Professional Documents
Culture Documents
FO R Pa rk in son ’s
1
There is no cure yet for
The content in this booklet is
Parkinson’s but there are
designed to be dipped in and out
many different drugs that can of – don’t feel like you need to
help manage the symptoms. read everything in one go. This
is particularly true because what
This booklet is for people works for you when starting
with Parkinson’s and their treatment for Parkinson’s may
family, friends and carers. change later on.
It provides information
Reading the bits of this
about the drugs most information that you need will
commonly used to help also make this booklet more
manage the condition. manageable and relevant for you.
Levodopa ..............................................................................................................17
This includes how it works, when it’s used as well as benefits,
risks and side effects.
Co-beneldopa (Madopar)................................................................................20
Co-careldopa (Sinemet, Caramet, Lecado and Apodespan)...............22
Co-careldopa (Duodopa).................................................................................23
Dopamine agonists ..........................................................................................24
This includes how they work, when they’re used as well as benefits,
risks and side effects.
Pramipexole (Mirapexin, Pipexus, Glepark, Oprymea, Zentiva)..........27
Ropinirole................................................................................................................28
Rotigotine (Neupro)............................................................................................30
Apomorphine.........................................................................................................30
Amantadine .........................................................................................................41
This includes how it works, when it’s used as well as benefits,
risks and side effects.
Anticholinergics ................................................................................................43
This includes how they work, when they’re used as well as benefits,
risks and side effects.
ProcyclidIne............................................................................................................45
Trihexyphenidyl (also called benzhexol)......................................................45
4
Section 3 This gives a list of all Parkinson’s drugs and space
to write down your specific treatment regime.
Notes.......................................................................................................................52
A blank page for you to write down notes you need.
Medication record............................................................................................53
This includes a table for you to write down your personal details
and information about the specific drugs you take.
Disclaimer
We’ve made every effort to make sure the information in this booklet
is correct at the time of printing. But Parkinson’s UK cannot take
responsibility for the correctness, sufficiency or completeness of
this information or any recommendation.
Please remember that information about drugs can change. Also, this
booklet does not list all the uses and side effects of different drugs.
For full details, please see the drug information leaflet that comes
with your medication.
5
Parkinson’s DRUGS:
aN INTRODUCTION
6
Once there are no longer any legal medical professionals to understand
rights to the brand name any what medication you take.
company can make generic
(unbranded) versions of a drug. Modified release, controlled
release and prolonged
The active ingredient of a generic release medication
drug is always the same as the You may see that your medication
branded version and lots of people is written as modified release. It can
won’t have any problems using also be written as controlled release
the generic medication. (CR) or prolonged release (PR). All
of these labels mean the same thing
In the UK, a generic or branded but drug companies can choose
medicine needs a licence and there which one to use with their drug.
is a strict process for this. This
means that the quality of a generic These types of medication are made
or branded version of the same to release your treatment slowly to
medicine will be the same, and help you have more even control of
they will also act in the same way. your symptoms throughout the day.
7
Most people find they tolerate Parkinson’s nurse or pharmacist
their treatment well and will return will work with you to find the best
to clinic after six to eight weeks combination of treatment that
to review their response. This is is best for you as an individual.
when your specialist or Parkinson’s
nurse will increase or decrease the Finding the best drug, dose and
doses, the frequency, or add new timing won’t happen straight away.
drugs until your symptoms are as Your treatment regime will usually
controlled as possible. need adapting as your Parkinson’s
symptoms change over time.
Before leaving the clinic you should
get the contact details of your Planning a medication routine is
Parkinson’s nurse or the number something that should be a joint
of the clinic in case you have any decision between you and your
problems with side effects. See the healthcare professionals. If you are
section on side effects further on prescribed medication, make sure
in this information. you ask about what you are taking,
when to take it, and any side effects.
Medication is specific to you
Your specialist or Parkinson’s nurse
Every person with Parkinson’s has
should explain things clearly and
a different experience of the
write down anything important.
condition so your specialist,
8
OTHER WAYS TO MANAGE
YOUR PARKINSON’S
Drug treatments are the main way Find out more about exercise
to manage Parkinson’s symptoms and the styles to focus on at
but other things can help. parkinsons.org.uk/exercise
Exercise Therapies
Exercise is good for everyone and Therapies can complement your
it is especially good for you if you treatment regime by focusing
have Parkinson’s. It can be as on a specific issue you may have.
important as your medication
in managing symptoms. The three main types of therapy
are physiotherapy, speech and
Emerging evidence suggests that language therapy and occupational
increasing exercise to 2.5 hours per therapy.
week can slow the progression of
your symptoms. Find out more: see our
information on physiotherapy,
There is something for everyone speech and language therapy
so go for it. and occupational therapy.
9
SIDE EFFECTS OF
Parkinson’s DRUGS
Like any drugs, Parkinson’s drugs can side effects should not put you off
have side effects. This means that taking your medication to control
some things you may think are your symptoms.
Parkinson’s symptoms could be
side effects of your medication. If you have a history of behaving
impulsively you should mention
Below we have listed some side this to your GP, specialist
effects that are important to be or Parkinson’s nurse.
aware of. We have also included
specific side effects information Asking your specialist to make
within each drugs class section. changes to your medication regime
or adjusting the doses that you
Impulsive and compulsive take is the easiest way to control
behaviours impulsive and compulsive behaviours.
So, if you or the person you care
People who experience impulsive and
for is experiencing this side effect,
compulsive behaviours can’t resist
tell your healthcare professional as
the temptation to carry out an
soon as possible before it creates
activity – often one that gives
large problems.
immediate reward or pleasure.
If you are not able to get through to
Behaviours may involve gambling,
your healthcare professional straight
becoming a ‘shopaholic’, binge eating
away, you can call our Parkinson’s UK
or focusing on sexual feelings and
helpline on 0808 800 0303.
thoughts. This can have a huge
impact on people’s lives including
We have advice that can help you
family and friends.
manage impulsive and compulsive
behaviours as well as information
Not everyone who takes Parkinson’s
on what behaviour to look out for.
medication will experience impulsive
and compulsive behaviours, so these
10
Find out more: see our Sleep issues
information on impulsive Some Parkinson’s drugs can make
and compulsive behaviours. you very sleepy. Sometimes this
happens suddenly and without
Hallucinations and delusions warning. Make sure you know what
Hallucinations and delusions can also safety precautions you need to take
have a huge impact on daily life. – if you can drive, for example.
11
YOUR Parkinson’s DRUGS:
KEY POINTS
12
You can cut out, copy and use Pill timers vary in cost, depending
our medication record at the end on the type and who it is made
of this information. by. An occupational therapist or
pharmacist can help you to choose
yy You may want to wear the right option. The Disabled Living
MedicAlert jewellery or carry our Foundation, an organisation that
medication card to help people provides information on a range of
know in an emergency situation equipment, can also advise you on
that you have Parkinson’s and available options. You can call their
what medication you take. helpline on 0300 999 0004.
14
OTHER TYPES OF
DRUGS YOU MAY TAKE
People with Parkinson’s can have These are some (but not all)
symptoms that aren’t connected of the drugs to avoid in Parkinson’s:
to movement problems, known as
non-motor symptoms. These include yy chlorpromazine (Largactil)
anxiety, pain and constipation.
yy fluphenazine (Modecate)
These types of symptoms may be yy perphenazine (Fentazin/
treated with the same drugs used Triptafen)
by everyone with that health issue,
rather than Parkinson’s-specific yy trifluoperazine (Stelazine)
drugs. For example, you may be yy flupentixol (Fluanxol/Depixol)
prescribed Movicol for constipation.
Parkinson’s and the drugs used to yy haloperidol (Serenace/Haldol)
treat it can interact with the drugs
used for other conditions. This means yy metoclopramide (Maxalon)
that a particular drug can become yy prochlorperazine (Stemetil)
weaker or stronger. Your specialist
or pharmacist can advise you on this. Complementary therapies
Always ask them before buying any Herbal or complementary treatments
over the counter medication. may also affect your Parkinson’s
drugs. For example, St John’s Wort
Drugs to avoid is not recommended for people with
Some drugs can bring on Parkinson’s- Parkinson’s. It is made up of many
like symptoms or react badly with elements which can interact with
Parkinson’s drugs and should be your Parkinson’s medication and
avoided unless they’re recommended cause side effects. So always check
by a specialist. with your specialist, Parkinson’s
nurse or pharmacist before taking
alternative medicines.
15
Cold remedies Domperidone can cause heart
Many decongestants and cold rhythm problems (arrhythmia).
remedies can stop your Parkinson’s If you are prescribed this
medication working properly. medication, your specialist,
This is especially important to Parkinson’s nurse or pharmacist
remember if you are taking selegiline, should talk to you about how
rasagiline and safinamide. They can to recognise signs of irregular
also increase the risk of side effects. heart rhythms. A test of your
Always check with your pharmacist pulse or another examination is
before taking cold remedies. often routinely performed to check
for irregular heart rhythms before
Anti-sickness drugs you are prescribed domperidone
Parkinson’s medication can cause or ondansetron (see below).
nausea and vomiting. Doctors will
usually prescribe domperidone Other anti-sickness drugs that
(Motilium) to prevent and treat are generally considered useful
this side effect. include cyclizine (Valoid) and
5-HT3 receptor antagonists
like ondansetron.
16
LEVODOPA
17
When are levodopa The patient information leaflet that
drugs used? comes with your drugs will tell you
the full range of side effects that
Levodopa drugs are sometimes
you may experience but some
one of the first types of medication
possible ones include:
that people with Parkinson’s are
prescribed. However, this will not
Wearing off
be the same for everyone.
When you take levodopa for a long
time you may experience wearing
Your levodopa treatment will usually
off. This is when your drugs wear
start with a low dose. This will
off before you take the next dose
gradually be increased until your
so you have times when you’re stiff
symptoms are under control.
and slow.
Benefits of levodopa Involuntary movements
Levodopa can help treat Parkinson’s (dyskinesia)
symptoms because it helps to top With long-term use of levodopa
up dopamine levels in the brain. you may experience involuntary
movements (dyskinesia). These
You may experience a big are muscle movements that
improvement in your symptoms you can’t control. They can
when taking it, especially with include twitches, jerks, twisting
stiffness and slowness of movement. or writhing movements.
19
Co-beneldopa (Madopar) Taking co-beneldopa
Co-beneldopa is a type of generic (Madopar)
(unbranded) levodopa medication. Below we have included the
Madopar is the brand name for different forms of co-beneldopa
co-beneldopa. (Madopar) medication and some
key points on taking them.
It contains two ingredients,
levodopa and benserazide. The most recent and complete
The benserazide ingredient helps information on your specific drug will
levodopa get into the brain where be on your patient information leaflet
it can be converted to dopamine. that comes with your medication
packet. Always read it carefully
The dose of co-beneldopa before you start your treatment.
(Madopar) is expressed with
the levodopa content first and For detailed information you
then the benserazide content. should follow the advice of your
For example, Madopar 50/12.5 specialist or Parkinson’s nurse
contains 50 mg levodopa and about how to take co-beneldopa
12.5 mg of benserazide. (Madopar) so that it works well
for your Parkinson’s.
20
Immediate-release co-beneldopa Co-beneldopa dispersible
capsules (Madopar capsules) tablets (Madopar tablets)
Taking this medication with a meal, These dispersible tablets can
or shortly after it, will mean you are be mixed with water to make
less likely to experience any nausea. a drink. It takes effect more quickly
If you don’t experience nausea than capsules because it doesn’t
it may be beneficial to take your need to be broken down in your
capsules 30 – 40 minutes before stomach to release the active
a meal to help your medication work. ingredient. It can also be used
if you have trouble swallowing
Controlled release co-beneldopa tablets or capsules.
capsules (Madopar CR capsules)
Controlled release co-beneldopa You should take these tablets
capsules (Madopar CR) let the with water or fruit squash.
levodopa enter your body slowly
instead of all at once. They are Taking this medication with a meal
particularly helpful if they are taken or after it will mean you are less
before going to bed to reduce likely to experience any nausea.
stiffness during the night.
Co-beneldopa dispersible tablets
Controlled release co-beneldopa (Madopar tablets) are useful
capsules (Madopar CR capsules) can if you experience slowness of
also help to reduce one of the side movement or the ‘on/off’ effect.
effects of levodopa medication - See the section on side effects of
involuntary movements (dyskinesia). Parkinson’s drugs to find out more.
21
Co-careldopa Always read it carefully before you
(Sinemet, Caramet, start your treatment.
Lecado, Apodespan)
For detailed advice you should
Co-careldopa is a type of generic speak to your GP, specialist
(unbranded) levodopa medication. or Parkinson’s nurse about
Sinemet, Caramet, Lecado and how to take co-careldopa so that
Apodespan are the branded it works well for your Parkinson’s.
versions of co-careldopa.
Co-careldopa (Sinemet,
Co-careldopa contains two Sinemet plus tablets)
ingredients, levodopa and carbidopa. You will usually take Sinemet
The carbidopa ingredient helps or Sinemet plus three or four
levodopa get in to the brain where times a day. But this will vary and
it can become dopamine. Carbidopa your healthcare professional will be
also helps to make sure you best placed to advise you on what
experience fewer side effects. dose is best for your Parkinson’s.
The dose of co-carledopa Co-careldopa (Sinemet
(Sinemet) is expressed with the controlled release tablets)
carbidopa content first and then Co-careldopa controlled release
the levodopa content. For example, lets the levodopa enter your body
Sinemet 12.5/50 contains carbidopa slowly instead of all at once. This is
12.5 mg and levodopa 50 mg. particularly helpful if taken before
going to bed to reduce stiffness
Taking co-careldopa during the night.
(Sinemet, Caramet,
Lecado, Apodespan) Co-careldopa controlled release
Below we have included the tablets mean that your medication
different forms of co-careldopa takes effect slowly during the day.
medication and some key points Your dose can be adjusted by your
on taking them. specialist or Parkinson’s nurse so that
your symptoms are well controlled.
The most recent and complete
information on your specific drug You should take these tablets whole.
will be on your patient information Don’t break, crush or chew them
leaflet that comes with your because they have been made
medication packet. to release your medication slowly.
22
Benefits and risks of Duodopa gel can help reduce:
taking co-beneldopa
and co-careldopa yy involuntary movements as a
side effect of your medication
Co-beneldopa (Madopar) and
Co-careldopa (Sinemet, Caramet, yy motor fluctuations from your
Lecado and Apodespan) are common drugs wearing off
drugs used to treat Parkinson’s and
most people will experience an yy problems with your symptoms
improvement in their symptoms. at night
23
DOPAMINE AGONISTS
26
Taking pramipexole to experience wearing off and
(Mirapexin, Pipexus, dyskinesia. This could be motor
Glepark, Oprymea, Zentiva) fluctuations, or wearing off before
your next dose of levodopa is due.
Below we have included the
different forms of pramipexole
Pramipexole tablets (Mirapexin,
(Mirapexin, Pipexus, Glepark,
Pipexus, Glepark, Oprymea
Oprymea, Zentiva) medication and
an overview of how to take them. or Zentiva)
Swallow the tablets with a drink
The most recent and complete of water. You can take your doses
information on your specific drug will before or after meals.
be on your patient information leaflet
that comes with your medication Your specialist or Parkinson’s nurse
packet. Always read it carefully will be able to advise you on the
before you start your treatment. best dose. Usually you will be given
these tablets on a low dose at first
For detailed information you should which will be increased roughly
follow the advice of your specialist every five to seven days until it is
or Parkinson’s nurse about how to right for you and your symptoms.
take pramipexole so that it works
well for your Parkinson’s. You will usually take Mirapexin
three times a day but your specialist
Pramipexole drugs are also used or Parkinson’s nurse will be best
to help your symptoms when your placed to advise you on this.
levodopa medication causes you
27
Pipexus and Mirapexin yy Requip XL (prolonged
(prolonged release tablets) release tablets)
You should take the capsules with
yy Spiroco XL (prolonged
a drink of water. Don’t break, crush
release tablets)
or chew them. This is because they
have been made to release the yy Ipinnia XL (prolonged
medicine slowly over the course release tablets)
of the day. You can take them
with or without food. yy Raponer XL (prolonged
release tablets)
Your healthcare professional will yy Ropilynz XL (prolonged
be able to advise you on the best release tablets)
dose. But usually you will be given
these tablets on a low dose at first Ropinirole medication can be
which will be increased roughly used as a substitute for dopamine
every five to seven days until it is because it can have an effect
right for you and your symptoms. on the same nerve cells where
dopamine works. Ropinirole can
You will be prescribed Pipexus or be used alone or with other
Mirapexin (controlled release tablets) medications to treat Parkinson’s.
once a day. This can make it easier
for you to remember your dose. Taking ropinirole (Requip,
Adartel, Requip XL, Ralnea
Ropinirole
XL, Spiroco XL, Ipinnia XL,
Ropinirole is a type of generic
(unbranded) dopamine
Raponer XL or Ropilynz XL)
agonist medication. Below we have included the
different forms of ropinirole
There are a number of brand medication and an overview
names for ropinirole. These are: of how to take them.
28
For detailed information you should levodopa becomes less effective
follow the advice of your doctor over time.
about how to take ropinirole so that
it works well for your Parkinson’s. yy You should take these tablets
once a day.
Ropinirole (Requip, Adartel)
Ropinirole (Requip, Adartel) is taken yy These tablets can be taken
as one dose per day, usually just with or without food.
before bedtime or around three yy It is important that you take
hours beforehand. Your healthcare these tablets whole. They must
professional can then increase your not be chewed, crushed or
dose during the rest of the first week divided into pieces.
if you don’t experience side effects.
At first your specialist will prescribe
However your specialist or you a low dose of Ralnea XL, Requip
Parkinson’s nurse will be best XL, Spiroco XL, Ipinnia XL, Raponer
placed to advise you on when to XL or Ropilynz XL. This will usually
take ropinirole so that it works well be once per day for an initial period
for your condition. They can increase of one week. Your healthcare
your daily dose over time until it is professional can then increase
right for you and your symptoms. your daily dose until it is right
Taking ropinirole with your meals for you and your symptoms.
will help to reduce any stomach
issues that you may experience. In some cases, a high fat meal may
create issues so speak to your
Ropinirole prolonged release specialist if you think that food is
tablets (Ralnea XL, Requip XL, creating problems when you take
Spiroco XL, Ipinnia XL, Raponer your medication.
XL, Ropilynz XL)
Prolonged release tablets release Tell your doctor if you experience
your medication slowly throughout side effects from any of these
the day. This can give you more prolonged release tablets as other
control of your symptoms. They forms of ropinirole medication may
can be taken alone to try and delay be more suitable for you.
the need for you to take levodopa.
This can be helpful because
29
Benefits and risks of How can a skin patch help?
pramipexole and ropinirole It may be useful if:
medication
Pramipexole and ropinirole yy you have trouble
swallowing tablets
medication is commonly used to
treat Parkinson’s and most people yy you experience wearing off
will experience an improvement of your levodopa medication
in their symptoms.
yy you experience fluctuations
See the section on risks and side in the way your levodopa
effects of dopamine agonists for medication works
an overview of the side effects yy you experience restless legs
you may experience. syndrome (an uncontrollable
urge to move your legs)
For the full range of side effects,
see the patient information leaflet Find out more at
that comes with your medication.
parkinsons.org.uk/rotigotine
Rotigotine (Neupro) Apomorphine
The brand name of rotigotine
Apomorphine is a strong dopamine
is Neupro. It is a skin patch which
agonist that stimulates the same
is applied to different areas of the
areas of the brain as dopamine.
skin and releases the drug slowly.
Apomorphine is injected or infused
How does the skin through a pump. It also comes in
patch work? a pen, cartridge or vial. The brand
Neupro is placed on your skin once names for apomorphine are
at the same time every day. You Apo-go and Dacepton.
should hold the patch in place for
30 seconds to allow the drug to start Apomorphine is often used
working. It can stay in place for 24 to improve symptoms quickly.
hours before you apply a new one. It may be helpful if:
30
yy oral drug treatments If you need more than 10 injections
have become less effective a day, you may be changed
or stopped working to a continuous infusion.
31
MAO-b inhibitors
32
Benefits of MAO–B inhibitors Your specialist should be able
to advise you on how to take
You don’t need to start gradually antidepressants alongside your
Many drug treatments for Parkinson’s medication.
Parkinson’s have to be started
gradually, with the dose slowly being Decongestants or cold remedies
increased over time. This is not the These can affect some types of
case for most MAO-B inhibitors. MAO–B inhibitors. If you need
to use them, check with your
Delaying levodopa treatment pharmacist to find out which
By taking a MAO–B inhibitor at an one is safe for you to use.
early stage of Parkinson’s, you may
be able to delay taking levodopa Worse levodopa side effects
until your symptoms become more Involuntary movements
difficult to manage. (dyskinesia) and sickness may get
worse because MAO–B inhibitors
Helping levodopa work well strengthen the effects of levodopa.
When you have been taking levodopa If this happens, your specialist or
for a while, you may find that its Parkinson’s nurse can reduce your
effects wear off too quickly. dose of levodopa.
A MAO–B inhibitor can help.
Impulsive and
Taking a MAO–B inhibitor may also compulsive behaviours
mean you can take less levodopa Impulsive and compulsive behaviours
and leave more time between doses. can happen with any Parkinson’s
drugs. See the section on side effects
of Parkinson’s drugs to find out more.
Risks and side effects
of MAO–B inhibitors Increased risk of low
blood pressure
Antidepressants If you take a high dose of MAO-B
If you’re taking some types of inhibitor medication, eating and
antidepressant, you might not drinking certain things can increase
be able to take MAO–B inhibitors. low blood pressure. Because of the
This is because these drugs can doses used in Parkinson’s this is not
interact with each other and raise thought to be a problem, but speak
blood pressure to a dangerous level. to your specialist or Parkinson’s
nurse if you have any concerns.
33
Other side effects You will take rasagiline once per
The patient information leaflet that day, which can be helpful if you
comes with your medication will tell prefer to take fewer doses. But be
you the full range of side effects aware that this option may not be
that you may experience. suitable for everyone. You can take
it with or without food.
Some of the possible side
effects include: Selegiline (Eldepryl, Zelapar)
Selegiline is a type of generic
yy headaches (unbranded) MAO-B inhibitor
medication. Eldepryl and Zelapar
yy constipation are the branded versions of selegiline.
yy dry mouth
Selegiline is started at 5 mg and
yy an urgent need to pass urine increased after two to four weeks
yy aching joints to 10 mg.
34
Zelapar dissolvable tablets Benefits and risks of
Selegeline is available as tablets rasagiline, selegiline
which dissolve on the tongue and safinamide
(Zelapar dissolvable tablets). This
Rasagiline (Azilect), selegiline
can be helpful if you experience
(Eldepryl, Zelapar) and safinamide
problems with swallowing.
(Xadago) are commonly used to
treat Parkinson’s and most people
To take Zelapar tablets, put one on
will experience improvement
your tongue before eating breakfast.
in their symptoms.
You should wait five minutes for
it to dissolve before eating,
See the section on the risks and
drinking, or rinsing your mouth
side effects of MAO-B inhibitors
so this medication can work.
to find out more.
Safinamide (Xadago) For the full range of side effects,
Safinamide is a type of generic see the patient information leaflet
(unbranded) MAO-B inhibitor that comes with your medication.
medication. Xadago is the branded
version of safinamide.
35
COMT inhibitors
38
Co-careldopa and Opicapone (Ongentys)
entacapone (Stalevo, Opicapone (Ongentys) is a type of
Sastravi) COMT inhibitor medication. If you
Stalevo and Sastravi are branded take levodopa for a long time, you
versions of co-careldopa and may experience end of dose motor
entacapone medication. This fluctuations when your symptoms
means they combine the levodopa are poorly controlled before your
medication co-careldopa (see next dose is due. If this happens
the section on co-careldopa) you can take opicapone with
with entacopone (see the your levodopa medication to
section on entacapone). ease this issue.
40
Amantadine
42
Anticholinergics
43
Benefits of anticholinergics Memory problems
Anticholinergics are not often given
Improving Parkinson’s symptoms to people with Parkinson’s because
Some anticholinergics may help they can cause memory problems
with tremor with some Parkinson’s or make existing problems worse.
symptoms when other medication This can happen at any age, but
is no longer working. particularly for older people.
44
Procyclidine (Kemadrin) Alternatively, it is available as
Procyclidine (Kemadrin) is a type a syrup. These options are useful
of anticholinergic medication. if you have difficulty swallowing
tablets. They can also release your
It may be helpful if you experience medication more quickly.
muscle spasms (dystonia) which
cannot be controlled with other Procyclidine (Kemadrin) can
medication. It may also help to be taken with levodopa and
control more complex Parkinson’s amantadine medication. Your
symptoms such as delusions specialist will be able to discuss
(seeing, hearing, feeling, smelling whether this option is right for you.
or tasting something that isn’t
really there). Trihexyphenidyl
(also called benzhexol)
Taking procyclidine (Kemadrin) Trihexyphenidyl or benzhexol is a
The most recent and complete type of anticholinergic medication.
information on your specific drug will
be on your patient information leaflet It may be helpful if you experience
that comes with your medication muscle spasms (dystonia), tremor
packet. Always read it carefully or excessive saliva production
before you start your treatment. (sialorrhoea) which cannot be
controlled with other medication.
For detailed information you should
follow the advice of your healthcare Taking trihexyphenidyl medication
professional about how to take You will usually take trihexyphenidyl
procyclidine (Kemadrin) so that medication three or four times
it works well for your Parkinson’s. a day at mealtimes. If you find
that it causes you to experience
You will usually take Kemadrin a dry mouth your specialist
three times a day. Your specialist or may recommend you take
Parkinson’s nurse can increase your trihexyphenidyl before your meal.
dose until it controls your symptoms.
This can make you feel sick. Instead
There is also the option to have you can take your medication after
procyclidine (Kemadrin) as an you have finished eating. If you do
injection into your muscles. this, you may notice an increased
thirst. Water, peppermint or
chewing gum can help this issue.
45
Your specialist will prescribe a small most people will experience a mild
dose of trihexyphenidyl at first improvement in their symptoms.
and this will be increased until
your symptoms are controlled. See the section on the risks and
side effects of anticholinergics
You can take trihexyphenidyl with to find out more.
your levodopa medication. Your
specialist will be able to discuss For the full range of side effects,
whether this option is right for you. see the patient information leaflet
that comes with your medication.
Benefits and risks
of procyclidine and
trihexyphenidyl medication
Trihexyphenidyl (or benzhexol) and
procyclidine (Kemadrin) is sometimes
used to treat Parkinson’s and
46
PARKINSON’S DRUGS AND
HOW TO PRONOUNCE THEM
This list shows the class of Parkinson’s drug in capital letters, the
unbranded name of the drug in bold and the brand name in bullet points.
The pronunciation of each drug is written in blue.
This list doesn’t show the order in which medications are prescribed. Everyone
with Parkinson’s will have a drug regime that is right for them.
LEVODOPA LE-vo-do-pa
Co-beneldopa koh–BEN–el –DOH-puh
yy Madopar (capsules, dispersible tablets) MAH-doh-par
yy Madopar CR (controlled release capsules)
Co-careldopa koh–KA-rul-DOH-puh
yy Caramet CR KA-ra-met
yy Lecado (modified release tablets) LEH–kah–doh
yy Half Sinemet CR (controlled release tablets) SIN-nuh-met
yy Sinemet (tablets)
yy Sinemet Plus (tablets)
yy Sinemet CR (controlled release tablets)
DOPAMINE AGONISTS
DOH-puh-meen-A-gu-nists
Pramipexole PRA-me-PEK-sol
yy Mirapexin (tablets) MIH-ruh-pek-sin
yy Mirapexin (prolonged release tablets)
yy Pipexus (modified release tablets) pi-PEX-us
yy Glepark (tablets) GLE-park
yy Oprymea (tablets) o-PRY-mea
yy Zentiva (prolonged release tablets) zen-TIVA
Ropinirole roh-PIH-nih-roll
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Rotigotine ra-TIH-goh-teen
yy Neupro (skin patch) NEW-pro
Apomorphine A-poh-MOR-feen
yy Apo-go pre-filled pen for intermittent injection A-poh–go
yy Dacepton cartridge for Intermittent injection (can be used with
a re-usable pen) DAH-sep-ton
yy Apo-go pre-filled syringe for infusion (can be used with a continuous
infusion pump)
yy Dacepton vial (can be used with a continuous infusion pump)
Bromocriptine bro–mo–KRIP-teen
We have not included information about bromocriptine because
this medication is rarely used.
yy Parlodel (tablets, capsules) PAR-luh-del
Cabergoline ka–BER–go– leen
We have not included information about cabergoline in this booklet
because this medication is rarely used.
yy Cabaser (tablets) ka-BA-suh
yy Dostinex (tablets) DOS-ti-nex
Pergolide PER-guh-lied
We have not included information about pergolide in this booklet
because this medication is rarely used.
49
MAO-B INHIBITORS
M-A-O-B-in-HIH-bi-tuz
Rasagiline ra-SAH-ji-leen
COMT INHIBITORS
KOMT in-HIH-bit-ers
Entacapone en-TA-kuh–pone
yy Comtess (tablets) KOM–tess
Co-careldopa and entacapone
koh–KA-rul-DOH-puh and en-TA-kuh–pone
yy Stalevo/Sastravi (tablets) sta-LE-voe / Sa-STRA-ve
yy Stanek (tablets) st-A-neck
50
yy Tolcapone TOLL-kuh-pone
We have not included information about Tolcapone in this booklet because
this medication is rarely used.
yy Tasmar (tablets) TAZ–mar
Opicapone oh-PEE-kuh–pone
ANTICHOLINERGICS
anti-colin-ER-gics
Procyclidine
pros-I-claire-deen
yy Kemadrin (tablets, syrup) ka-MAY-drin
yy Kemadrin (solution for injection)
Trihexyphenidyl (benzhexol) (tablets, syrup)
TROX-i-fen-i-dril
BEN-ex-ol
Sometimes, new Parkinson’s medication is produced, or stopped.
The most recent list of treatments is available at
parkinsons.org.uk/drug-treatment
51
NOTES
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52
MEDICATION RECORD
MY DETAILS USEFUL CONTACTS
Name GP name and phone number
53
54
Apomorphine DBS
Name and phone number of the person I have a DBS unit. The serial number is
who administers my pump is
Flow rate and start stop time of my My DBS nurse and phone number is
pump is
Apomorphine devices that I use are My DBS specialist and phone number is..0
(Name of syringe, needle pen, vile,
cartridge?)
My medication
Date Medication name Dose Times of doses Notes
55
56
My medication
Date Medication name Dose Times of doses Notes
My medication
Date Medication name Dose Times of doses Notes
57
58
My medication
Date Medication name Dose Times of doses Notes
more information
and support
Reporting a side effect Parkinson’s nurses
The Medicines and Healthcare Parkinson’s nurses provide expert
Products Regulatory Authority advice and support to people with
(MHRA) is the government body Parkinson’s and those who care for
that makes sure that drugs work them. They can also act as a liaison
and are safe. It is keen to receive between other health and social
feedback about medication care professionals to make sure
side effects. your needs are met.
59
affected by Parkinson’s. They can
also provide links to local groups
and services.
60
Drug treatments for Parkinson’s (PKB013/2019)
Do you have any feedback about this information? Your comments
will help us ensure our resources are as useful and easy to understand
as possible. Please return to Information Content team,
Parkinson’s UK, 215 Vauxhall Bridge Road, London SW1V 1EJ,
or email publications@parkinsons.org.uk. Thank you!
*We ask about your ethnicity to ensure our information is reaching a broad range of people.
However, this question is optional.
Name
Address
Email
Telephone
63
Every hour, two people in the UK are told they have Parkinson’s – a brain
condition that turns lives upside down, leaving a future full of uncertainty.
We want everyone to get the best health and social care. So we bring
professionals together to drive improvements that enable people to live
life to the full.