Although the terms ON and OFF have been used to describe responses to levodopa therapy for more than 40 years, there is still no universally agreed-upon definition for the term OFF, and everyone with Parkinson's experiences it differently. OFF periods occur when your medication isn't working optimally, and your motor and non-motor symptoms return. OFF is much more nuanced but understanding its scientific causes can help you minimize it in your daily life.
Dr. Cherian Karunapuzha explains how drinking a glass of water when you take your levodopa helps "flush" the medicine from your stomach to your small intestine, where it is absorbed. Drinking a glass of water and taking your levodopa on an otherwise empty stomach will ensure that more of the medication is absorbed, giving you the full benefit of the levodopa.