Carbidopa + levodopa


Generic Medicine Info
Administration
Should be taken on an empty stomach. Take on an empty stomach if possible. If GI distress occurs, take w/ food.
Contraindications
Major psychotic disorder, narrow-angle glaucoma, and history of melanoma. Concurrent use of or within 14 days of discontinuing MAOIs.
Special Precautions
Patient with severe CV disease (e.g. history of MI who have residual atrial, nodal or ventricular arrhythmias), psychotic disorder, pulmonary or endocrine disease, wide-angle glaucoma, history of or risk factors for neuropathy (e.g. diabetes mellitus, hypothyroidism), history of peptic ulcer. Avoid abrupt withdrawal or dose reduction. Hepatic and renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause dark discolouration of the saliva, urine or sweat. May also cause dizziness and somnolence, if affected, do not drive or operate machinery. Monitoring Parameters Monitor hepatic, haematopoietic, renal and cardiac function; standing and sitting blood pressure; intra-ocular pressure in patients with glaucoma. Perform routine dermatologic tests. Monitor for signs and symptoms of neuroleptic malignant syndrome, peripheral neuropathy, depression, somnolence.
Adverse Reactions
Significant: Dyskinesia, neuroleptic malignant syndrome, somnolence, orthostatic hypotension, impulse control disorders (e.g. urge to gamble, increased sexual urges), abnormal thinking, behavioural changes, hallucinations, melanoma, peripheral neuropathy. Blood and lymphatic system disorders: Leucopenia, haemolytic and non-haemolytic anaemia, thrombocytopenia, agranulocytosis. Cardiac disorders: Palpitations. Eye disorders: Blurred vision, diplopia, dilated pupils, blepharospasm, oculogyric crises. Gastrointestinal disorders: Nausea, vomiting, constipation, diarrhoea, sialorrhoea, dysphagia, flatulence, dyspepsia, gastrointestinal pain and bleeding, dry mouth, dysgeusia, discoloured saliva, bruxism, hiccups. General disorders and administration site conditions: Asthenia, fatigue, weakness, malaise. Metabolism and nutrition disorders: Anorexia, weight gain or loss. Musculoskeletal and connective tissue disorders: Muscle spasms, shoulder and back pain. Nervous system disorders: Headache, numbness, convulsions, dizziness. Psychiatric disorders: Confusion, nightmares, insomnia, depression (with or without suicidal ideation), euphoria, dementia, agitation, fear, disorientation, dysphonia. Renal and urinary disorders: Dark urine, urinary retention, urinary incontinence. Reproductive system and breast disorders: Priapism. Respiratory, thoracic and mediastinal disorders: Dyspnoea, upper respiratory tract infection. Skin and subcutaneous tissue disorders: Angioedema, alopecia, urticaria, pruritus, hair loss, rash, discoloured sweat, Henoch-Schonlein purpura. Vascular disorders: Hypertension, hypotension, syncope, phlebitis, hot flushes.
Drug Interactions
Levodopa: Decreased levodopa absorption and increased risk of postural hypotension with TCA (e.g. imipramine). Diminished therapeutic effect with concomitant use of antipsychotic agent (e.g. risperidone). Anticholinergic agents (e.g. atropine) decrease the absorption of levodopa and may diminish its therapeutic effect. Concomitant use with antihypertensives may cause postural hypotension. Decreased therapeutic response is observed with papaverine, phenytoin, and isoniazid. Decreased bioavailability with concurrent Fe salt use. Increased parkinsonian symptoms with metoclopramide.
ATC Classification
N04BA01 - levodopa ; Belongs to the class of dopa and dopa derivative dopaminergic agents. Used in the management of Parkinson's disease.
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