Of the many degenerative disorders, a long-term medical condition is Parkinson’s disease. It is associated with the central nervous system (CNS) and can impair your motor function. It often takes a very long time for this condition to emerge in full. However, its likely incidence can be inferred with the help of early warnings such as rigidity of muscles, shakes, slowing down of movements as well as difficulties experienced while walking. Levodopa is a drug widely used for treating the signs of this degenerative disorder. What are the adverse effects levodopa causes when taken with other medications, and what are the needful precautions? It is important to know more on these before you start your treatment plan.

Parkinson’s is largely attributed to the death of cells at the midbrain region – an area called substantia nigra. These cells are known to have a direct impact on your motor function. But, why do these cells die or get damaged? Medical studies are underway on these domains are underway, and are yet to ascertain proper reasons to their incidence. The initial findings indicate that a few misfolded strands of protein may be one of the causes. But, more studies are needed to substantiate this initial finding.

The role played by inherited factors as well as environmental conditions cannot be fully ruled out. So, if you have a close relative (like a parent) who had this disorder, the odds of an onset are quite high. As part of environmental risk factors, exposure to a few forms of pesticides and sustaining injuries in the head are a few likely triggers. The good news is: tea drinkers or coffee consumers / smokers of tobacco products are less likely to face risks of Parkinson’s.

Levodopa for treating Parkinson’s

There is no permanent remedy or cure for this degenerative disorder. But, drugs are widely administered to reduce the severity of its signs. Treatment plan includes intake of drugs such as levodopa, dopamine agonists as well as MAO-B inhibiting medications. Of these drugs, levodopa is commonly administered for treating a likely relapse of signs associated with Parkinson’s. In clinical terms, these are termed as off-episodes. The fact is: this degenerative disorder worsens with the passage of time. Hence, during the later stage, the condition only worsens further. In such cases, dosage of drugs (such as levodopa) may have to be increased.

The most commonly used combinatorial treatment is carbidopa / levodopa. Stand-alone doses of levodopa are not a substitute for the above combination of drugs. Parkinson’s is considered to worsen when dopamine levels are at a low; drugs like levodopa work to change the dopamine content of your brain. Once your dopamine makeup is improved, it helps ease your movements by reducing rigidity of muscles.

Precautions needed prior to taking levodopa

It is a safe practice to inhale the powdered form of levodopa. This drug is seldom or never swallowed. Inhalation is done through your mouth and the dosage levels are as per the instructions of your treating physician. In general, strength of doses is based on the severity of your clinical condition as well as how well our body responds to the initial doses of levodopa.

Key chemicals of this drug are likely to cause drowsiness, spells of dizziness, being lightheaded, hallucinations as well as a few symptoms of infections; such symptoms include an increase in body temperature or high fever, a runny nose and soreness of throat. In some cases, you may find discharge of mucus (from nasal airways) or saliva turning dark / black. This is not a severe side effect; but, these darkened fluids may stain your garments. Hence, needful precautions are required to manage this effect. If you encounter other discomforts such as coughing or a choking sensation, talk to your treating doctor. Most of these side effects may go away once you continue with your dosage plan for a few days. If any of these side effects is persisting, seek medical help without any further delay.

It is important to remember that your treating physician has prescribed this drug as the benefits of this med far outweigh the risks of side effects. For instance, you are likely to suddenly witness a short spell of sleepiness while you are performing your daily tasks like driving or answering your phone; you are hence advised not to perform very intricate activities or tasks needing a high level of mental focus. People who have used levodopa for a longer timespan have also experienced these instant episodes of sleepiness. Owing to this risk, you are advised not to take alcohol while using levodopa.

Other safety precautions needed while using levodopa

You may experience accidental falls while using levodopa; mainly due to feeling lightheaded or excessively dizzy. Your physician may advise you to slow down your movements – especially, while you are shifting postures. When you are lying down and are shifting to a standing posture, you are advised to do this as slowly as you possibly can.

Upon witnessing worsening of the signs of Parkinson’s – such as twitching of eyelids, blurring of vision, mood shifts, internal bleeding, etc., talk to your caregiving team. Similarly, if you are experiencing severe pains in your eyes, acute or a stabbing pain in your lower stomach region, uncontrollable spells of spasms or muscular twitches, etc., take clinical assistance on an emergency basis. Some users have reported of chest pains soon after taking a few doses of levodopa. If left unattended, it may lead to a near-fatal outcome; owing to such grave risks, you are advised to seek needful care and support in a proper healthcare setting (like a hospital or a clinic). If you are a resident of the US, talk to the helpline of food and drug administration (FDA) or reach out to 911 on an emergency mode. Those who are living in a Canadian province are advised to quickly call Health Canada or a local poison control unit.

Risks of allergies and precautions needed

Levodopa is unlikely to cause any major allergies. However, among users with prior / known allergies or hypersensitivity, this drug may cause a few adverse reactions; these include itchiness, inflammation, rashes on skin, respiratory conditions such as wheezing or panting; in some cases, users have experienced acute spells of wheezing. In some one-off (and extremely remote) instances, some users have witnessed swelling of their oral parts such as throat, lips and tongue. Such signs can be indicative of acute levels of allergies. In all such cases, it becomes important to consult with your treating doctor on a top priority basis.

Also, it is useful to remember that the above list of discomforts does not constitute a complete list of all side effects and allergic reactions. Hence, it is likely to experience allergies and / or side effects that are not listed here. It is a safe practice to talk to your caregiver if you encounter unknown and / or unlisted allergic reactions and discomforts.

Levodopa – Other precautions needed

It becomes necessary to inform your doctor of your other medical conditions. This includes cardiac ailments (like erratic heartbeats or faster pulse rates), hepatic conditions (such as hepatitis or inflammation of the liver, cirrhosis, etc.) and chronic obstructive pulmonary disorders / diseases (COPD – like asthma, bronchitis, bronchial asthma, wheezing, etc.). As an extended precaution, those who are living with kidney based disorders – such as reduction in the filtering efficiency of your kidneys, formation of ulcers, mental conditions like depression, bipolar disorders, schizophrenia, etc., must keep their caregiving team updated of these conditions.

Prior to a surgery or a dental procedure, your caregiving team needs to know of your intake of levodopa. In general, it is a safe practice to tell your surgical / dental team about all the drugs you are presently taking. It is safer to compile a list of all drugs / medical plans you are currently pursuing. While you make this list, add over the counter (OTC) drugs, prescription meds, herbal medications, mineral or protein supplements and dietary aids. Also, if you are taking a shot of vaccine – having a live microbe in it – your treating team needs to know about your treatment plan.

Women who are pregnant must take added precautions. Your doctor must know about your term of pregnancy. Those who are planning to become pregnant must tell their doctor of such plans. In most cases, your doctor may recommend the use of a contraceptive, preferably a non-hormonal birth control measure. You may choose from a wide range of birth control options such as vaginal rings, skin patches, etc. As an added safety precaution, talk to your caregiver about likely risks and possible side effects. The key chemicals of levodopa may pass through breastmilk; hence, nursing mothers or those who are breastfeeding a newly born infant are advised to take more precautions.

In sum, levodopa is used in the treatment of relapse of symptoms of Parkinson’s disease a condition linked to the health of your central nervous system (CNS). Dosages may need to be strengthened as time lapses; your dosage plan is determined by your age, body weight, severity of motor conditions, how well your body takes the first few doses, etc. This is not an over the counter med and hence needs to be taken as per the instructions of your treating physician. Women who are pregnant, or those planning for pregnancy, women who are nursing a baby, those who have prior heart or liver conditions must take needful precautions before starting your medication plan.

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