Medications to avoid (or use with caution) for people with Parkinson’s disease.
This medication list is not intended to be complete and additional brand names may be found for each medication. Every patient is different, and you may need to take one of these medications despite caution against it. Please discuss your particular situation with your physician and do not stop any medication that you are currently taking without first seeking advice from your physician. Most medications should be tapered off and not stopped suddenly. Although you may not be taking these medications at home, one of these medications may be introduced while hospitalized.
If a hospitalization is planned, please have your neurologist contact your treating physician in the hospital to advise which medications should be avoided.
Medications to be avoided or used with caution in combination with Selegiline HCL (Zelapar®), Rasagiline (Azilect®) and Safinamide (Xadago®)
| Medication Type | Medication Name | Trade Name® |
| Narcotics/Analgesics (see note below) | Meperidine | |
| Tramadol | Ultram | |
| Methadone | Dolophine | |
| Antidepressants (see note below) | St. John’s Wort | Several Brands |
| Muscle Relaxants | Cyclobenzaprine | Flexeril |
| Cough Suppressants | Dextromethorphan | Robitussin products, Other brands — Found as an ingredient in various cough and cold medications |
| Decongestants/Stimulants | Pseudoephedrine Phenylephrine Ephedrine | Sudafed products, other brands— found as an ingredient in various cold and allergy medications |
| Medications that inhibit Monoamine oxidase non-selectively | Linezolid (antibiotic) | Zyvox |
| Phenelzine | Nardil | |
| Tranylcypromine | Parnate | |
| Isocarboxazid | Marplan |
Medications to be avoided or used with caution in all patients with Parkinson’s disease
| Medication Type | Medication Name | Trade Name® | Mechanism of Action |
| Typical Antipsychotics | Chlorpromazine | Block D2 (dopamine) receptors in the brain, which can worsen Parkinson’s symptoms | |
| Fluphenazine | |||
| Haloperidol | Haldol | ||
| Loxapine | |||
| Thioridazine | |||
| Thiothixene | |||
| Trifluoperazine | |||
| Pimozide | Orap | ||
| Perphenazine | |||
| Atypical Antipsychotics (see note below) | Risperidone | Risperdal | Block dopamine receptors, but dissociate from the receptor more quickly than typical antipsychotics. They also tend to block serotonin receptors in addition to dopamine receptors. The result is less parkinsonism than that caused by the typical antipsychotics. |
| Olanzapine | Zyprexa | ||
| Ziprasidone | Geodon | ||
| Aripiprazole | Abilify | ||
| Lurasidone | Latuda | ||
| Paliperidone | Invega | ||
| Iloperidone | Fanapt | ||
| Brexpiprazole | Rexulti | ||
| Cariprazine | Vraylar | ||
| Asenapine | Saphris | ||
| Antiemetics (used to treat nausea or vomiting) | Chlorpromazine | Block D2 (dopamine) receptors in the brain, which can worsen Parkinson’s symptoms | |
| Droperidol | Inapsine | ||
| Metoclopramide | Reglan | ||
| Prochlorperazine | |||
| Promethazine | |||
| Drugs to treat hyperkinetic movements such as chorea and tardive dyskinesia | Tetrabenazine | Xenazine | Decrease dopamine stores |
| Deutetrabenazine | Austedo | ||
| Valbenazine | Ingrezza | ||
| Antihypertensives | Methyldopa | Inhibits an enzyme which converts L-dopa into dopamine in the brain | |
| Antidepressants | Amoxapine | Although classified as a tricyclic antidepressant, it can also block dopamine receptors |
Note: If an antipsychotic that blocks dopamine receptors needs to be used, atypical antipsychotics are better choices than typical antipsychotics. Clozapine (Clozaril®) and Quetiapine (Seroquel®) are dopamine blockers with the least risk of worsening Parkinson symptoms. Pimavanserin (Nuplazid®) is a serotonin inverse agonist and was approved specifically for use as an antipsychotic in patients with Parkinson’s disease.
The information contained in this supplement is solely for the information of the reader. It should not be used for treatment purposes, but rather for discussion with the patient’s own physician.
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