Prescription medication is one of the primary ways to manage the symptoms of Parkinson’s disease. Several drugs can be used to delay the progression of this disease. You might need to take a combination of them to manage your symptoms.

Although Parkinson’s drugs are considered safe, they can cause side effects. Some of these medications can also interact with other drugs you take.

Below is a list of common drug treatments for Parkinson’s disease, their possible side effects, and how to manage them.

Levodopa

Levodopa increases levels of the chemical dopamine in your brain. A lack of dopamine is what causes the jerky movements and other symptoms of Parkinson’s disease. Levodopa is usually combined with carbidopa, and it comes in both long-acting and short-acting forms (Rytary, Parcopa, Stalevo).

Side effects include:

  • vomiting
  • nausea
  • lightheadedness
  • appetite loss
  • low blood pressure
  • confusion
  • uncontrollable movements of the face, arms, legs, or torso (dyskinesia)

Dopamine agonists

These drugs mimic the effects of dopamine on the brain. They come in:

  • pill form, like pramipexole (Mirapex) and ropinirole (Requip)
  • as a patch, like Neupro
  • as a short-acting injection, like apomorphine (Apokyn)

Side effects include:

  • daytime sleepiness
  • hallucinations
  • confusion
  • ankle swelling
  • compulsive behaviors, such as gambling and overeating
  • dyskinesia

Amantadine

Amantadine (Symmetrel) is an antiviral drug that helps reduce Parkinson’s tremors. Amantadine extended release (Gocovri) is relieves dyskinesia (involuntary movement) caused by levodopa.

Common side effects of both forms include:

  • nausea
  • lightheadedness
  • trouble sleeping
  • confusion
  • hallucinations
  • ankle swelling

COMT inhibitors

COMT inhibitors such as entacapone (Comtan) help levodopa’s effects last longer in your body. Side effects include:

  • worsening of levodopa side effects like dyskinesia
  • confusion
  • hallucinations
  • diarrhea
  • reddish-brown urine

Anticholinergics

Anticholinergics like trihexyphenidyl (Artane) and benztropine mesylate (Cogentin) help with tremors. Side effects include:

  • blurred vision
  • dry mouth
  • constipation
  • confusion
  • memory problems
  • hallucinations
  • inability to urinate

MAO-B inhibitors

MAO-B inhibitors such as selegiline (Eldepryl, Zelapar) and rasagiline (Azilect) keep more dopamine in your brain. Possible side effects include:

  • nausea
  • trouble sleeping
  • hallucinations (when taken with levodopa and carbidopa)

1. Know what to expect

Each time you get a new prescription, discuss with your doctor and pharmacist what side effects the drug might cause. Then you’ll know what symptoms to look out for and report to your doctor. Also, find out whether any of the other drugs you take might interact with your Parkinson’s medication, so you can avoid taking them together.

2. Stay on track

Follow directions carefully to prevent side effects. Take the exact amount of medication your doctor prescribed at the same time each day. Also, note whether you need to take the drug with or without food. If you have a hard time remembering to take your medication or you sometimes take the wrong dose, use a pill organizer and smartphone reminder to keep you on track.

3. Eat a snack

Nausea and vomiting are two of the most common side effects when you first start taking levodopa and carbidopa. Eating plain, high-carbohydrate foods like crackers or toast can help relieve these symptoms.

4. Adjust your drug dose

Side effects like dyskinesia might be due to the amount of levodopa you’re taking. Ask your doctor whether you can lower your dose enough to prevent side effects while still managing your Parkinson’s symptoms. It might take some trial and error to get the dose just right.

Another option is to switch to an extended-release form of dopamine. Because the drug releases more slowly into your blood, it prevents the dopamine spikes and valleys that can trigger dyskinesia.

You might also need to add more of a drug. For example, adding extra carbidopa to levodopa can cut down on nausea.

5. Change the timing

Sometimes you can prevent a drug’s side effects by changing the time of day you take it. For example, if a medication makes you sleepy, take it at night rather than in the morning. If a drug causes insomnia, take it in the morning or afternoon.

6. Try another treatment

Medication isn’t the only way to treat Parkinson’s disease. Deep brain stimulation (DBS) is a type of surgery used to treat Parkinson’s symptoms, like tremors and stiffness. Your doctor might recommend this procedure if you’ve had Parkinson’s for at least 4 years and you have dyskinesia. Having DBS can cut down on the amount of medication you have to take.

7. Talk with your doctor

If you do have side effects from your Parkinson’s drugs, report them to your doctor right away. Your doctor can help you manage them. For example, they may change your dose or switch you to another drug. Don’t stop taking any medication without first consulting with your doctor.

Drugs for Parkinson’s disease can significantly improve your life when monitored by your doctor. It may take some trial and error to get your dosage and routine right, but it’s well worth it to find the right treatment to prevent unnecessary side effects.

Discuss treatment options with your doctor and any potential side effects. Make sure not to change your medications or treatment schedule without talking with your doctor.