Levodopa
Generic name: Levodopa
Trade name: Levodopa
- Considered to be the most effective medicine for Parkinson's disease. It is a natural amino acid, which the brain turns into dopamine and therefore it replaces the missing chemical substance and comes in its place.
- The most common Levodopa drugs in Israel are: Levophor, Dupicer, Sinemat and Stalvo.
- Sometimes levodopa is given together with carbidopa because it prevents it from early conversion to dopamine outside the brain, which prevents or reduces side effects.
- The drugs also contain another substance that prevents levodopa from turning into dopamine, before it reaches the brain and also reduces the side effects of dopamine (mainly nausea).
- Levodopa medication usually starts with a low dose, which is gradually increased, depending on the symptoms.
- They help control tremors but their usefulness is limited due to the side effects
- There are different mechanisms of action: immediate release, controlled release and suspension
Immediate release levodopa
- Except for Sinemat CR, all drugs containing levodopa are immediate release levodopa.
Controlled-release levodopa
- In all preparations of this type, the letters CR (Controlled Release) appear after the name of the medicine. The CR preparations release the drug for 4 to 6 hours, which causes less fluctuations in levodopa levels in the blood.
- Sinemet CR must not be crushed or chewed. The pill must be swallowed in its original form, to fully benefit from the slow release action of the drug. Together, this is because in Israel there is no 100 mg dose of Sinemat, you can cut the pill in half and take half a pill each time.
Levodopa in suspension - medofar
- The tablet can be swallowed whole or dissolved in water or orange juice. The absorption of the suspension is faster, and it can be used in the morning, or during difficult and painful OFF times.
Advantages
The suspension is convenient to use, when the patient has difficulty swallowing tablets or capsules.
Disadvantages
The drug cannot be obtained in Israel.
Side Effects
Nausea, dizziness, loss of appetite.
As the disease progresses, the effectiveness of levodopa may decrease.
Also, a patient may experience involuntary movements (dyskinesia).
Click here to review the Ministry of Health's circular from the "All Health" website
Generic name: Entacapone
Commercial name: Comtan
- Entecone is always given in combination with levodopa preparations (such as Dupicer and Levobufer Plus). It is not effective as a single treatment for Parkinson's disease.
- The drug increases levodopa levels by inhibiting the COMT enzyme in the blood and thus increases the effectiveness of the drug.
- Initial intake of the drug as well as its discontinuation is gradual.
Side Effects
The most common side effect (the lewdopa effect) is dyskinesia. This side effect occurs mainly at the beginning of taking the drug.
Gastrointestinal problems, such as nausea, abdominal pain and diarrhea.
The drug can cause the color of the urine to turn reddish-brown. This is a harmless side effect and not a cause for concern.
Click here to review the Ministry of Health's circular from the "All Health" website