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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