Parkinson's Disease Medications
Amantadine Hydrochloride (Symmetrel)
Benztropine Mesylate (Cogentin)
Bromocriptine (Parlodel)
Carbidopa/Levodopa (Sinemet)
Levodopa (Dopar, Larodopa)
Pergolide Mesylate (Permax)
Pramipexole (Mirapex)
Selegiline (Eldepryl)
Trihexiphenidyl HCl (Artane, Tremin)
Nutritional Considerations:
Take with food. With levodopa, do not take protein, which can impair drug absorption. (Facts and Comparisons 1999) (Bianchine 1976)
Avoid alcohol with amantadine HCl, benztropine mesylate, bromocriptine, and trihexiphenidyl. (Facts and Comparisons 2000) (Pronsky 1999)
Avoid iron, protein, and pyridoxine with levodopa; it may reduce the effect of the drug. However, the combination form e.g. Sinemet, may be less vulnerable to larger doses (over 5 mgs) of pyridoxine. (Pronsky 1999)
Levodopa contains tartrazine which may cause hives or asthma attacks in sensitive people. (Facts and Comparisons 1999)
Avoid methionine (an amino acid found in meat, fish, and dairy products). It may reduce the effects of levodopa. (Facts and Comparisons 1999)
Avoid phenylalanine (amino acid found in proteins) with levodopa or it may increase certain side effects. (Nutt 1984)
Use of levodopa with food amines (beans or cheese) is discouraged due to the risk of increased blood pressure. (Facts & Comparisons 1999)
Herbal Considerations:
Avoid scopolia with amantadine HCl. It can increase the effects of the drug. (Blumenthal 1998)
Do not use kava and levodapa together. Kava could reduce the effect of the drug. (Brinker 1998)
St. John's Wort theoretically may interact with some of these medications. Consult your pharmacist before taking this herb with any of the above-mentioned drugs. (Gordon 1998)
Chasteberry may interact with parlodel and should not be used with this drug. (Jarry 1994)
Avoid acacia. It may interact with certain alkaloids such as atropine, and others to destroy them. (Leung 1996)
References
Bianchine, JR et al., Clinical pharmacokinetics of levodopa in Parkinson's disease. Clin. Pharmacokinet. 1976, 1:313-328.
Blumenthal M, et al. ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000.
Gordon JB. "SSRIs and St. John's Wort: possible toxicity?" Am Fam Physician, 1998; 57(5): 950,953
Jarry H, et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus-castus: Direct evidence for a dopaminergic principle by the dopamine receptor assay. EYP Clin Endocrinol 102: 448-454, 1994.
Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996
Nutt, JG et al., The \"on-off\" phenomenon in Parkinson's disease. Relation to levodopa absorption and transport. NEJM, 1984, 310, Feb 23:483-488.
Pronsky, Z Food Medication Interactions, 11th edition, 1999.
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