Water and Medications

To make its way from your mouth to your brain, carbidopa/levodopa must travel from your stomach to your small intestine, where it is absorbed by an extensive neutral amino acid active carrier system. A similar transport system transfers carbidopa/levodopa across the blood-brain barrier to the brain, where it is metabolized to produce dopamine. The more quickly the carbidopa/levodopa reaches the small intestine, the faster it passes through the intestinal walls and the brains' carrier system. The quicker it converts to dopamine, the more quickly you feel ON.

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The key to minimizing delayed and partial ON times is to take your carbidopa/levodopa on an empty stomach with a full glass of water. The water "flushes" the medicine quickly to the small intestine, and the absence of food in your stomach means nothing can slow its emptying. (Crushing or chewing carbidopa/levodopa can also help speed the process, as can choosing a carbonated water beverage such as club soda or sparkling water.) Ideally, you would take each dose of your carbidopa/levodopa one hour before a meal (to give it time to move from the stomach to the small intestine) or two hours after (the amount of time it takes for food to empty the stomach.) Because this is not always possible, especially as your Parkinson's progresses and you take carbidopa/levodopa more often, aim to take each dose at least 30 minutes after a meal -- and, again, always with a tall glass of water.