Madopar

In Aotearoa New Zealand, Madopar is available in different forms and strengths with different amounts of carbidopa and benserazide in each capsule or tablet. This combination is available in 3 forms, capsules, modified-release capsules and dispersible tablets. Modified release means that the capsules release the medicine slowly over several hours, so the effect of the medicine lasts longer than that of standard capsules. Dispersible means that the tablets can be dissolved in water for people who find it hard to swallow tablets or capsules. 

• Madopar capsules: 62.5mg, 125 mg, 250 mg
• Madopar HBS (also called modified-release capsules): 125 mg
• Madopar Rapid (also called dispersible tablets): 62.5 mg.

The dose of Madopar is different for different people.

• You will be started on a low dose and, depending on your response, your doctor will increase your dose to control your symptoms.
• Always take your Madopar exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much Madopar to take, how often to take it, and any special instructions.

• Capsules (also called immediate release capsule): swallow the capsule whole. If you are struggling to swallow the capsules, you can open it and mix the contents of the capsule with a liquid or soft food such as a spoonful of yoghurt.
• Modified release capsules (usually has HBS after the name): swallow the capsule whole, with a glass of water. Do not crush or chew the capsules because this will release all the medicine at once, increasing the chance of side effects and causing a loss in symptom control.
• Dispersible tablets: swallow the tablets whole, or you can disperse (dissolve) the tablet into a small glass of water or orange cordial (but not fruit juice).
• Timing: Take Madopar at the same times of day each day. Madopar is best taken on an empty stomach, but if it upsets your stomach, take it with or just after food. Avoid taking Madopar with a high-protein meal because the protein may decrease the effects of this medication.
• Missed dose: If you do miss a dose and it is nearly time for your next dose, skip the missed dose and take your next dose at the usual time. Otherwise, take the missed dose as soon as you remember. Do not take two doses at the same time or very close together.
• Keep taking Madopar regularly. Do not stop taking Madopar or lower the dose, without checking with your doctor. Your doctor may want you to gradually reduce your dose before stopping completely. This may help reduce the possibility of withdrawal symptoms such as muscle stiffness, fever and mental changes.

For some people with Parkinson’s, protein (which is found mainly in meat, fish, eggs, cheese, beans and pulses) seems to interfere with how well levodopa medications are absorbed by the body. Because of this, you may benefit from taking your medicine 30–60 minutes before you eat a meal.

You may also benefit from a protein redistribution diet, where you take most of your daily protein in the evening. This can help the levodopa treatment to be more effective in the daytime, when you are likely to need it more.

Protein is essential for a healthy diet so you should not reduce your overall intake. Talk to your doctor before you make any changes to what you eat.

Like all medicines, Madopar can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Madopar can interact with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting Madopar and before starting any new products.