For Non-US Residents
These areas of life may require special attention for people with Parkinson’s disease.
Diet. A good, balanced diet is recommended. Eating more fruits
and vegetables and drinking plenty of fluids (at least eight 8-oz. glasses of
a day) will help relieve the constipation that many patients experience.
Some people with Parkinson’s disease have a poor appetite and find themselves losing weight. Making appetizing, easy to eat foods will be best, as will eating slowly in a pleasant environment. People with swallowing difficulties may want to prepare and consume softer foods.
Some people also find that protein interferes with the effects of their medication, and may want to limit the amount of protein in their diets.
Exercise. It's the last thing patients
may feel like doing, but exercise is essential to managing PD. Mobility is
improved by staying active. Regular exercise and physical therapy can help
keep the classic symptoms of PD at bay. It also helps secondary symptoms such
as depression and constipation. Bending and stretching (“restorative”, “gentle”,
or “senior” yoga classes are ideal) fights the disease symptoms with the most
Driving. This is one of the most difficult
issues patients and their families may face. There are few state guidelines
regarding PD and driving, and doctors are not required to report PD to motor
vehicle bureaus. However, patients with PD may pose serious risks to themselves
and others when they drive. PD patients have slowed visuospatial processing,
and could find themselves unable to move if affected by an unpredictable “wearing-off” spell
behind the wheel. A general rule is, when there is reason for concern, it’s
time to turn the wheel over.
Depression, discouragement and sadness. PD patients may want
to remember that these emotions exist everywhere in everyone, with or without
PD. PD makes them more likely, as people find themselves feeling shut out from
life and connections to others. In fact, this happens so often that depression
and sadness are considered co-occurring disorders with PD — in other
words, they go hand in hand.
Sometimes, doctors can prescribe anti-depressants or support sources that
Making an effort, being courageous and patient, and doing something about
it are excellent antidotes to feelings of depression or hopelessness. Practicing
meditation has helped people with depression for ages. A healthy diet and exercise
combat depression naturally.
Family. While the challenge of PD is to
remain as independent as possible, patients and family members soon learn that
change is sometimes the only constant with PD. One day patients may be able
to dress and feed themselves, another day they may have difficulty getting
out of bed.
Honesty, frequent communication, patience, and humor are
the keys to getting through PD with family. Having fewer expectations allow
some patients to roll with life’s surprises, and can make things easier when the unexpected
occurs. The changing relationships that happen with PD can cause misunderstandings
and abrasive family conflicts, but these can be blessings in disguise, real
opportunities for healing relationships. With or without PD, learning to live
with others takes time and effort, but is usually worth it.
TASMAR SHOULD NOT BE USED BY PATIENTS UNTIL THERE HAS BEEN A COMPLETE DISCUSSION OF THE RISKS AND THE PATIENT HAS PROVIDED WRITTEN INFORMED CONSENT (SEE PATIENT ACKNOWLEDGEMENT FORM).
WARNING: Because of the risk of potentially fatal, acute fulminant liver failure, TASMAR (tolcapone) should ordinarily be used in patients with Parkinson's disease on l-dopa/carbidopa who are experiencing symptom fluctuations and are not responding satisfactorily to or are not appropriate candidates for other adjunctive therapies (see INDICATIONS and DOSAGE AND ADMINISTRATION sections).
TASMAR therapy should not be initiated if the patient exhibits clinical evidence of liver disease or two SGPT/ALT or SGOT/AST values greater than the upper limit of normal. Patients with severe dyskinesia or dystonia should be treated with caution (see PRECAUTIONS: Rhabdomyolysis).
Laboratory Tests: Although a program of frequent laboratory monitoring for evidence of hepatocellular injury is deemed essential, it is not clear that periodic monitoring of liver enzymes will prevent the occurrence of fulminant liver failure. However, it is generally believed that early detection of drug-induced hepatic injury along with immediate withdrawal of the suspect drug enhances the likelihood for recovery. Accordingly, the following liver monitoring program is recommended.
Please see accompanying complete prescribing information including BOXED warning.
TASMAR® is a registered trademark of Valeant Pharmaceuticals International