We know that living with Parkinson's disease can be challenging at times. You may already be taking a variety of medications to manage your symptoms. So, today we're going to talk about a medication used to treat Parkinson's disease that may be new to you. It's called Istradefylline.
Simply put, what is Istradefylline?
Istradefylline is a medication used to treat Parkinson's disease. However, it is not usually the first-line treatment. It is often used as an "add-on therapy" to standard Parkinson's medications, such as Levodopa and Carbidopa (Levodopa/Carbidopa).
For example, if you feel like your main medication is not controlling your symptoms enough, meaning you are having more "off" periods, your doctor may prescribe this medication to help you control your symptoms better. This medication is commonly available under the brand name Nourianz.
Things you need to tell your doctor before starting this medication
It is very important that your doctor has a complete picture of your health condition. Only then can he/she be able to give you the most suitable and safest treatment. Therefore, before starting Istradefylline, do not forget to inform your doctor about these facts.
- If you are a smoker: Smoking can affect the way this medicine works, so be sure to tell your doctor about it.
- If you have liver disease: If your liver function is impaired, your medication dosage may need to be adjusted.
- If you have had or currently have a mental health condition: It is important to tell your doctor about any previous mental health problems.
- If you have any allergies: Tell us about any allergies you have not only to this medicine, but also to other medicines, foods, or dyes.
- If you are pregnant, trying to get pregnant, or breastfeeding: This medicine is not recommended for use during these times. So be sure to talk to your doctor about this.
How should I use the medicine exactly?
Swallow this tablet with a glass of water. You can take it with or without food. However, if you experience stomach upset, it is better to take it with food. The most important thing is to take the exact dose, at the exact time, as prescribed by your doctor. Do not take more than the prescribed amount, or take it more often.
Very important: Never stop taking this medicine suddenly without your doctor's advice. Doing so can cause serious side effects. If you do stop, there is a way to do it, and your doctor will explain it to you.
What to do if you take too much medicine? (Overdose)
If you have any suspicion that you have taken more than the prescribed dose of this medicine, call the National Poisons Information Centre at the Colombo National Hospital immediately. Otherwise, go to the nearest hospital Emergency Department (ETU) without delay.
What if I miss a dose? (Missed dose)
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose to make up for a forgotten dose.
Other things that may interact with this medicine
Some other medications, herbs, and supplements you are taking may interact with Istradefylline. Therefore, give your doctor a list of all the medications you are taking, including vitamins and herbal remedies . Below are some of the most common medications that can cause problems.
| Drug class or name | Examples and descriptions |
|---|---|
| Some antibiotics | Ex: Clarithromycin |
| Some cholesterol-lowering medications | Ex: Atorvastatin, Lovastatin, Simvastatin |
| Medicines for fungal infections | Eg: Ketoconazole, Itraconazole, Posaconazole |
| Some medications for epilepsy ( seizures ) | Ex: Carbamazepine, Phenobarbital, Phenytoin |
| Other medications | Herbal medicines such as Digoxin, Rifampin, and St. John's wort. |
Things to be especially careful about while taking the medicine
Be aware of unusual urges
This is very important. Some people may experience unusual and uncontrollable urges when taking this medication. For example:
- A strong desire to play games of chance.
- Spending money unnecessarily.
- Abnormal increase in sexual desire.
- Uncontrolled overeating.
This is not your fault or weakness. This is a side effect that can occur due to the effects of the medication. If you or your family notice any changes like this, don't be ashamed or afraid, but tell your doctor about it immediately.
Smoking and pregnancy
If you are a smoker, the effectiveness of this medicine may be reduced. Also, if you are thinking of quitting smoking, tell your doctor about it as the dosage of the medicine may need to be changed.
Avoid becoming pregnant while taking this medicine. There is a risk of serious harm to the baby. If you are planning to become pregnant or suspect you are pregnant, talk to your doctor right away.
What side effects can be seen?
Like any medicine, Istradefylline can cause side effects. Some of them can be serious and some of them can be common.
| Classification of side effects | |
|---|---|
| Side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Mental changes | Anxiety, mental confusion, seeing or hearing things that are not there (hallucinations). |
| Strong urges (Urges) | New or increased gambling, spending, sexual desires, etc. |
| Uncontrollable movements (Dyskinesia) | Uncontrollable shaking or dancing of the hands, feet, face, mouth, neck, or upper body. |
| Usually not serious (but tell your doctor if it persists) | |
| Constipation | Difficulty going to the toilet. |
| Dizziness | Dizziness . |
| Nausea | Feeling like vomiting. |
| Insomnia | Difficulty falling asleep at night. |
This list is not all possible side effects. If you experience any unusual symptoms, talk to your doctor about them.
Take-Home Message
- Istradefylline is a medication that is given in addition to main medications such as Levodopa/Carbidopa to control Parkinson's symptoms.
- Before starting this medication, tell your doctor about all your medical conditions (especially liver disease, mental health problems) and whether you smoke.
- Avoid stopping the medication suddenly without your doctor's advice.
- If you experience unusual, strong urges, such as gambling or excessive spending, while taking the medication, do not be shy and inform your doctor immediately, as this may be a side effect of the medication.
- Keep your doctor informed about all medications you are taking (including Sinhala medications).
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