LEVODOPA/CARBIDOPA TABLET:

Carbidopa/levodopa, also known as levocarb and co-careldopa, is the combination of the two medications carbidopa and levodopa. It is primarily used to manage the symptoms of Parkinson’s disease but does not change the course of the disease. It is taken by mouth.

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:

(expressed in 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 elderly 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;
 - 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

Remarks:

– Tablet must be swallowed whole. Do not chew or dissolve.
– Storage: below 25 °C -