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Diet And Sinemet:
What's The Connection?

Have you ever wondered why some medicines work best when taken with meals,
others when taken without any food or drink, and still others are unaffected
by what or when you eat? One reason is that different medicines are absorbed
into your bloodstream in different ways.  Sinemet (carbidopa/levodopa),
unlike some other medicines, is not absorbed into the bloodstream from the
stomach. It is absorbed from the small bowel after the stomach empties its
contents there. Anything that delays the emptying of your stomach into your
small bowel can reduce the amount of Sinemet that is absorbed into your blood
and transported to your brain. Also, certain foods, such as those that are
high in protein, contain substances that actually compete with Sinemet for
entry into the brain. When less Sinemet gets to your brain, poor symptom
control results.
Because diet can reduce the effectiveness of your Sinemet therapy, doctors
sometimes suggest dietary changes that help ensure consistent levels of this
medicine in your system. The need for these changes must be evaluated along
with the need for a well-balanced diet that allows you to maintain an ideal
body weight.  For example, to maintain an appropriate level of protein in
your diet but keep it from interfering with your medication, your doctor may
suggest: (1) restricting your protein intake if it is higher than the
recommended daily allowance, (2) distributing it more evenly throughout the
day, or (3) restricting it to the evening meal to make sure that you get the
full benefit of your medication during the day.
It is especially important to discuss diet with your doctor if you are
experiencing changes in the control of your symptoms throughout the day, or
if you've noticed that your ability to function seems to be affected when you
eat certain foods. These are signs that your diet is interfering with the
absorption of your medication, and some adjustments may be needed.
If you are taking Eldepryl (selegiline hydrochloride) Capsules along with
Sinemet, it's helpful to know that there are no specific dietary restrictions
associated with taking them at the recommended doses of a 5-mg capsule with
breakfast and a 5-mg capsule with lunch. Unlike some similar medicines,
Eldepryl Capsules at recommended doses work on one specific enzyme, and are
therefore rarely affected by foods that contain a substance called tyramine,
like some fermented cheeses and red wines.

Please contact Susan Reese or Judy Wilson at the APDA Young Parkinson
Information and Referral Center at 1-800-223-9776, if you know the source of
this letter.

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