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NERVOUS SYSTEM › ANTI-PARKINSON DRUGS › DOPAMINERGIC AGENTS › Dopa and dopa derivatives
levodopa and decarboxylase inhibitor
N04BA02
Forms & Strengths
- Tablets: 100mg levodopa + 10mg carbidopa
- Tablets: 100mg levodopa + 25mg carbidopa
- Tablets: 250mg levodopa + 25mg carbidopa
- Extended-release tablets: 50mg levodopa + 12.5mg carbidopa
- Extended-release tablets: 100mg levodopa + 25mg carbidopa
- Extended-release capsules: 50mg levodopa + 12.5mg carbidopa
- Extended-release capsules: 100mg levodopa + 25mg carbidopa
Adult Dosing
- Initial dose: 1 tablet (100mg levodopa + 10mg carbidopa) 3 times a day
- Titrate every 2-3 days to optimal response
- Max dose: 8 tablets (800mg levodopa + 80mg carbidopa) per day
- Extended-release: switch from immediate-release on a mg:mg basis
Pediatric Dosing
- Not recommended for children under 18 years old
- Limited data in pediatric patients, consider alternative treatments
Indications
- Treatment of Parkinson's disease
- Symptomatic treatment of parkinsonian syndrome
Mechanism of Action
- Levodopa: precursor to dopamine, increases dopamine availability
- Carbidopa: peripheral decarboxylase inhibitor, prevents levodopa conversion
- Increases dopamine in brain, alleviates Parkinson's symptoms
Contraindications
- Hypersensitivity to levodopa or carbidopa
- Narrow-angle glaucoma
- Melanoma or suspicious skin lesions
- Concomitant use of monoamine oxidase inhibitors (MAOIs)
Adverse Reactions
- Nausea and vomiting
- Dyskinesia
- Confusion
- Hallucinations
- Cardiovascular effects: orthostatic hypotension
- Gastrointestinal: dry mouth, anorexia
Drug Interactions
- Concomitant use with MAOIs: increased risk of hypertensive crisis
- Pyridoxine (vitamin B6): reduces levodopa efficacy
- Ferrous sulfate: reduces levodopa absorption
- Antipsychotics: may reduce levodopa efficacy
Curated Content: Needs Vetting Before Put to Clinical Use