This article addresses some common questions about MADOPAR. It does not contain all available information and is not intended to replace your doctor, who knows you better and knows how to take care of you.
All medications have both unwanted effects and benefits. If you have any questions or doubts about this medicine, consult your doctor or pharmacist.
What is MADOPAR used for?
MADOPAR contains two active ingredients called levodopa and benserazide. It belongs to a group of medicines called antiparkinsonian agents and is used for the treatment of Parkinson’s disease.
Antiparkinsonian agents work on the central nervous system. The symptoms of Parkinson’s are caused by a deficiency of a brain chemical called dopamine. MADOPAR helps to correct this deficiency.
By improving muscle control, MADOPAR enables more normal body movements. The symptoms of patients with Parkinson’s can be reduced by taking this medicine.
However, MADOPAR does not cure the disease, as it does not address the cause of the dopamine deficiency in the brain.
Nevertheless, your doctor may have prescribed it for other purposes; ask your doctor why it has been prescribed to you.
You can purchase this medicine only with a doctor’s prescription.
Before taking MADOPAR
Do not take it if you are allergic to:
- any medicine containing levodopa or benserazide
- any of the ingredients listed in the package insert of the medicine
Some symptoms of an allergic reaction may include:
- shortness of breath
- labored or difficult breathing
- swelling of the face, lips, tongue, or other parts of the body
- skin rash, itching, or hives
Do not take it if:
- you have taken a non-selective monoamine oxidase inhibitor (MAOI) like phenelzine or tranylcypromine in the last 2 weeks
- you have taken a combination of an MAO-A inhibitor, such as moclobemide, with an MAO-B inhibitor, like selegiline or rasagiline.
- you have heart, liver, kidney, lung, blood, or endocrine (hormonal) diseases
- you have narrow-angle glaucoma (high eye pressure)
- you are being treated for severe mental illnesses (active psychosis or severe psychoneurosis)
- you have melanoma or suspected melanoma
- you are under 30 years old
- you are being treated for Huntington’s chorea or intentional tremor
Do not take MADOPAR after the expiration date (EXP) printed on the packaging or if the packaging is torn or shows signs of tampering. Taking this medicine after the expiration date may not work as well.
If you are unsure whether you should or can take MADOPAR, talk to your doctor.
You must inform your doctor if:
- you are allergic to any other medicine, food, dyes, or preservatives
- you are pregnant or planning to become pregnant
- you are breastfeeding or planning to breastfeed
- you intend to have surgery
- you have other health problems, including:
- seizures
- diabetes
- stomach ulcers
- feeling down (depression) or other psychological disorders
- osteoporosis or osteomalacia
- irregular heartbeat
- wide-angle glaucoma (high eye pressure)
- any compulsive behavior disorder
- sudden onset of sleep disturbances
- other illnesses.
Your doctor will discuss any potential risks of taking MADOPAR during pregnancy or breastfeeding.
If you haven’t discussed this with your doctor yet, do so before starting to take MADOPAR.
When taken with certain foods, MADOPAR may not have the same effect if taken with a protein-rich meal (e.g., meat).
Taking other medicines
Inform your doctor if you are taking other medications or supplements, even if you have purchased them without a prescription at a pharmacy, supermarket, or natural food store.
SOME MEDICINES AND MADOPAR MAY INTERFERE WITH EACH OTHER.
These medications include:
- sympathomimetics such as cough and cold medicines containing ephedrine or pseudoephedrine, adrenaline, noradrenaline, isoprenaline, desamfetamine, asthma preparations, Epi-pens
- blood pressure-lowering drugs like metoprolol, atenolol
- other antiparkinsonian drugs like anticholinergics, amantadine, selegiline, bromocriptine, and dopamine agonists
- iron-containing medicines
- relief from nausea drugs like metoclopramide
- some medicines used to treat mental illness, especially phenothiazines, tricyclic antidepressants, and butyrophenone derivatives such as chlorpromazine, fluphenazine, prochlorperazine, thioridazine, haloperidol, or trifluoperazine
- general anesthetics, especially cyclopropane and halothane. If you know you are going to have surgery, you should stop MADOPAR 2-3 days before. Discuss this with your doctor beforehand.
- opioids like morphine, pethidine, methadone, and codeine (these may be present in some cough medicines and cold preparations)
- antacids (heartburn or indigestion medicines) should not be taken at the same time as MADOPAR HBS, as they interfere with the controlled release of Madopar HBS. Antacids can be taken at other times of the day.
Taking these medicines can affect the effectiveness of MADOPAR or vice versa; you may need to adjust the dose or change the medication to maintain efficacy.
Your doctor or pharmacist has more information on which medicines to avoid or be cautious about while taking this medication.
If you haven’t discussed this with your doctor yet, do so before starting the medication. Ask your doctor or pharmacist if you have any doubts about the medicines in this list.
How to take MADOPAR
Follow your doctor’s or pharmacist’s instructions carefully. This may vary from the information provided in this leaflet.
HOW MUCH TO TAKE
Your doctor will tell you exactly how many tablets or capsules you should take each day.
The dose depends on the symptoms and the patient’s response to the medicine. The dose is adjusted for each person. If you take too little MADOPAR, you won’t be able to control your symptoms.
If you take too much, you may experience unwanted effects. It may take several weeks before the right dose for you is reached.
Remember that this is just a guideline.
Treatment with MADOPAR typically begins with low doses, which can be increased every week until the right amount is reached. The doctor will decide which dose is best for you.
Do not stop taking it without discussing it with your doctor.
MADOPAR HBS Capsules (slow-release)
MADOPAR HBS is different from other MADOPAR products. It takes longer to take effect, but its action window is longer.
If you switch from regular MADOPAR to MADOPAR HBS, start with the same number of capsules or tablets, and then the doctor will gradually increase the dose.
Some people switching to MADOPAR HBS capsules may experience a slight worsening at the beginning. The worsening should be temporary, but discuss it with your doctor if you are concerned.
When you take MADOPAR HBS, the doctor may advise you to take a MADOPAR tablet or MADOPAR Rapid tablet (disperse) in the morning to help better control your symptoms.
HOW TO TAKE IT
MADOPAR Capsules
Capsules or tablets should be swallowed with a glass of water or a non-alcoholic beverage.
MADOPAR HBS Capsules
MADOPAR HBS capsules should be swallowed whole and not chewed, opened, or dissolved in liquid.
MADOPAR Rapid Tablets (disperse)
Rapid tablets are intended for people who have difficulty swallowing whole tablets or need the medicine to work quickly. They can be dissolved in at least 25-50 ml of water. The tablets dissolve completely in a few minutes, producing a milky-looking liquid that you should drink within 30 minutes. Remember to mix the liquid immediately before taking it.
MADOPAR Tablets
Tablets can be broken along the scoreline. Tablets that do not break cleanly along the scoreline should not be taken. Do not chew capsules or tablets.
WHEN TO TAKE IT
If possible, it should be taken 30 minutes before a meal or an hour after a meal. However, some patients prefer to take it with food.
If you experience stomach upset shortly after taking MADOPAR, try taking it with a small snack (e.g., a biscuit). If you have any concerns, discuss them with your doctor.
HOW LONG TO TAKE MADOPAR
Once you start taking it, you should take it forever. You may need at least 6 months before deciding if it is the right medication for you.
Continue taking it until your doctor tells you to stop.
IF YOU FORGET TO TAKE IT
If it is almost time for the next dose, skip the missed dose and take the next dose.
Otherwise, take it as soon as you remember, and then continue your treatment as usual.
Do not take a double dose to make up for the one you missed. This could increase the risk of unwanted side effects.
If you have difficulty remembering to take the medication, ask the pharmacist for advice. If you are unsure of what to do, ask your doctor or pharmacist.
If you think you or someone else has taken too much, please contact the Poison Information Center (there is no national number; you can check the number of the center closest to you at this link) for advice or go to the nearest hospital for an emergency.
Do this even if there are no signs of disturbances or poisoning. Urgent medical intervention may be necessary.
Keep emergency numbers handy. If you take an overdose of MADOPAR, it could be more severe.
While taking MADOPAR
Things you must do
If you have surgery, tell the surgeon or anesthetist that you are taking this medicine.
Inform the doctor if you become pregnant while taking MADOPAR.
Inform the doctor if, for any reason, you have not taken the medicine exactly as prescribed. Otherwise, the doctor may think it was not effective and change the treatment unnecessarily.
Tell the doctor if you believe the drug is not affecting your condition.
Tell your doctor if you experience insomnia or, conversely, if you experience daytime sleepiness.
Make sure to keep all appointments with the doctor so that your progress can be monitored.
The doctor may want to perform regular tests while you are taking this medication.
Things you must not do
Do not stop taking MADOPAR or change the dose without consulting your doctor.
Do not run out of medication during the weekend or on holidays.
Do not give the medication to anyone else, even if they have the same condition as you.
Do not use the medication to treat other disorders unless your doctor tells you to do so.
Do not take other medications without first talking to your doctor, even if a prescription is not required.
Things to be careful of
Be cautious about driving or operating dangerous machinery until you know how this medication affects you; it is associated with excessive drowsiness, and very rarely excessive drowsiness is associated with daytime sleep attacks.
Inform the doctor if you experience these effects so that they can be addressed.
Side effects
Inform the doctor or pharmacist as soon as possible if you do not feel well while taking the medicine; MADOPAR helps most people with Parkinson’s disease, but it may have unwanted effects on some people.
All medicines can have side effects. Sometimes they are serious, but most of the time they are not. Medical intervention may be necessary if you experience some of the side effects.
Do not be alarmed by the following list of side effects. You may not experience any of them.
Ask your doctor or pharmacist about any doubts you may have.
Inform the doctor if you notice any of the following symptoms:
- involuntary abnormal body movements. These are usually caused by a too-high dose and will decrease when the dose is reduced
- mental changes, including paranoia, depression, mania, agitation, and hallucinations (seeing, hearing, or feeling things that are not there)
- fluctuations in the effect known as freezing episodes. These can be resolved by asking the doctor to adjust the drug dose
- nausea and vomiting
- loss of appetite
- weight gain
- constipation
- skin rash or itching
- confusion, tiredness, insomnia, or sudden onset of sleep episodes
- low muscle tone, hiccups
- restlessness
- fluid retention, cramps
The above are common, especially if you have just started taking MADOPAR.
- changes in sexual desire or hypersexuality
- signs of compulsive behavior (performing a repetitive and purposeless activity)
- loss of taste
- your urine, mouth, saliva, tongue, and teeth may become darker with a reddish hue
- increased bleeding or bruising
- frequent infections such as fever, severe chills
- sore throat or mouth ulcers
Inform the doctor as soon as possible if you notice any of the following symptoms:
- palpitations or changes in heart rate or rhythm, chest pain, dizziness when standing
- diarrhea
- confusion
These can be serious side effects, and the doctor may need to change the dose.
This is not a complete list of all possible side effects. Others may occur in some people, and there may be some side effects not yet known.
Tell your doctor if you notice anything else that makes you feel unwell, even if it is not on this list.
Ask the doctor or pharmacist if you do not understand anything on this list.
After taking MADOPAR
Storage
- Keep the capsules or tablets in the bottle with the cap tightly closed until you take them.
- If you remove the capsules or tablets from the bottle, or if the cap is loose, they may not store well.
- Store the capsules and tablets in a dry place where the temperature remains below 25°C.
- Do not store it in a bathroom or near a sink.
Do not leave it in the car or on window sills.
Heat and moisture can destroy medicines. - Keep it out of the reach of children.
A locked cupboard at least one and a half meters above the ground is a good place to store medicines.
Disposal
If the doctor tells you to stop taking MADOPAR, or if the tablets/capsules have exceeded the expiration date, ask the pharmacist what to do with the remaining medicine.
