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NERVOUS SYSTEM › ANTI-PARKINSON DRUGS › DOPAMINERGIC AGENTS › Dopa and dopa derivatives
foslevodopa and decarboxylase inhibitor
N04BA07
Forms & Strengths
- Subcutaneous infusion: foslevodopa 240 mg/mL and foscarbidopa 12 mg/mL
Adult Dosing
- Continuous subcutaneous infusion 24 hours daily
- Dosing individualized based on baseline levodopa requirements
- Comprises continuous basal rate, extra doses for sudden off episodes, and maximum daily dose limits
Pediatric Dosing
- Safety and effectiveness in pediatric patients below 18 years have not been established
Indications
- Treatment of motor fluctuations in patients with advanced Parkinson's disease inadequately controlled by oral dopaminergic therapy
Mechanism of Action
- Foslevodopa is a prodrug of levodopa; converted to dopamine in the brain to replenish depleted striatal dopamine
- Foscarbidopa is a peripheral dopa-decarboxylase inhibitor that prevents peripheral metabolism of levodopa, increasing central availability
Contraindications
- Concomitant use of non-selective monoamine oxidase (MAO) inhibitors
- Clinical conditions where sympathomimetic amines are contraindicated
- Narrow-angle glaucoma
- History of melanoma or suspicious undiagnosed skin lesions
Adverse Reactions
- Infusion site reactions (erythema, pain, cellulitis, nodule)
- Dyskinesia
- Hallucinations and psychotic symptoms
- Orthostatic hypotension
- Falls
- Anxiety and sleep disorders
Drug Interactions
- Non-selective MAO inhibitors risk hypertensive crisis
- Antihypertensive agents may cause additive hypotension
- Dopamine D2 receptor antagonists and isoniazid may reduce efficacy
- Iron salts may chelate levodopa and reduce its bioavailability
Curated Content: Needs Vetting Before Put to Clinical Use