– Antiparkinson drug
– 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
(expressed in levodopa)
• 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 elderly patients.
– 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;
- psychiatric disorders more frequent in elderly patients: confusion, hallucinations, delirium, depression with or without suicidal tendencies;
• later in treatment : fluctuation of the effect during the day (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 psychiatric disorders, cardiac disease, gastro-duodenal ulcer.
– Do not administer simultaneously with MAOIs, antidepressants, antipsychotics, reserpine.
– Pregnancy: CONTRA-INDICATED
– Breast-feeding: CONTRA-INDICATED
– Tablet must be swallowed whole. Do not chew or dissolve.
– Storage: below 25 °C -