LEVODOPA/CARBIDOPA oral

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    Last updated: April 2024

     

    Prescription under medical supervision

     

     
    Due to the numerous and potentially severe adverse effects of levodopa/carbidopa, patients should be kept under close surveillance.

     

    Therapeutic action

    • Antiparkinson drug

    Indications

    • Parkinson’s disease and extrapyramidal disorders except those induced by antipsychotics

    Forms and strengths

    • 100 mg levodopa + 10 mg carbidopa tablet
    • 250 mg levodopa + 25 mg carbidopa tablet

    Dosage

    Doses are expressed as levodopa:

    • Adult:
      • Initial dose: 50 to 125 mg 3 times daily, immediately after meals. Increase by 50 to 125 mg every day or every 2 days until the optimal dose for the individual patient is reached.
      • Maintenance dose usually: 250 to 500 mg 3 times daily, immediately after meals (max. 2 g daily)
    • Reduce dosage in older patients.

    Duration

    • According to clinical response

    Contra-indications, adverse effects, precautions

    • Do not administer in case of severe psychosis, confusion, closed-angle glaucoma, recent myocardial infarction, malignant melanoma.
    • May cause:
      • early in treatment, when dose is not adjusted : anorexia, vomiting, orthostatic hypotension, cardiac arrhythmia, agitation, insomnia or drowsiness, depression;
      • frequent delayed adverse effects, signs of excessive dosage, mainly:
        • dyskinesia, tremor;
        • mental disorders more frequent in older patients: confusional state or depression with or without suicidal tendencies;
      • later in treatment : fluctuation of the effect during the day (in this event, daily dosage may be divided into smaller doses and taken more frequently); or reduction of the effect (progression of the disease).
    • Administer with caution in mental disorders, cardiac disease, gastroduodenal ulcer.
    • Do not administer simultaneously with MAOI antidepressants, antipsychotics, reserpine.
    • Pregnancy: CONTRA-INDICATED
    • Breast-feeding: CONTRA-INDICATED

    Remarks

    • Tablet must be swallowed whole. Do not chew or dissolve.

    Storage

     
    –  Below 25 °C