Protein and Levodopa
Lindy Wood, PhD
The first time you picked up levodopa from the pharmacy, you were probably told to take it on an empty stomach, but maybe you found that the medication upset your stomach and you were then advised to take it with food. When it comes to levodopa a common question is whether to take it with food or not. The answer? It depends.
Why is food an issue with levodopa?
When you take this medication, it goes into your stomach, travels to the intestine, where it is absorbed into the blood stream, and then into the brain. Levodopa is chemically similar to some amino acids, the building blocks of protein. These proteins use the same pathway for absorption into the brain and therefore can compete with your levodopa for absorption. If you are absorbing less levodopa, you may not be receiving the full effects of your medication. For this reason you may be told to take your medicine before or after meals.
Not everyone needs to worry about protein and levodopa
People with early Parkinson's and mild symptoms can take levodopa with a meal and not notice any difference over taking it on an empty stomach. If this is your experience, you do not need to worry about protein. As Parkinson's advances, you may experience a wearing off effect (noticed as a return of movement problems before your next dose of levodopa is due). If you experience these end of dose wearing off states you are more dependent on
A good rule with levodopa is to take it on an empty stomach, about 30 minutes before eating or an hour or two after. However this may be hard to do if you take many doses per day or it you feel nausea when taking medicine on an empty stomach. Foods low in protein will interfere less with levodopa absorption. If you find levodopa upsets your stomach, try taking it with low protein foods such as fruit, crackers, bread, and granola bars.
What about protein and other PD medications?
Levodopa is the only PD medication that competes with protein for absorption. You do not have to worry about this problem with other medicines such as dopaminergic agonist or MAO-B inhibitors. In fact, these medicines can cause nausea so it helps to take then with food when initiating or increasing a dose. The most important thing is that you are taking the levodopa as prescribed and receiving its benefit.
As with any change to your medication management, if you have concerns about the effects of food, or if your medication is making you nauseated, talk to your healthcare provider.
Reprinted with permission by the Northwest Parkinson Foundation, July 2, 2010
