# Progress and Prospects in Parkinson's Research/Symptoms/Drug side effects

The following side effects to common drugs used in the treatment of Parkinson's disease have been notified by pharmaceutical companies:
Azilect (rasagilene) :
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AZILECT ® is prescribed as a supplement to levodopa for the treatment of Parkinson’s disease symptoms.
Active ingredients
Rasagiline
Rasagiline is an irreversible inhibitor of monoamine oxidase used as a monotherapy in early Parkinson's disease or as an adjunct therapy in more advanced cases. It is selective for MAO type B over type A by a factor of fourteen.
Inactive ingredients
Mannitol
Colloidal anhydrous silica
Maize starch
Stearic acid
Talc
Most common adverse reactions to AZILECT
Very common (Affecting more tham 1 user im 10)
Dyskinesia
Headache
Common (Affecting 1 to 10 users in 100}
abdominal pain
falls
allergy
fever
flu (influenza)
general feeling of being unwell (malaise)
neeck pain
chest pain (angina pectoris)
orthostatic hypotension
decreased appetite
constipation
dry mouth
nausea and vomiting
flatulence
leucopenia(abnormal blood tests)
arthralgia (joint pain)
musculoskeletal pain
joint inflammation (arthritis)
carpal tunnel syndrome (weakness or numbness of the hands)
decreased weight
abnormal dreams
postural instability
depression
dizziness
dystonia (muscle contractions)
rhinitis (runny nose)
dermatitis (skin irritation)
conjunctivitis (eye irritation)
urinary urgency
Less common adverse reactions to AZILECT
{Affects 1 to 10 users in 1,000)
stroke (cerebrovascular accident)
heart attack (myocardial infarction)
blistering rash (vesiculobullous rash)
Drug interactions
AZILECT should not be taken concurrently with:-
monamine oxidase (MAO) inhibitors
pethidine
St. John's Wort
Further Reading
Search the scientific literature (Azilect)
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Azilect.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
Pubmed (abstracts)
Pubmed_Central (Full_Text)
Google_Scholar
References
↑ Oldfield V, Keating GM, Perry CM (2007). "Rasagiline: a review of its use in the management of Parkinson's disease". Drugs 67 (12): 1725–47. PMID 17683172. 
↑ Gallagher DA, Schrag A (2008). "Impact of newer pharmacological treatments on quality of life in patients with Parkinson's disease". CNS Drugs 22 (7): 563–86. doi:10.2165/00023210-200822070-00003. PMID 18547126. 
↑ Binda C, Hubálek F, Li M et al. (2005). "Binding of Rasagiline-related Inhibitors to Human Monoamine Oxidases: A Kinetic and Crystallographic Analysis". Journal of Medical Chemistry 48 (26): 8148–54. doi:10.1021/jm0506266. PMID 16366596. PMC 2519603. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2519603/. :
Madopar :
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MADOPAR ® is widely prescribed for the treatment of Parkinson’s disease symptoms.
Active ingredients
Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (—)-L-α-amino-β-(3,4-dihydroxybenzene) propanoic acid. Its empirical formula is C$_9$H$_{11}$NO$_4$.
Decarboxylase benzeraside
Inactive ingredients
Most common adverse reactions to MADOPAR
Allergies (rash, itch,irregular heartbeat, blood in stools)
Reduced white blood cells (infections of mouth, gums, lungs or throat)
Reduced red blood cells (fatigue, bruise easily, prone to infections)
Reduced platelets in blood (bruising, nose bleeds)
Less common adverse reactions to MADOPAR
Digestive system
Loss of appetite
Nausea
Diarrhoea
Heart and circulatory system
Dizziness
Blood
Anaemia (Palpitations, Pale skin, Fatigue, Heart flutters, Shortness of breath).
Mental Problems
Excitement, Anxiety, Agitation, Agressin, Depression, Disorientation.
Hallucinations, Out of touch with reality.
Narcolepsy, Insomnia.
Excessive urge to gamble.
Excessive sex drive.
Miscellaneous
Dyskinesia.
Loss of taste, Taste abnormalities.
Redness of face or neck.
Abnormal sweating.
Drug interactions
Further reading
Search the scientific literature (Madopar)
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Madopar.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
Pubmed (abstracts)
Pubmed_Central (Full_Text)
Google_Scholar
References :
Sinemet :
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SINEMET® is widely prescribed for the treatment of Parkinson's disease and some Parkinson's_Plus syndromes.
Active ingredients
Carbidopa, is an inhibitor of aromatic amino acid decarboxylation, and is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.3. It is designated chemically as (—)-L-α-hydrazino-α-methyl-β-(3,4-dihydroxybenzene) propanoic acid monohydrate. Its empirical formula is C$_{10}$H$_{14}$N$_{2O4}$•H$_{2O}$.
Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (—)-L-α-amino-β-(3,4-dihydroxybenzene) propanoic acid. Its empirical formula is C$_9$H$_{11}$NO$_4$.
Inactive ingredients
Hydroxypropyl cellulose
Pregelatinized starch
Crospovidone
Microcrystalline cellulose
Magnesium stearate
SINEMET 10-100 and 25-250 Tablets also contain:-
FD&C Blue #2/lndigo Carmine AL.
SINEMET 25-100 Tablets also contain:-
D&C Yellow #10 Lake.
Most common adverse reactions to SINEMET
Dyskinesia
Nausea
Less common adverse reactions to SINEMET
Body as a Whole
Chest pain, asthenia.
Cardiovascular
Cardiac irregularities, hypotension, orthostatic effects including orthostatic hypotension, hypertension, syncope, phlebitis, palpitation.
Gastrointestinal
Dark saliva, gastrointestinal bleeding, development of duodenal ulcer, anorexia, vomiting, diarrheoa, constipation, dyspepsia
, dry mouth, taste alterations.
Hematologic
Agranulocytosis, hemolytic and non-hemolytic anemia, thrombocytopenia, leukopenia.
Hypersensitivity
Angioedema, urticaria, pruritus, Henoch-Schonlein purpura, bullous lesions (including pemphigus-like reactions).
Musculoskeletal
Back pain, shoulder pain, muscle cramps.
Nervous System/Psychiatric
Psychotic episodes including delusions, hallucinations, and paranoid ideation, neuroleptic malignant syndrome, bradykinetic episodes ("on-off" phenomenon), confusion, agitation, dizziness, somnolence, dream abnormalities including nightmares, insomnia, paresthesia, headache, depression with or without development of suicidal tendencies, dementia, pathological gambling, increased libido including hypersexuality, impulse control symptoms.
Respiratory
Dyspnea, upper respiratory infection.
Skin
Rash, increased sweating, alopecia, dark sweat.
Urogenital
Urinary tract infection, urinary frequency, dark urine.
Drug interactions
Symptomatic postural hypotension has occurred when SINEMET was added to the treatment of a patient receiving antihypertensive drugs.
Severe orthostatic hypertenson can occur for patients receiving MAO inhibitors (Type A or B).
There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and SINEMET.
Dopamine D2 receptor antagonists (e.g. phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of levodopa. In addition, the beneficial effects of levodopa in Parkinson's disease have been reported to be reversed by phenytoin and papaverine.
Iron salts may reduce the bioavailability of levodopa and carbidopa.
Although metoclopramide may increase the bioavailability of levodopa by increasing gastric emptying, metoclopramide may also adversely affect disease control by its dopamine receptor antagonistic properties.
Further Reading
(1997)
Block et alcarried out a multi-centre trial over 5 years comparing the effects of Sinemet (immediate Release) and Sinemet CR (Controlled Release) and found favourably for the latter.
Search the scientific literature (Sinemet)
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Sinemet.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
Pubmed (abstracts)
Pubmed_Central (Full_Text)
Google_Scholar
References
↑ Block, G,; Liss, C.; Reines, S.; Irr. I. and Nibbelink, D. AbstractEur. Neurol. 37 (1) 23 – 27 Comparison of Immediate-Release and Controlled Release Carbidopa/Levodopa in Parkinson’s Disease http://www.karger.com/Article/Abstract/117399 :
Stalevo :
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STALEVO ® is widely prescribed for the treatment of Parkinson's disease and some Parkinson's_Plus syndromes.
Active ingredients
Carbidopa, is an inhibitor of aromatic amino acid decarboxylation, and is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.3. It is designated chemically as (—)-L-α-hydrazino-α-methyl-β-(3,4-dihydroxybenzene) propamic acid monohydrate. Its empirical formula is C$_{10}$H$_{14}$N$_{2O4}$•H$_{2O}$.
Entacapone is somewhat similar to carbidopa or benserazide, in that it is an inhibitor of an enzyme that converts L-DOPA into a compound that cannot cross the blood brain barrier.
Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (—)-L-α-amino-β-(3,4-dihydroxybenzene) propanic acid. Its empirical formula is C$_9$H$_{11}$NO$_4$
Inactive ingredients
croselcarmellose sodium
magnesium stearate
maize starch]
manitol (E421)
povidone K30 (E1201)
glycerol (422)
hypromellose
polysorbate 80
red iron oxide (E172)
sucrose
titanium dioxide (E171)
yellow iron oxide (E172)
Most common adverse reactions to STALEVO
Dystonia (Uncontrolled movements)
Nausea
Paranoia and psychotic symptoms
Depression (possibly with thoughts of suicide)
Amnesia and cognitive deficits
Less common adverse reactions to STALEVO
Irregular heart rate and rhythm
Light headedness or fainting due to low blood pressure
Dizziness
Drowsiness
Sudden worsening of Parkinson's symptoms
Loss of appetite
Vomiting
Bleeding in the gut
Ulcers
Abdominal pain
Dry mouth
Constipation
Diarrhoea
High blood pressure
Inflammation of the veins in the legs
Insomnia
Hallucinations
Confusion
Unpleasant dreams
Tiredness
Muscle cramps
Sweating
Falls postural instability)
Changes in blood cells
Fainting
Infections
Bleeding
Chest pain
Shortness of breath
Tingling or numbness
Convulsions
Rare or very rare effects
Agitation
Itching and rashes
Weight loss or gain
vision disturbances
Muscle cramps
Drug interactions
Selective MAO-A plus MAO- inhibitors
>non-selective MAO inhibitors (e.g. Moclobemide-aka Aurorix and Manerix.}
noradrenaline re-uptake inhibitors (e.g. Desipramine- aka Desmethylimipramine; Maprotiline aka -Deprilept, Ludiomil, Psymion; Venlaxafine - aka Effexor or Efexor )
tricycline antidepressants (e.g. Amitryptiline - aka Tryptomer, Elavil, Tryptizol, Laroxyl, Saroten, Sarotex, Lentizol, Endep)
Paroxetine aka Aropax, Paxil, Pexeva, Seroxat, Sereupin
Isoprenaline aka Isoproterenol, Medihaler-Iso and Isupre
Dopamine
Dobutamine
Alpha-methyldopa
Apomorphine aka Apokyn, Ixense, Spontane, Uprima]]
rimiterole
Dopamine antagonists
Phenytoin
Papaverine
iron supplements
Adrenaline
Further reading
Search the scientific literature (Stalevo)
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Stalevo.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
Pubmed (abstracts)
Pubmed_Central (Full_Text)
Google_Scholar
(current)
U.S. Food and Drugs Administration report on Stalevo, http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm206513.htm
(2010)
Podcast for Healthcare Professionals:Ongoing Safety Review of Stalevo (entacapone/carbidopa/levodopa) and possible development of Prostate Cancer http://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm207688.htm
FDA Drug Safety Communication: Ongoing Safety Review of Stalevo and possible increased cardiovascular risk
http://www.fda.gov/Drugs/DrugSafety/ucm223060.htm
FDA Drug Safety Podcast for Healthcare Professionals: Ongoing Safety Review of Stalevo and possible increased cardiovascular risk
http://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm223620.htm
FDA Drug Safety Communication: Ongoing Safety Review of Stalevo (entacapone/carbidopa/levodopa) and possible development of Prostate Cancer
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm206363.htm
Eurpean Medicines Agency report on stalevo. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000511/human_med_001063.jsp&mid=WC0b01ac058001d124
References :