Your central nervous system chiefly comprises the spinal cord and brain. Degeneration of the nervous system can lead to conditions like Parkinson’s disease, Alzheimer’s and a few other autoimmune disorders. Of these, Parkinson’s disease has a slow but steady onset. But, this neuro condition may give out a few early signs such as rigidity of muscles, slowing down of motor functions, tremors or shakes as well as problems faced while walking. As part of the medication plan, doctors widely prescribe drugs like l-dopa. This drug can increase the availability of dopamine. However, l-dopa is often prescribed with a few decarboxylase inhibiting drugs to minimise excessive synthesis of dopamine in your nervous system. Above all, it is essential to know the common side effects of l-dopa and also understand the precautions needed to minimise such discomforts.
Parkinson’s disease occurs when an active part of your central nervous system suffers damages. As a result, the dopamine levels are known to drop to a sub-optimal degree. L-dopa – unlike other neurotransmitters like dopamine, etc. – can breach the brain-blood barricade. In essence, this drug is a predecessor of dopamine. Once it gains entry into your nervous system, it turns into dopamine. This drug is available in multiple forms – namely, oral intake, inhaled form and an infused variant. Oral forms of l-dopa can either be an extended release version or an immediately released drug. Apart from these two versions, this drug is also available in controlled-release and as a disintegrating pill.
Your treating physician will start l-dopa in smaller doses. The introductory dose is often prescribed at less than 400 milligrams (mg) each day. Once your body gets used to the active ingredients of this drug, higher doses – say, at more than 1000 mg are prescribed. Those taking disintegrating pills of l-dopa must need to first dissolve the drug with saliva. You are advised to swallow the drug only after a complete dissolution in your mouth. The capsule form of this drug has posed difficulties in people who have problems with swallowing foods; in such cases, ingredients of these capsules can be mixed along with foods you eat.
It is important to divide your daily doses into three to ten dosages to avoid excessive production of dopamine. This metered dosing is essential as a larger production of dopamine can lead to toxicity. Such divided dosages are known to enable better absorption rate of this drug. Doctors treating Parkinson’s disease will advise taking l-dopa (in smaller doses) once every 60 minutes. You may be advised not to consume foods rich in fats or those containing high amounts of calories; such foods can reduce the absorption potential of l-dopa. There is also an association between intake of proteins and its absorption rates; consult your dietitian to know more details about the right foods to take while consuming l-dopa.
Side effects of l-dopa
L-dopa may trigger a few side effects. Most common among its side effects are difficulties to pass stools, muscular pains or spasms, abdominal discomforts like nausea, vomiting and being in a confused or restless state of mind. Most of these side effects may cease to show up once your body gets used to the active ingredients of l-dopa. A few serious side effects this drug can cause are erratic heartbeats and mental conditions like mood shifts, restlessness, depression, etc. Serious side effects of l-dopa include acute spell of nausea, difficulties experienced while urinating, persistent episodes of vomiting, etc. In order to prevent likely discomforts in the abdominal region or the gastric tract, this drug is usually taken along with a meal. Upon noticing any of these severe discomforts, you are advised to contact your treating physician without any delay.
Very rare side effects of l-dopa
L-dopa is mostly used along when other drugs administered to treat Parkinson’s disease fail to yield the desired results. This drug is essentially used as a substitutive agent for dopamine. Apart from Parkinson’s disease, other uses of l-dopa include treatment of restless legs as well as limb movements during sleep. In rare instances, l-dopa may cause a few side effects; these include episodes of high blood pressure, internal bleeding or ulcers in the gastrointestinal tract and a few forms of blood disorders.
Needful medical attention may be needed when l-dopa is administered to people with a hypersensitive nerve condition. Such people are more likely to experience serious side effects like fear psychosis, aggression, hallucination, etc. Other side effects include increased secretion of saliva, problems faced while swallowing, etc. A small number of people have reported discomforts like blurring of eyesight, dilation of pupil, rapid pulse rates and faster heartbeats. It is a good practice to talk to your doctor upon noticing any such adverse reactions and side effects.
Adverse side effects like sleepiness during daytime and feeling excessively tired are also noticed in some users. In general, your doctor will advise you not to engage in activities like driving or operating heavy machines. It is also a good practice to stay away from all work needing a high level of mental agility. In some instances, people have reported respiratory problems such as gasping, wheezing as well as shortness of breath. In such circumstances, you may also witness discoloration of the sputum, runny nose and frequent spells of coughing, bronchial asthma or other serious respiratory infections like pneumonia. In most cases, discomforts in the respiratory system are observed in the top part (i.e., the upper section) of the respiratory tract.
Withdrawal of l-dopa
Your doctor will advise not to discontinue the intake of l-dopa all of a sudden. An abruptly discontinued medication plan runs the risks of involuntary twitching of muscles, stiffness of joints as well as neuro conditions such as neuroleptic-malignant-syndrome. The typical side effects of such syndrome include increase in body temperature, loss of consciousness, stiffness of limbs, etc. Upon developing any of these signs, it is strongly recommended to seek medical help as early as possible. A few other side effects include orthostatic low pressure (hypotension) – i.e., a drop in pressure levels while you are in an erect or standing position. Those who developed such low blood pressure conditions also were known to have reported pains in the chest region.
Pregnant women and breastfeeding women
There is not much clinical data available on the safety of l-dopa on women who are pregnant. Studies done on animals however led to new-borns with deformities as well as other congenital problems. Hence, it is highly recommended to take needful inputs from your treating doctor, especially if you are planning to get pregnant or if you are already pregnant.
Also, women who are breastfeeding or nursing their baby need to take additional precautions. As the active ingredients of l-dopa may enter into mother’s milk, it may result in likely discomforts to the feeding infant. Also, the level of milk produced is also known to reduce or thin down when nursing women consume l-dopa. Owing to these risks, this drug is prescribed to nursing women when it is direly needed. In all other circumstances, your doctor may advise you to stay away from taking l-dopa if you are breastfeeding.
Interactions with other drugs
MAO inhibitors are known to calm down mental conditions like phobia or panic. A few elders may be advised to take MAO inhibiting drugs. Intake of l-dopa along with antidepressant medications can lead to sudden changes in your blood pressure level. Your treating doctor will advise you to start taking l-dopa after a time gap of 2 weeks from the last dose of MAO inhibitors.
People who are taking drugs for intra-ocular hypertension or glaucoma (narrow angle) must refrain from taking such meds along with l-dopa. Those who took these drugs together experienced spikes in their ocular pressure levels. Here again, an interval of 15 days or more is provided between these medication plans.
As a precautionary measure, regular health checks to monitor levels of creatinine and BUN are required. Creatinine is a substance discharged as part of normal use of muscles. BUN stands for blood urea nitrogen – the levels of BUN are key indicators of your renal health as well as hepatic wellbeing. Such monitoring will ensure timely detection of abnormal readings which are triggered by regular intake of l-dopa.
In sum, l-dopa is a predecessor to dopamine and is widely used in the case management of Parkinson’s disease. This drug has the ability to transcend the brain-blood obstacle. This drug is likely to cause a few side effects; most common among discomforts it can cause are mental conditions like mood shifts, restlessness, depression, erratic heartbeats, nausea, vomiting as well as difficulties faced while urinating. As the abdominal system as well as gastric tract is more vulnerable, it is always recommended to take this drug along with your meal.
In some remote circumstances, it is likely to trigger hypertension or high blood pressure, internal ulcers or bleeding in gastric tract. A few people may report psychosis, needless aggression, inexplicable dreams, etc. A few eye related problems – such as blurring, excessive dilation of your pupil, doubling of sight – have also been noticed in rare conditions. If you notice any of the aforesaid symptoms, you need to consult your treating doctor immediately. If you are a resident of the US, reach out to 911 as promptly as possible or you can also contact a poison control center. Women who are pregnant are not recommended to take this drug as a few animal studies have led to delivery of malformed offspring. The impact of this drug and its active ingredients on breastfeeding mothers is not fully evidenced as well as not clearly documented. Due to a limited level of clarity, women who are breastfeeding are advised not to take it while they are nursing their newly born baby.