Levodopa - inhalation

Patient Medicine Information
Why do I need this medicine?
Levodopa is used together with other medicines (carbidopa + levodopa) to treat the worsening of the symptoms during an “off” episode of Parkinson’s disease. Parkinson's disease is a disorder that affects movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking.
How do I use this medicine?
Use Levodopa exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.

You must be taking a daily Parkinson's disease medicine that contains carbidopa and levodopa before you start using this medicine.

If you have been given a capsule for inhalation, a device called inhaler will be used. To take a dose:
  1. Tear off package of 2 capsules (remove capsule only before use). Do not leave the capsule exposed to air for too long.
  2. Pull off the cap of the inhaler and set aside. Twist and pull off the mouthpiece to separate it from the handle.
  3. Carefully peel back the foil and take out 1 capsule. Hold the inhaler upright using the handle and drop 1 capsule into the opening of the capsule chamber.
  4. Line up the white arrows on the handle and mouthpiece and firmly push the mouthpiece and handle together until you hear a click. Do not push the handle and mouthpiece together more than 1 time. This may damage the capsule and you may not get your full dose.
  5. Release the mouthpiece and it will spring back and stay attached.
  6. Stand or sit with your head and chest upright. Hold the inhaler level and away from your mouth. Breathe out completely.
  7. While keeping the inhaler level, close your lips firmly around the mouthpiece.
  8. Take in a deep, comfortable breath until your lungs feel full. As you breathe in, you will hear and feel the capsule whirl (spin). This means the inhaler is working and you are getting your medicine.
  9. Take the inhaler out of your mouth and hold your breath for 5 seconds then breathe out.
  10. If you cough or stop your dose or if you did not hear or feel the capsule whirl while inhaling, you may need to clean the mouthpiece and repeat steps 7-8.
  11. Twist and pull off the mouthpiece and take out the used capsule. Repeat steps 3-10 with the 2nd capsule.
Make sure you know how to use the device. If you have problems or if you do not understand the instructions, ask your doctor or pharmacist to show you how to use it.

Do not share your inhaler with others as it could spread infection.

Use Levodopa only when you feel Parkinson’s symptoms start to return.
When should I not use this medicine?
Do not use Levodopa if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) in the last 14 days.
What should I take note of while using this medicine?
Inform your doctor if you have the following conditions:
  • glaucoma (increased pressure in the eye)
  • history or a present mental illness
  • lung disease
Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving this medicine to the elderly. Elderly people may be more sensitive to the side effects.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
  • Routine tests (e.g. liver and kidney function, complete blood count, eye examination) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
  • Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure during treatment.
  • Regular monitoring of side effects that may require discontinuation or dose adjustment may also be needed.
What side effects could I experience?
Levodopa may cause you to suddenly fall asleep during your daily activities such as eating and watching television. Do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: nausea, vomiting, headache, cough, colds, chest discomfort, pain in the limb, difficulty sleeping, sensation of choking (right after use).

Your phlegm, urine, saliva or sweat may discolour. This is normal while you are being treated with this medicine, do not be alarmed.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • uncontrolled body movements e.g. twitching or jerking
  • unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
  • seeing, hearing or feeling things that are not existent
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Can I use this with other medicines?
Do not use Levodopa if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor and pharmacist if you are taking any of the following medicines:
  • medicines for depression e.g. selegiline, rasagiline
  • isoniazid (medicine for lung infection known as TB)
  • medicines for mood disorders e.g. phenothiazines, butyrophenones, risperidone
  • metoclopramide (medicine for nausea or vomiting)
  • medicines for high blood pressure
This list does not include all medicines that may interact with Levodopa.

Inform your doctor and pharmacist if you are taking iron supplements or any fat-soluble vitamins e.g. vitamin A, D, E or K.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
What special dietary instructions should I follow?
Avoid alcohol.

Avoid taking Levodopa together with protein-rich foods.

Avoid taking too much food which contain vitamin B6 (pyridoxine) such as liver, fish, whole grain cereals and beans. Too much vitamin B6 may work against the effects of Levodopa.

Ask your doctor or dietitian about the type of foods you need to avoid.
How should I store this medicine?
Store in a cool, dry place away from the reach of children.

Keep your Levodopa capsules in the original packaging until just before you are ready to use them.

Throw away the inhaler after all capsules in the carton have been used. Use the new inhaler that comes with your prescription refill.

Medicines must not be used past the expiry date.
This information is independently developed by MIMS based on levodopa - inhalation and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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