Is it safe to take multivitamins etc with... - Cure Parkinson's
Is it safe to take multivitamins etc with PD medicines?
Hi - My neurologist told me I should be taking a multivitamin that corresponds to my age. I would say yes, it's safe with your meds, but check with your dr. to make sure. Mine said a generic of the popular brands is just as good as the name brand ones.
I take 1000mg of Vitaman C every day. Haven't had a cold in years.
selegiline ? 5-hydroxytryptophan
Applies to: selegiline, 5-HTP (5-hydroxytryptophan)
CONTRAINDICATED: By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs) may potentiate the activity of serotonergic agents such as serotonin reuptake inhibitors, 5-HT1 receptor agonists, ergot alkaloids, buspirone, dextromethorphan, and most antidepressants. The result may be an increased risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.
MANAGEMENT: In general, serotonergic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with serotonergic agents. A washout period of 7 to 14 days minimum is recommended when switching from another antidepressant to an MAOI.
amitriptyline ? 5-hydroxytryptophan
Applies to: amitriptyline, 5-HTP (5-hydroxytryptophan)
MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.
MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is recommended following use of fluoxetine before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.
amantadine ? amitriptyline
Applies to: amantadine, amitriptyline
MONITOR: The anticholinergic-like adverse effects of amantadine may be potentiated by agents with anticholinergic properties such as antihistamines, antispasmodics, class IA antiarrhythmics, neuroleptics, phenothiazines, skeletal muscle relaxants, and tricyclic antidepressants. The cumulative parasympatholytic effects of these agents may produce paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.
MANAGEMENT: Caution is advised when amantadine is used in combination with anticholinergic agents, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic and/or amantadine dosage may be necessary if excessive adverse effects develop.
entacapone ? rotigotine
Applies to: Stalevo 200 (carbidopa/entacapone/levodopa), Neupro (rotigotine)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
amitriptyline ? rotigotine
Applies to: amitriptyline, Neupro (rotigotine)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
carbidopa ? 5-hydroxytryptophan
Applies to: Stalevo 200 (carbidopa/entacapone/levodopa), 5-HTP (5-hydroxytryptophan)
GENERALLY AVOID: Coadministration with carbidopa may potentiate the pharmacologic effects of 5-hydroxytryptophan (5-HTP), which is converted to 5-hydroxytryptamine (5-HT), or serotonin, in vivo. Carbidopa inhibits the peripheral metabolism of 5-HTP, and this effect has been exploited in the treatment of certain neurological disorders such as postanoxic myoclonus to enhance the amount of 5-HTP that reaches the central nervous system. However, higher CNS levels of serotonin may also potentiate the risk of serotonin syndrome, which is a rare but potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. Pharmacodynamically, the combination has been associated with a scleroderma-like skin condition in several case reports. The mechanism is unknown.
MANAGEMENT: In general, 5-hydroxytryptophan should not be given with carbidopa. If the combination is used, close monitoring is recommended for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia.
entacapone ? levetiracetam
Applies to: Stalevo 200 (carbidopa/entacapone/levodopa), levetiracetam
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
amitriptyline ? levetiracetam
Applies to: amitriptyline, levetiracetam
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
amitriptyline ? entacapone
Applies to: amitriptyline, Stalevo 200 (carbidopa/entacapone/levodopa)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
levodopa ? selegiline
Applies to: Stalevo 200 (carbidopa/entacapone/levodopa), selegiline
ADJUST DOSE: When used as an adjunct to levodopa/carbidopa in the treatment of Parkinson's disease, selegiline may enhance levodopa-associated side effects in some patients. The presumed mechanism is enhanced peripheral catecholamine availability due to decreased degradation (MAOI activity) and increased synthesis (levodopa effect) of dopamine and, probably, norepinephrine. The concomitant administration of carbidopa has been reported to prevent or blunt the hypertensive response by inhibiting peripheral conversion of levodopa to dopamine.
MANAGEMENT: Two to three days after adding selegiline to the regimen, the levodopa/carbidopa dosage may require reduction by 10 to 30%. Due to the risks of nonselective MAO inhibition and drug interactions, selegiline doses should not exceed 10 mg/day.
levodopa ? hydroxychloroquine
Applies to: Stalevo 200 (carbidopa/entacapone/levodopa), hydroxychloroquine
MONITOR: The risk of peripheral neuropathy may be increased during concurrent use of two or more agents that are associated with this adverse effect. In some cases, the neuropathy may progress or become irreversible despite discontinuation of the medications.
MANAGEMENT: Caution is advised during concomitant use of agents with neurotoxic effects. Patients should be monitored closely for symptoms of neuropathy such as burning, tingling, pain, or numbness in the hands and feet. Since the development of peripheral neuropathy may be dose-related for many drugs, the recommended dosages should generally not be exceeded. Consideration should be given to dosage reductions or immediate discontinuation of these medications in patients who develop peripheral neuropathy to limit further damage. If necessary, therapy should generally be reinstituted only after resolution of neuropathy symptoms or return of symptoms to baseline status. In some cases, reduced dosages may be required.
levetiracetam ? rotigotine
Applies to: levetiracetam, Neupro (rotigotine)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
amitriptyline ? levodopa
Applies to: amitriptyline, Stalevo 200 (carbidopa/entacapone/levodopa)
Tricyclic antidepressants may slightly reduce the serum concentrations of levodopa and carbidopa and reduce their effects. The mechanism may be related to slowed gastric emptying and increased gastric degradation. Anecdotal reports also suggest that coadministration of tricyclic antidepressants and levodopa or carbidopa may occasionally result in hypertensive episodes; however, causality was not clearly established. The mechanism is unknown. Until more information is available, it may be prudent to monitor patients for altered efficacy and safety.
No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
Other drugs that your selected drugs interact with
• amantadine interacts with more than 100 other drugs.
• amitriptyline interacts with more than 500 other drugs.
• hydroxychloroquine interacts with more than 100 other drugs.
• levetiracetam interacts with more than 100 other drugs.
• rabeprazole interacts with more than 100 other drugs.
• selegiline interacts with more than 300 other drugs.
• 5-HTP (5-hydroxytryptophan) interacts with more than 50 other drugs.
• Health Aid Melatonin (melatonin) interacts with more than 40 other drugs.
• Neupro (rotigotine) interacts with more than 200 other drugs.
• Paracetamol (acetaminophen) interacts with more than 70 other drugs.
• Stalevo 200 (carbidopa/entacapone/levodopa) interacts with more than 400 other drugs.
Interactions between your selected drugs and food
selegiline ? food
Applies to: selegiline
GENERALLY AVOID: Foods that contain large amounts of tyramine may precipitate a hypertensive crisis in patients treated with monoamine oxidase inhibitors (MAOIs). The mechanism is inhibition of MAO-A, the enzyme responsible for metabolizing exogenous amines such as tyramine in the gut and preventing them from being absorbed intact. Once absorbed, tyramine is metabolized to octopamine, a substance that is believed to displace norepinephrine from storage granules. Although selegiline is considered a selective inhibitor of MAO-B, the selectivity may not be absolute even at recommended dosages. Rare cases of hypertensive reactions associated with ingestion of tyramine-containing foods have been reported in patients taking the recommended daily oral dose of selegiline. Data for transdermal selegiline indicate that the 6 mg/24 hour dosage may be given safely without dietary restrictions. However, limited data are available for higher dosages.
MANAGEMENT: Patients treated with oral selegiline and transdermal selegiline (greater than 6 mg/24 hour) should preferably avoid consumption of products that contain large amounts of amines and protein foods in which aging or breakdown of protein is used to increase flavor. These foods include cheese (particularly strong, aged or processed cheeses), sour cream, wine (particularly red wine), champagne, beer, pickled herring, anchovies, caviar, shrimp paste, liver (particularly chicken liver), dry sausage, salamis, figs, raisins, bananas, avocados, chocolate, soy sauce, bean curd, sauerkraut, yogurt, papaya products, meat tenderizers, fava bean pods, protein extracts, yeast extracts, and dietary supplements. Caffeine may also precipitate hypertensive crisis so its intake should be minimized as well. At least 14 days should elapse following discontinuation of selegiline therapy before these foods may be consumed. Specially designed reference materials and dietary consultation are recommended so that an appropriate and safe diet can be planned. Patients should also be advised to promptly seek medical attention if they experience potential signs and symptoms of a hypertensive crisis such as severe headache, visual disturbances, difficulty thinking, stupor or coma, seizures, chest pain, unexplained nausea or vomiting, and stroke-like symptoms. The recommended dosages of selegiline should not be exceeded, as it can increase the risk of nonselective MAO inhibition and a hypertensive crisis.
melatonin ? food
Applies to: Health Aid Melatonin (melatonin)
Oral caffeine may significantly increase the bioavailability of melatonin. The proposed mechanism is inhibition of CYP450 1A2 first-pass metabolism. After administration of melatonin 6 mg and caffeine 200 mg orally (approximately equivalent to 1 large cup of coffee) to 12 healthy subjects, the mean peak plasma concentration (Cmax) of melatonin increased by 137% and the area under the concentration-time curve (AUC) increased by 120%. The metabolic inhibition was greater in nonsmokers (n=6) than in smokers (n=6). The greatest effect was seen in subjects with the *1F/*1F genotype (n=7), whose melatonin Cmax increased by 202%. The half-life did not change significantly. The clinical significance of this interaction is unknown.
See also...
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Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Do not stop taking any medications without consulting your healthcare provider.
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Hi, A lot of Pd people don't tell anyone, what supplements they take, big mistake, I learned the hard way. drugs.com. is a good place to find out the interractions between drugs food and supplements. 5-HTP is a very good supplement, but if you are on certain meds it can kill you, the company I bought it from call it Happy Days. it made ill, for a couple of months I was ill. and when I stopped taking 5-htp, I recovered, remember we are all different, what's good for you, might make someone else ill.
Not according to American PDA pamphlet "Meds to be avoided , , , with PD" given out at Parkie walk. Very clear. Only supplement mentioned is iron. Take well apart from PD meds!
I'm sorry but earlier I tried to explain, just how dangerous these drugs we take every 3 or 4 hours, they can kill . they can give you Impulsive- compulsive behaviour, I believe every pill we take has a good side and a bad side. below is a list of my meds, what I haven't listed is that I'm taking the maximum doseage on most,
Amantadine 4 pills - 100 mg
Stalevo 6 pills - 200mg
amitriptyline
hydroxychloroquine
levetiracetam
rabeprazole
selegiline
5-HTP (5-hydroxytryptophan] STOPPED WARNING HAPPY DAYS IT IS NOT
Health Aid Melatonin (melatonin)
Neupro (rotigotine)
Paracetamol (acetaminophen)
Stalevo 200 (carbidopa/entacapone/levodopa)
How many with PD (have taken or does take) Tyrosine
Comprehensive supplements list (when to take and with what)? Not just for PD.
How many of us have taken or are taking beta blockers? Is there a link to PD?
Confirming it's NOT PD
gastroparesis and PD
