Timing of meds on an empty stomach

A week ago I was diagnosed with Parkinson’s. Yesterday I started on Madapar 12.5mg/50mg, twice a day for the first two weeks. Then rising to three times a day. I have been given conflicting instructions from my neurologist, GP practice pharmacist and the dispensing pharmacist.

I have also recently started taking Alendronic acid (once a week), for osteoporosis. And lansoprazole and naproxen, for frozen shoulders.

Neuro told me to take the Madapar 30 mins before meals. For the one day a week I take the Alendronic acid, one pharmacist told me to take in the morning, on an empty stomach, lansoprazole and Madapar together, wait 30 mins, then take the Alendronic acid. The other pharmacist told me to take the Alendronic acid, wait 30 mins, then take the lansoprazole and Madapar together. What should I do?

Also, is it ok to take Madapar and lansoprazole together at the same time. Both are meant to be taken on an empty stomach.

Additionally I am meant take at least one Cholestyramine sachet, for bile acid malabsorption. This should be taken at least one hour after other meds, or 4- 6 hours after other meds. How do I fit this into these new medications? Help! Really looking forward to some clarification- i feel a little lost.

Hi and welcome to the forum, @Jomo1. No wonder you feel lost with so many different instructions and not knowing which to follow. Each person reacts differently so it’s hard for anyone to say which way is the best way to take your medication. You may feel better doing it one way, while someone else feels better following another plan. What’s important is to keep taking your madopar as you’ve been told to do by a health professional.

I’d strongly encourage you to get in touch with your neurologist and ask their advice, letting them know what you’ve been told by the pharmacists. They can put your mind at ease and can take into account your own experience so far. You have a lot to juggle so it’s only natural that you need some advice on how to fit everything together in the best way possible. I’m sure it can be done :+1:

Our friendly forum members will have their own experiences to share and I hope they are along soon to join the conversation. Bear in mind that their routine is what works for them. We have a great information page on levodopa drugs for you to read. You may find it helpful. Then why not give our helpline a call on 0808 800 0303 for some support with this?

I do hope that you get your answers really soon and can relax a bit.

Forum Moderation Team


Hello there

Protein inhibits the absorption of dopamine. Therefore you should take any PD meds 30 mins either side of a meal to counteract this. This starts to become more important over time . Not sure if this will clarify . Suggest you make a chart to make sense of it all. Good luck soldier!!!

1 Like

Hi there.
Don’t know about the other drugs but the Madapar (levodopa) works less well if taken close too or soon after eating protein, and this i found gets more tricky as time goes on.
I have so much trouble with food “robbing” my drugs (sometimes it’s like eating food flicks a switch off on the drugs) i try and not eat an hour before taking my drugs and not eating for an hour after taking them, and i still get in trouble sometimes.
Also about your frozen shoulder. i was warned when first diagnosed with PD that PD suffers often get frozen shoulders because they don’t swing their arms while walking.
I’m sure you’ll find a way around this that’s best for you. All the best


The pharmacist should be the expert on when to take meds that’s their job. As a retired nurse practitioner I found most drs were excellent at prescribing the right meds they just didn’t know about timing and interactions.Baz always tries to take his PD meds on an empty tum followed 30 mins later by something low protein to eat. in a different vein, if you don’t exercise regularly you might want to take a look at PD Warrior. It’s a 10 week exercise programme and would really help those frozen shoulders.Also as you are newly diagnosed you might like to try a week at the European Parkinson’s therapy centre.It was the best thing Baz did.We both went and learnt so much from it and had a wonderful holiday too.After 5 years we plan a revisit.

Follow the link, its about how levodopa is absorbed into the blood stream…you will find it very helpful

Hope its helps

Hope you have solved the problems with timing/sequence of medications.
I also take Madopar and used to take Alendronic Acid for Osteoporosis. It is important that the Alandronate is taken on an empty stomach and that you stay upright for an hour afterwards. Even bending to pick up something off the floor can give a burning sensation. I have the whole house trained not to disturb me while I sat out my hour.
If I woke early enough I took my first Madopar 3/4 of an hour before the Alandronate, otherwise if I had a long sleep(ha ha) it would be afterwards.
I was swooped after 5 years to an annual infusion of another bisphosfonate but was then moved to daily injections of Teriparatide when I had another vertebra collapse.

Hi Thorny
Thanks for the message. Apologies for only noticing it yesterday.
When I posted this question, it was just a bit too early on my Parkinson’s journey to have the various professionals having conflicting advice. It just didn’t help.

Now sorted. Once a week I take Alendronic acid first thing in the morning. Get dressed etc, take Madapar, and then wait 30 mins to have breakfast. Stilll have problems fitting in the Cholestyramine. But it’s easier now.

I’m sorry to hear about your osteoporosis and your back problems. I hope you are coping and have the help and support you may need.