NWPF

Medication Side Effects

Dopamine Side Effects

MedicationAll dopaminergic medicines share similar side effects. The more common side effects are listed below:

  • Nausea and vomiting
  • Heartburn
  • Confusion
  • Visual Hallucinations
  • Sedation, daytime sleepiness, sudden sleep attacks (may be more frequent with agonists)
  • Impulsive or compulsive behaviors such as gambling, overeating, hypersexuality problems (may be more frequent with agonists)
  • Leg swelling
  • Lightheadedness or dizziness

Motor side effects noted below are more common with advancing disease. Higher dose levodopa increases the risk of developing these problems:

  • Flucutations and dyskinesia. 
Medicine Specific Side Effects

Although all dopaminergic medicines share similar side effects, the following side effects should be specifically monitored with the following medicines:

  • Selegeline- Insomnia, anxiety, hallucinations
  • Amantadine- Memory problems, hallucinations, dry mouth, constipation, urine retention, leg swelling and rash
  • Agonists- Hallucinations, confusion, sedation and sleep attacks (falling asleep during activity), impulsivity control
  • Entacapone (Stalevo) and tolcapone- Orange urine and perspiration, diarrhea
  • Tolcapone- Fatal liver disease

Medication PreCautions & Interactions: 

MAOB Inhibitors:
Selegiline (Eldepryl, Zelopar) and Rasagiline (Azilect).

Do not take with the following medicines due to potentially lie threatening drug interaction (severe high blood pressure):

  • Specific narcotic pain medicines- mepiridine (Demerol), tramadol (Ultram), and propoxyphene (Darvocet)
  • St John’s Wort
  • Cyclobenzaprine (Flexeril)- muscle relaxant
  • Dextromethorphan- over the counter cough suppressant

Note that this list is not complete, so talk to your doctor or pharmacist about these and other medicines you should not take with MAO B inhibitors.

Remember medicines are sometimes used in combination which can increase the risk of side effects and potential interaction with your other medications. New side effects are often experienced when a new medicine is added. If you experience a side effect from a new medicine it could be related to that medicine or the combined effect of other PD medicines you may be taking. It is important to tell your doctor about any side effects you are experiencing.

Alcohol can intensify or increase the risk of sedation, confusion, low blood pressure and falls when taking dopaminergic medications.
Helpful Hint: 

Help your doctor help you by keeping a current list of all medications including prescription and non-prescription drugs. Update this list and bring to each medical appointment. Statements like “my doctor knows what I am on” or “same as before” is one of the biggest sources of medical errors in an outpatient clinic.

You can download and print a medication log sheet and other helpful workshheets at My Medical Chart.

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