Medicines for Parkinson's disease

Medicines do not prevent Parkinson's but they aim to improve your daily functioning. Medicines are usually started when symptoms begin to disrupt your daily life.

Everybody's experience of Parkinson's is different and your healthcare team will work with you to find the best treatments for your particular symptoms. Depending on your symptoms and responses to medicines, you may need to try a combination of medicines and your medicines may change over time as your symptoms change.

On this page you will find information about:

What are the main medicines for Parkinson's?

In Parkinson's, brain cells that produce dopamine stop working properly and are lost slowly over time. Dopamine is a chemical in your brain that helps control movement. The main aim of medication when you have Parkinson’s is to increase the level of dopamine that reaches your brain.  
There are many different types of medicines for Parkinson's. Most medicines work by topping up or mimicking (copying) the effect of dopamine. Read more about Parkinson's.

(Parkinsons's UK)

Medicines
Levodopa

Levodopa medicines are the medicines most commonly used for Parkinson's.

  • Levodopa is always combined with another medicine (either carbidopa or benserazide) to prevent levodopa from changing to dopamine in your bloodstream before it reaches your brain. This means that more levodopa can enter your brain, causing fewer side effects from dopamine, eg, nausea and vomiting. 
  • Read more about levodopa + carbidopa and levodopa and benserazide
Dopamine agonists

  • Ropinirole (Ropin®)
  • Pramipexole (Rampipex®)
  • Apomorphine (Movapo®)
  • Dopamine agonists work by tricking your brain into thinking they are dopamine. They improve movement symptoms. 
  • Apomorphine is often used when pills or capsules no longer work well enough to control Parkinson's symptoms on their own.
  • Read more about ropinirolepramipexole and apomorphine.
COMT inhibitors

  • Entacapone: (Entapone®, Comtan®)
  • Tolcapone: (Tasmar®)
  • Entacapone and tolcapone prolong the effects of levodopa by preventing the breakdown of the medicine in your brain. 
  • They have to be taken at the same time as levodopa, otherwise they won't be effective.
  • Read more about entacapone and tolcapone.
MAO-B inhibitors
  • Rasagiline (Azilect®)
  • Selegiline (Apo-Selegiline, Eldepryl®)
  • MAO-B is an enzyme that breaks down dopamine. Rasagiline and Selegine work by stopping this enzyme so that more dopamine is available to treat your symptoms.
  • These medicines may be suitable if you have mild symptoms.
  • Read more about rasagiline.
Note: In early 2022 selegiline tablets will no longer be available in New Zealand. If you are taking selegiline tablets, talk to your doctor about other treatment options. 
Amantadine (Symmetrel®)

  • Amantadine is used to control tremor and stiff muscles.
  • It’s thought to increase dopamine in your brain.
  • Amantadine is a weak dopamine agonist and is usually used with levodopa.

How do I take my Parkinson’s medicines?

The following tips will help you take your Parkinson's medicines properly.

Timing is important

It is important to take your Parkinson’s medicines on time, every time. Not taking your medicines at the right time can lead to your symptoms becoming worse, and it can take a while for this to be put right again.

For best results, take medicines at the same time each day. If you are going to be changing your routine, eg, when going on holiday or into hospital, talk to your doctor or pharmacist so you can plan your medicine schedule beforehand.

Keep a medicine and symptoms diary

Keeping a diary can help you to monitor your condition and keep track of your medicines. A diary can be a useful way of letting your doctor know what problems you’re experiencing, any changes in your condition from day-to-day or over a period of time, and how well your medicine is controlling your symptoms. It can also help remind you of things you want to discuss during your appointment that you may otherwise forget. You can also use it to record any embarrassing issues that you want help with but find difficult to ask about. Here is some advice on the type of information you might want to keep track of if you have Parkinson's yourself, or if you are caring for somebody else with Parkinson's.

Side effects – talk to your doctor or pharmacist 

Like any medicines, Parkinson's medicines can give you side effects. If you get side effects from your Parkinson's medicines, tell your doctor or pharmacist. Common side effects include nausea (feeling sick), light-headedness, leg swelling and sleep problems. Also let them know if you think your medicines are causing confusion, hallucinations or involuntary movements. Some people have an unusual desire to gamble or engage in other obsessive behaviours. Tell your doctor if you experience any side effects, they may adjust the amount of medicine you take or you may be given another type. It is important that you don't stop taking your Parkinson’s medicines until you are advised to do so.

Swallowing problems

Swallowing difficulty can occur at any stage of Parkinson's. This can be a problem when taking your medicines. Tell your doctor or pharmacist if you have problems swallowing your medicines. They may recommend you see a speech language therapist.

Some medicines should not be broken or crushed and your doctor may switch you to another type of medicine if this is needed. Ask your pharmacist for advice. Read more about difficulty swallowing medicines

Medicines to avoid

Some medicines can bring on Parkinson’s-like symptoms or react with Parkinson’s medicines and should be avoided unless they’re recommended by a specialist. That's why it is always important to let your doctor, nurse or pharmacist know about any medicines you are taking before starting any new ones. This includes over the counter medicines (eg, antihistamines, cold and cough medicines), herbal supplements and rongoā Māori

Learn more

Medication used in the treatment of Parkinson's Parkinson's New Zealand
Parkinson's and complementary therapies Parkinson's New Zealand
Parkinson's New Zealand

References

  1. The management of Parkinson’s disease: which treatments to start and when? BPAC, NZ, 2014
  2. Parkinson's disease NZ Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 22 Nov 2021