How does co-careldopa work?
Co-careldopa works by increasing the amount of dopamine in your brain. Dopamine is an important chemical which sends nerve messages from your brain to your muscles.
With Parkinson's disease, you have less dopamine and so it's harder for your brain to send these messages. This can make you shake, as well as making your muscles stiff and your movements slow.
Co-careldopa contains 2 medicines that help your symptoms:
- levodopa – this is changed into dopamine in your brain, allowing your nerves to send messages to your muscles and improve the way you move
- carbidopa – this stops levodopa from being changed into dopamine in the rest of your body. This reduces the risk of side effects such as sickness and a fast heartbeat
When will I feel better?
You may notice an improvement after taking your 1st dose. However, it can take up to a week for co-careldopa to have its full effect.
Talk to your specialist if you do not see any change after taking co-careldopa for 2 weeks.
Are there any long-term side effects?
Many people take co-careldopa safely for many months or years. However, it does not work as well over time and you may notice the effects wearing off. This is when the benefits wear off before the next dose, so there are times when you're stiff or slow.
Speak to your doctor or specialist nurse if this happens. They may need to change your dose.
If you take co-careldopa for several years, or at a high dose, you can get uncontrolled movements (called dyskinesias). These can include twitching, twisting or writhing movements. Speak to doctor or specialist nurse if this happens.
How does co-careldopa compare to other Parkinson's disease medicines?
Co-careldopa contains levodopa and carbidopa. These can also be combined with other Parkinson's disease medicines to treat your symptoms.
Benserazide can be combined with levodopa to make co-beneldopa (brand name Madopar). This comes as capsules or soluble tablets and works in the same way as co-careldopa.
Entacapone can be combined with co-careldopa (brand names Stalevo, Sastravi or Stanek). This combination can help if the effects of co-careldopa are wearing off and it's no longer working for you on its own.
When is co-careldopa gel used and who is it for?
Co-careldopa gel (brand name Duodopa) can be used to treat advanced Parkinson's disease. This is when symptoms are more difficult to manage and tablets are no longer working. The symptoms may start to affect your daily life.
If your specialist wants you to try co-careldopa gel, they’ll usually give it to you for a few days to see if it helps. They’ll put a tube down your nose so the gel can go into your stomach.
If your symptoms improve, and you and your specialist agree to continue using the gel, you’ll need surgery. A permanent tube will be connected to your small intestine. This is done by putting it in through the skin near your belly button and gently pushing it through into your small intestine. The gel is then given as a single dose, over 10 to 30 minutes (called a bolus dose) in the morning, followed by a continuous dose given gradually through the day (basal dose). You'll have a break of about 8 hours overnight.
Your doctor or specialist nurse will show you how to use the gel and how to keep your tube clean. You'll have regular check-ups to see how it's working for you.
Will it affect my contraception?
Co-careldopa does not stop any type of contraception from working, including the combined pill and emergency contraception.
But if co-careldopa makes you vomit, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Find out more:
Can I drive or ride a bike?
Some people find that co-careldopa makes them sleepy, dizzy or makes them fall asleep suddenly.
If this happens to you, do not drive, cycle or operate machinery. Speak to your doctor. They’ll tell you when you can start driving again once these side effects stop.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
GOV.UK has more information on the law on drugs and driving.
If you've been diagnosed with Parkinson's disease, you must tell the DVLA and your car insurance company straight away.
Can I drink alcohol with co-careldopa?
Drinking alcohol while taking co-careldopa tablets can make you feel sleepy or tired.
It's best to stop drinking alcohol when you start taking co-careldopa, until you know how the medicine affects you.
Is there any food or drink I need to avoid?
You can eat and drink normally while taking co-careldopa.
However, it's best to avoid taking co-careldopa at the same time as meals containing lots of protein (such as meat, eggs, cheese, beans or lentils). Protein can reduce the amount of co-careldopa your body takes in, meaning that your medicine will not work properly.
What else can help with symptoms of Parkinson's disease?
There's currently no cure, but there are treatments for Parkinson's disease to help relieve the symptoms and maintain your quality of life.
These treatments include:
- supportive therapies, such as physiotherapy or speech therapy
- medicine
- surgery (for some people)
You may not need any treatment during the early stages of Parkinson's disease, as symptoms are usually mild. But you may need regular appointments with your specialist so your condition can be monitored.
A care plan will usually be agreed with your healthcare team and your family or carers. This will outline the treatments and help you need now and what you're likely to need in the future. This will need to be reviewed regularly.
Regular exercise is particularly important, as it helps relieve muscle stiffness, improves mood and relieves stress.
Find out more about living with Parkinson’s disease, including advice on staying active.