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Absorption of Sinemet requires optimal GI health. Is anyone working on a sublingual delivery of the medication?

Tuesday January 29, 2013

 Carbidopa/Ldopa is one of the most commonly used medicines for Parkinson’s disease. Ldopa chemically resembles the amino acids or building blocks that make up protein. Because of this, Ldopa ‘competes’ with protein for absorption through the intestines and into the brain.

As the question suggests, optimal absorption of ldopa is important to avoid fluctuations in motor response. A dissolvable form of carbidopa/ldopa does exist but unfortunately it does not absorb through the mouth and still requires swallowing of medicine into the intestine for absorption. An infusion form of Ldopa gel was developed to deliver Ldopa directly to the intestine. This allows precise changes or titration of  the  amount delivered by using a pump to match the needs of the patient. This form of the medicine and pump delivery is still being studied in clinical research trials and requires that a feeding tube be placed by a surgical procedure into the stomach and advanced through to the small intestines where Ldopa is absorbed. Researchers are also studying different ways to deliver Ldopa using special techniques such as a patch formation. This mode of delivery is not currently available because Ldopa does not easily absorb through the skin requiring special technology to enhance its absorption.

The following tips can help:

  • Treat constipation and bloating
  • Be sure to get plenty of water, fiber and exercise to help transit of food through the GI tract
  • Separate timing of Ldopa dosing from meals
  • Eat the majority of your day’s protein when you are less active such as the endo of day
  • Eat plant sources (nuts, beans, soy) over animal sources of protein

Click here to read more on this topic.

Monique L. Giroux, MDMonique L. Giroux, MD
Guest Blogger, Former Medical Director of NWPF

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