
How to Take Levodopa
- Take levodopa exactly as directed by your doctor.
- Try to take levodopa at the same times each day to avoid missing any doses.
- Take levodopa tablets with or after food to lessen the chance of stomach upset (feeling sick and vomiting). If stomach upset continues, speak with your doctor.
- You may have to take levodopa for several weeks or months before you feel the full benefit.
- Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of levodopa contact your doctor or go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if it is empty.
- Levodopa is for you. Never give it to others even if their condition appears to be the same as yours.
Getting the most from your treatment
- Keep your regular appointments with your doctor so your progress can be checked. During the first few weeks of treatment your dose may require adjusting to suit your individual needs. You may also have you to have blood tests and other investigations to check your liver, kidneys and heart whilst you are taking levodopa.
- Do not stop taking this medicine without speaking to your doctor first.
- If you have diabetes: This medicine may alter the results of your urine or blood tests. Your doctor will be able to advise you about this.
- Before having any kind of surgery, including dental or emergency treatment, tell the doctor or dentist that you are taking levodopa.
- Levodopa may cause a reddish discolouration of urine and other body fluids may also be affected. This is completely harmless and is no cause for concern.
- Levodopa can cause drowsiness and dizziness. Make sure you know how you react to this medicine before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.
- When you first start taking levodopa you may find you are incredibly sleepy during the day. This is fairly common and should improve as your body gets used to your new treatment.
- In rare cases some patients have experienced sudden onset of sleep with little or no warning of tiredness. If you experience this you should avoid driving, operating machinery or other tasks where you need to be fully alert. You should see your doctor as soon as possible.
- Dizziness, light-headedness or faintness may occur when getting up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, speak with your doctor.
- As your condition improves and your body movements become easier, be careful not to overdo physical activities. Physical activities must be increased gradually to allow your body to adjust to changing balance, circulation and co-ordination. This is especially important in the elderly.
- After taking levodopa for long periods of time, such as one year or more, some patients suddenly lose the ability to move and their muscles do not seem to work. This loss of movement may last from a few minutes to several hours. After this time the patient is then able to move as before. This condition may unexpectedly occur again and again. If you experience this problem, speak with your doctor.
Can Levodopa cause problems?
Along with their useful effects, all medicines can cause unwanted symptoms. These usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following symptoms continue or become troublesome.
Loss of appetite, feeling or being sick, difficulty sleeping, agitation, dizziness, a fast or fluttering heartbeat, uncontrollable movements of the body, mood changes, headache, flushing (redness of the face), sweating, black or bloody stools, numbness of the extremities, such as fingers and toes; problems with taste, skin rash or itching.
If you experience any other worrying symptoms, which you think may be due to this medicine, discuss them with your pharmacist or doctor.
How to store Levodopa
- Keep all medicines out of the reach of children.
- Store in a cool, dry place, away from direct light and heat.
- Do not keep out of date or unwanted medicines. Discard them safely out of the reach of children or take them to your pharmacist who can dispose of unwanted medicines for you.
Ropinirole
About Ropinirole
This belongs to the group of medicines known as dopamine agonists.
Ropinirole is used alongside other medicines to relieve the symptoms of Parkinson's disease.
Before Taking Ropinirole
Before taking Ropinirole make sure your doctor or pharmacist knows:
- if you are pregnant, trying for a baby or breast-feeding
- if you suffer from heart, liver or kidney problems
- if you have ever suffered from mental problems
- if you suffer from hypotension (low blood pressure)
- if you have ever had an allergic reaction to this or any other medicine
- if you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines
How to Take Ropinirole
- Take Ropinirole exactly as directed by your doctor.
- Always read the manufacturer's information leaflet, if possible, before beginning treatment.
- Take Ropinirole tablets with or immediately after food.
- Do not stop taking this medicine without speaking to your doctor first. Your doctor will need to reduce your dose of Ropinirole gradually before stopping.
- Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of Ropinirole contact your doctor or go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if it is empty.
- Ropinirole is for you. Never give it to others, even if their condition appears to be the same as yours.
Getting the most from your treatment
- Ropinirole can cause drowsiness and dizziness, particularly during the first few days of treatment. Make sure you know how you react to Ropinirole before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.
- When you first start taking Ropinirole you may find you are very sleepy during the day. This is fairly common and should improve as your body gets used to your new treatment.
- In rare cases some patients have experienced sudden onset of sleep with little or no warning of tiredness. If you experience this you should avoid driving, operating machinery or other tasks where you need to be fully alert. You should see your doctor as soon as possible.
- This medicine may cause you to experience faintness or dizziness when getting up from a lying or sitting position. Getting up slowly should help. If this becomes too troublesome ask your pharmacist or doctor for advice.
- Before taking any 'over-the-counter' medicines, check with your pharmacist which medicines are safe for you to take alongside Ropinirole.
- Before having any kind of surgery, including dental and emergency treatment, tell the surgeon, dentist or doctor that you are taking this medicine.
- As your condition improves and your body movements become easier, be careful not to overdo physical activities. Physical activities must be increased gradually to allow your body to adjust to changing balance, circulation and co-ordination. This is especially important in the elderly.
Can Ropinirole cause problems?
Along with their useful effects all medicines can cause unwanted symptoms. These usually improve as your body adjusts to the new medicine. Speak to your doctor or pharmacist if any of the following symptoms continue or become troublesome.
Feeling or being sick, drowsiness, swollen legs and ankles, tummy pain, fainting, uncontrollable movements of the body, seeing or hearing things that are not real, or confusion.
If you experience any other worrying symptoms, which you think may be due to Ropinirole, discuss them with your doctor or pharmacist.
How to store Ropinirole
- Keep out of reach of children.
- Store in a cool, dry place, away from direct light and heat.
- Never keep out of date or unwanted medicines. Discard them safely out of the reach of children or take them to your local pharmacist who will dispose of unwanted medicines for you.
Pramipexole
About Pramipexole
This belongs to the group of medicines known as dopamine agonists.
Pramipexole is used alongside other medicines to relieve the symptoms of Parkinson's disease.
Pramipexole is available in tablet form.
It is also sometimes known as: Mirapexin. You may notice the use of any of these names on the packaging of your medicine.
Before Taking Pramipexole
Before taking Pramipexole make sure your doctor or pharmacist knows:
- if you are pregnant, trying for a baby, or breast-feeding
- if you suffer from heart or kidney problems
- if you have ever suffered from mental problems or hallucinations (seeing or hearing things that are not real)
- if you suffer from hypotension (low blood pressure)
- if you have ever had an allergic reaction to this or any other medicine
- if you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines
How to Take Pramipexole
- Take Pramipexole exactly as directed by your doctor.
- Always read the manufacturer's information leaflet, if possible, before beginning treatment.
- Do not stop taking this medicine without speaking to your doctor first. Your doctor will need to reduce your dose of Pramipexole gradually before stopping.
- Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of Pramipexole contact your doctor or go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if it is empty.
- Pramipexole is for you. Never give it to others, even if their condition appears to be the same as yours.
Getting the most from your treatment
- Pramipexole can cause drowsiness and dizziness, particularly during the first few days of treatment. Make sure you know how you react to this medicine before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.
- When you first start taking Pramipexole you may find you are incredibly sleepy during the day. This is fairly common and should improve as your body gets used to your new treatment.
- In rare cases some patients have experienced sudden onset of sleep with little or no warning of tiredness. If you experience this you should avoid driving, operating machinery or other tasks where you need to be fully alert. You should see your doctor as soon as possible.
- Before taking any 'over-the-counter' medicines, check with your pharmacist which medicines are safe for you to take alongside Pramipexole.
- As your condition improves and your body movements become easier, be careful not to overdo physical activities. Physical activities must be increased gradually to allow your body to adjust to changing balance, circulation and co-ordination. This is especially important in the elderly.
Can Pramipexole cause problems?
Along with their useful effects all medicines can cause unwanted symptoms. These usually improve as your body adjusts to the new medicine. Speak to your doctor or pharmacist if any of the following symptoms continue or become troublesome.
Feeling sick, constipation, drowsiness, seeing or hearing things that are not real, uncontrollable movements of the body, swelling of the ankles or fingers.
If you experience any other worrying symptoms, which you think may be due to this medicine, discuss them with your pharmacist or doctor.
How to store Pramipexole
- Keep out of reach of children.
- Store in a cool, dry place, away from direct light and heat.
- Never keep out of date or unwanted medicines. Discard them safely out of the reach of children or take them to your local pharmacist who will dispose of unwanted medicines for you.
There are many other drugs used to treat Parkinson's Disease and you can find out more from your Parkinson's disease nurse specialist, doctor or on the following websites:
Some of the drugs used for Parkinson's disease can sometimes cause your blood pressure to become lower, below we have listed some general information about this, but if you would like more advice see your GP or PDNS.
Blood pressure can vary over a wide range. For instance, the top pressure when the heart contracts (systolic) can vary from 90 to 240 mmHg and the bottom pressure when the heart relaxes (diastolic) can vary from 40 to 160 mmHg.
It is only in a tiny minority of people with low blood pressure, ie, readings below
90/60 mmHg,
What is blood pressure?
Your heart pumps blood around your body through a network of tubing called arteries and capillaries and then back to your heart via your veins. As your heart contracts it pushes blood into your arteries and this causes an increase in pressure. When your heart contracts, the pressure is at its highest in your arteries and this is known as systolic pressure. As your heart relaxes and refills with blood, the pressure in your arteries falls and this is known as diastolic pressure. When blood pressure is measured in your arm, both of these pressures are measured.
Your blood pressure varies by large amounts, depending on what you are doing. The lowest blood pressures occur when you are asleep or if you relax all your muscles. Standing up, exercising or anxiety all cause an increase in blood pressure. In a single day your blood pressure may vary by 30 to 40 mmHg systolic with similar proportionate changes in diastolic pressure. This is why when you have your blood pressure level assessed it is so important to have it measured under the same conditions every time.
The higher your blood pressure, the higher your risk of heart disease and stroke, whatever your level is.
What is normal blood pressure?
Until recently, normal blood pressure was considered to be the average blood pressure of the population, ie, in the
What is low blood pressure?
Low blood pressure is defined as being below 90/60. If the Yamomamo Indians have an average blood pressure of 96/62 mmHg and are extremely fit and well, it is difficult to define what is meant by low blood pressure. Most people with blood pressures at these levels, ie, around 90/60 mmHg are completely normal and are very lucky that for some reason they are protected from all the bad things we do that increase our blood pressure, like eating too much salt, not eating enough fruit and vegetables, being overweight and inactive etc. However, there are a few people with a blood pressure at these levels who have an underlying cause for their low blood pressure. In nearly all of these cases, blood pressure is much lower when you stand up, particularly if you stand up suddenly. This fall in blood pressure on standing is likely to cause symptoms of fainting and/or dizziness.
Normally, when you stand up blood tends to pool in the veins in your legs. This is stopped by nerves, which contract the veins in your legs ensuring that enough blood returns to your heart and that there is no reduction in the amount of blood that your heart pumps. This maintains the blood supply to your brain.
However, if there is pooling of blood in your veins, less blood returns to your heart and less is pumped out which means a reduction in the amount of blood going to your brain. This causes symptoms of dizziness and some people may faint. This is exactly what happens to guards on parade when they faint because they have been standing in one position for too long. You can mimic this effect when you squat down for a while, for instance when looking at books on a low shelf, and then stand up suddenly.
Therefore, if you have a low blood pressure and you also have symptoms of dizziness or faintness when standing up suddenly you should have your blood pressure checked, both when you are lying down and when you then stand up. This drop in blood pressure when you stand up is called postural hypotension, see managing postural hypotension leaflet.
We are unable to offer specific advice on how low, low blood pressure can be because every body is different. The main concerned is if you have a low blood pressure and you feel faint, and possibly fall when standing from sitting.
Parkinson’s Disease Nurse Specialist
Disabled Living foundation advice
Pill box with reminder functions.
Many people find it difficult to remember when to take their medications, something that has helped are specialist pill boxes, with a built in alarm clock that can be set to remind you to take your medications. Below we have listed and described various pill boxes available, their price and where to purchase them from.
Rectangular clear plastic pill box.
Price Guide £20.00 When upright, shows seven compartments for each day and small clock at end with flip up cover. When medication is due it gives a bleep and a red light flashes. No need to reset each time
Available from:
Supplier information: Morecare Mobility & Healthcare Specialists
36 The Nursery
Bath Road
Devizes
Wiltshire
SN10 2AG
(01380) 727555
Bath Road
POCKET LCD PILL BOX AA9907
Pill box with interior compartment for pills and sliding lid. Digital display at top shows real time in hours and minutes. Buzzer sounds for one minute. Uses one 1.5 volt button cell battery.
Where to buy: Supplier information:
Independent Living Company
11 Hale Lane
Mill Hill
London
NW7 3NU
(020) 8931 6000
Morecare Mobility & Healthcare Specialists
36 The Nursery
Bath Road
Devizes
Wiltshire
SN10 2AG
(01380) 727555
Bath Road
TABTIME PILL DISPENSER
PRICE GUIDE: £14.00
Product Summary
Programmable and self-contained pill box. Comprises: alarm; push time buttons; digital display; battery operated; audio or visual alarms; warning tones; adjustable volume and tone; hinged lid; four compartment trays; safety catch; 32-tablet capacity; automatic cancellation of alarms; patient record card; four volume levels and sliding controls. Shows eight alarms in 24 hours.
Where to buy: Supplier information:
Tabtime Ltd
41 Park Lane
Sandbach
Cheshire
CW11 1EN
(01270) 767207
www.tabtime.co.uk
tfj@tabtime.co.uk
Independent Living Company
11 Hale Lane
Mill Hill
London
NW7 3NU
(020) 8931 6000