When to medicate?

Anonymous






Posted: Sun Nov 29, 2009 2:12 pm Post subject: when to medicate

--------------------------------------------------------------------------------

Dear Kathrynne,

What to do when you have an invitation for Thanksgiving dinner at the time you are supposed to take one of your meds?

Are the pills more effective when taken with th e meal at the correct hour, or waiting for two hours after the meal, whicb will throw off your pill schedule for the whole day.

And all of this for "quality of life".

Back to top


Kathrynne Holden, MS



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Mon Nov 30, 2009 11:46 am Post subject:

--------------------------------------------------------------------------------

.
Dear Friend,
This is a very good question, and it’s difficult to give a perfect answer. I am assuming you refer to use of levodopa. If you take the levodopa at the correct hour and that coincides with the start of the meal, it will not have time to be absorbed and enter the bloodstream ahead of the meal. If, however, you take levodopa right after a meal, the proteins in the food are likely to block its absorption. Either way, your PD symptoms will not be well controlled.

Two hours is normally enough time for the stomach to clear a meal; but if the meal is high in fat, that will slow clearance by as much as an hour or more. A large meal also takes longer to clear. And, many folks with PD have gastroparesis (slowed stomach emptying), which means the meal takes much longer to empty from the stomach. So, two hours is not a guarantee.

The very best solution generally, if it is possible for you, would be to reschedule your day’s medications, starting about 30 to 60 minutes earlier than usual. That would allow you to take the levodopa about 30 minutes ahead of the Thanksgiving dinner, and allow them to be absorbed ahead of the food.

For example, if you normally take levodopa at 8:00 am, 12:00, 4:00, and 8:00 pm, and dinner is scheduled for 4:00 pm, you might take your first levodopa at 7:30 am, 11:30, 3:30 (then have dinner at 4:00), and at 7:30 pm. Taking it at 3:30 should allow the levodopa to clear the stomach and enter the bloodstream before the start of the meal. Hopefully, this will improve quality of life, which I know is of concern for folks with PD.

If you have further questions, or if I didn’t explain this well enough, let me know and I’ll try again.
.
_________________
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

Back to top


Anonymous






Posted: Tue Dec 01, 2009 7:13 am Post subject: when to medicate

--------------------------------------------------------------------------------

thank you for y our prompt reply.

My problem i s that I must take my medication every 3 hrs.
And what do I do if it takes longerto finish a course?

Thank y ou so much for being there for us.

Back to top


Kathrynne Holden, MS



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Tue Dec 01, 2009 11:24 am Post subject:

--------------------------------------------------------------------------------

.
Dear Friend,
Thanksgiving is a problem when scheduling levodopa, for sure, for one thing because it usually lasts a good deal longer than most meals. And that makes it even more difficult to take medications on time.

I would try to work with your host/hostess ahead of time, explaining the times that you will need to take levodopa, and the importance of taking them about 30 minutes before the meal. Also, try to reschedule your levodopa for that day – for example, if you take your medications at 7:00 am, 10:00 am, 1:00 pm, 4:00 pm, and 7:00 pm, and dinner is scheduled for 4:00, try to re-schedule yourself for that day – take your first levodopa at 6:30 am, then 9:30, 12:30, 3:30. Have dinner at 4:00. Perhaps your hostess can see that you are able to complete your meal by 5:00. Then by 6:30 you will need to take your next medication. You may need to stretch the time to 7:00 pm, because if the meal is large, it may take longer than usual to clear your stomach.

It does bring up a couple of points to my mind, however.

1) Do you use Stalevo? It extends the effective time of levodopa, and might allow you to take your medications less often

2) If you already do take Stalevo (or cannot tolerate the Comtan component) you might discuss occasional use of “liquid Sinemet” with your neurologist. It does not last as long as regular Sinemet, but it is absorbed much faster and can be taken closer to meals.

3) Is it possible that you might have gastroparesis (slowed stomach emptying)? This is fairly common among folks with PD. Food stays in the stomach much longer than normal, and the medications taken while the stomach is full of food cannot clear the stomach to reach the bloodstream. PD symptoms thus are not well controlled, and the physician may prescribe more frequent doses. If you have not yet done so, I would ask your primary care physician about the possibility of gastroparesis, because if present, there are ways of eating that can help, and also some medications that can speed stomach emptying.

I hope this helps, but if not, let me know.
_________________
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/