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What Ingredients Does Madpar Contain?

Posted on Sat, 22 Nov 2014

Question: Hullo Doctor, my question is : I am currently on Madopar 125 which I take 2 capsules 5 times a day. Also 1 Azilect 1mg once daily. 8 mg Neupro Rotigotine Patches. 1 Madopar HBS SR Capsule 100mg/25mg daily and if I need it Madopar Rapid 62.5. I can take up to 2 capsules daily. I was up to about 6 weeks ago on Kinson Tablets, also 5 times daily. I have been going through a bad time as I was also put on Stalevo by another Dr.and also told to stop Kinson, but she cut down my intake of Levodopa which affected me dreadfullly. I went back to my original Dr. who has got me on the Madopar. He now has said I must take
Amantadine. What ingredient/s does Amantadine have and do you think I will be taking too much medi ation? I get very tired and feel I want to sleep (but don't and can't) when it is time to take my medication.
is this right? also I suffer periodically from Dystonia in both my feet and my face goes into a spasm, very distressing, but as I have said, I would like to know about taking Amantadine.
Thank you Doctor for your trouble. XXXXXXX
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Answered by Dr. Prakash H Muddegowda (1 hour later)

Brief Answer:
Try levodopa reduction first

Detailed Answer:
Hi XXXXXXX
Thanks for asking.

I am Dr. Prakash HM and I will be answering your query.

Based on your query, my opinion is as follows:

1. You are on
a. Madopar - contains bensarazide and levodopa - you are using these in various methods and compositions
b. Azilect - rasagiline composition - Possible neuroprotective effect
c. Neupro Rotigotine patches - rotigotine composition
d. Kinson - Contains carbidopa and levodopa

2. Stalevo and Kinson are almost similar as both contain similar composition. Additionally Stalevo contains entocapone - which helps in increasing levodopa availability in blood. If you had taken for more time, it could have been helpful.

3. Amanatidine is a weak dopamine agonist. It has modest therapeutic effect and numerous side effects. If there is drug induced dyskinesia, amatidine needs to be added and will prove to be useful. It could reduce spasms and dystonias (side effect of Levodopa). However, levodopa reduction should be tried first before starting on Amanatidine.

4. Yes, you are on multiple medications - and all of them have different functions. Dosage reduction of levodopa is necessary before starting amanatidine

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prakash H Muddegowda (19 hours later)

Hullo Dr. thank you for your reply. You suggest I cut down on Levodopa before going on to Amantidine, how do I go about doing that without suffering the affects of reduction of Levodopa to my body? Thank you. XXXXXXX

Answered by Dr. Prakash H Muddegowda (3 hours later)

Brief Answer:
Need to reduce peak dose levodopa.

Detailed Answer:
Hi,
Thanks for asking again.

Levodopa induced dyskinesia usually occurs at the peak. If you have any specific period, during which the dyskinesia is extreme - you can try reducing the specific dose or the total daily dose. For my patients, I would ask them to reduce the specific dose, when dyskinesia is extremely high.

To reduce the effects of reduction of levodopa on body, I would advise my patients to take smaller, but frequent doses to avoid severity of peak dose dyskinesia.

Addition of entacopone, will further help in reducing the dose of levodopa.

If still not reduced, amanatidine can be added to improve symptoms.

Levodopa induced dyskinesia is difficult to manage, but is necessary. For the management - dose change, reduction, addition of medication, meet your doctor.

Hope it helps.

Any further queries, happy to help again.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar