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How do I best time doses of carbidopa/Ldopa?

Sunday March 17, 2013

The following excerpt is from a question received by NWPF.

We were told by our neurologist that my husband should take carbidopa/Ldopa (Sinemet) every 5 hours and also told to take it with meals. What is the best way to time the dose of this medicine?
There is no standard way to take carbidopa/ldopa. Dosage truly depends on the person’s symptoms, stage of disease and side effects.  The following situations describe some of the different ways that carbidopa/ldoap can be given:
  • Without food. Protein does delay absorption of this medicine from the intestines.  For this reason you sometimes hear the recommendation to avoid this medicine with food so it can be absorbed faster.
  • With food. This is helpful if disease is mild, a person has no wearing off symptoms, or nausea is a problem. In this case, medicine is often taken with meals for convenience and to minimize side effect.
  • Spread dose out during waking hours. To keep things easy, your doctor can simply tell you to spread out doses during the day (in your case every 5 hours.) This is especially helpful early in disease or if there is no wearing off, dyskinesia or side effect.
  • Specific times given. Timing of doses is also tailored to the individual’s day and night.  If a person wears off at end of dose, has dyskinesia or side effects then medicine is given at more specific times based on these symptoms.
The best thing to do is to talk to your Neurologist about the conflicting guidance you have been given so that you can decide together which one is best for your husband.
See related article to learn more about protein and medicine.

Monique L. Giroux, MDMonique L. Giroux, MD
Medical Director, Northwest Parkinson's Foundation

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