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    Coenzyme Q-10 drug interactions
    mazaranne posted:
    I am currently taking Sinamet and Azilect. This was working fine for several months, but lately I have been noticing a drop in my energy level. I've heard that Q-10 helps restore energy and was thinking about trying it. Is it safe to take with Sinamet and Azilect?
    susiemargaret responded:
    hello, M --

    i have run an interactions checker on two sites i trust,,2273-13897,515-250 and , and found nothing that indicates that Q-10/ubiquinone would react badly with your other two meds, sinemet/carbadopa-levodopa and azilect/rasagiline.

    however, the sites do warn that taking sinemet and azilect together may increase the intensity of any tardive dyskinesia you are suffering (loss of control over voluntary movements). this combination can also increase the occurrence of postural hypotension (also called orthostatic hypotension, which is a sudden decrease in blood pressure upon rising from a lying or sitting position) and hallucinations. these reactions are considered a moderate risk.

    both sinemet and azilect contain serotonin, so with this mix you need to keep a lookout for signs of serotonin syndrome, which is too much serotonin in the body. this can cause heart problems.

    azilect and some types of food -- specifically foods high in tyramine such as some aged cheeses -- can also be a problem. there is a moderate risk of blood pressure becoming dangerously high with this combination. signs of dangerously high blood pressure include stroke-like symptoms, seizures, headache, visual anomalies, chest pain, unexplained nausea/vomiting, confusion, stupor, or coma. to avoid these serious side effects, the dosage of azilect should not exceed 1 mg/day.

    i hope this helps.

    -- susie margaret
    what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
    Haylen_WebMD_Staff responded:
    WebMD has a drugs and medication area where you can look up all information on a drug (including side effects and interactions) as well as user reviews. Members can often find additional information to take to their doctor or pharmacist there. Click the link below:

    WebMD Drugs & Medication A - Z

    mazaranne replied to susiemargaret's response:
    Thank you very much, Susie. I don't exceed 1mg/day Azilect and am on high BP medication. I have been noticing a mild worsening of my dyskinesia, especially an hour or so after I take my Sinamet. It manifests itself mainly in a very irritating head shaking which subsides after approximately three hours. I just very recently learned about the tyramine. Unfortunately, I had been eating aged cheese, but am now trying to cut it out of my diet. The other movements are also annoying, but what really bothers me is the rigidity. Wish there was something I could take which would relax me without making me totally lethargic. I've also recently heard about something called forced excercise and am going to check if there is anything like it in my area. Once again, thank you.
    Mark A Stacy, MD responded:
    Hi, mazaranne
    Please know that whenever I hear of a drop in energy in a PD patient, I always make sure it is not from low blood pressure. Please check your BP sitting and standing. If there is a drop or your standing BP is below 100 systolic, bet this is contributing to your symptoms.

    If you are on medicines for high blood pressure, discuss this with your doctor. If not, increase your water intake by a 12-oz glass of water at breakfast and lunch. Also a little salt may raise your BP to the point you feel better.

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