Levodopa

Brand names of levodopa

  • Apo-Levocarb
  • Bendopa
  • Dopar
  • Endo Levodopa / Carbidopa
  • Larodopa
  • Nu-Levocarb
  • Prolopa [CD]
  • Sinemet [CD]
  • Sinemet CR [CD]

Levodopa-carbidopa is a combination drug comprising two drugs - levodopa and carbidopa. This prescription drug is available in the form of tablets and extended-release tablets under a number of brand names and is used in treating Parkinson's disease. It is believed that Parkinson's disease is associated with low levels of dopamine in specific areas of the brain. When taken orally, levodopa is said to pass through the 'blood-brain barrier' and inside the brain, it is subsequently changed to dopamine. The ensuing augmentation of brain dopamine intensification is supposed to perk up the condition of nerve and facilitate movement malady in Parkinson's disease.

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On the other hand, carbidopa does not pass through the 'blood-brain barrier', but it supplements levodopa and helps in averting the disintegration of levodopa prior to going into the brain. In fact, supplementing carbidopa also permits the usage of lower dosage of levodopa. This, in turn, lowers the risks of the side effects of using levodopa, for instance, queasiness and vomiting.

The Food and Drug Administration (FDA) approved the sale and use of this combination prescription drug for treating Parkinson's disease in 1988.

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Things you need to tell your physician before taking levodopa

As is the case with starting treatment with any new drug, you ought to exercise a few precautions before and while you take the combination prescription drug levodopa-carbidopa to cure Parkinson's disease and related syndromes. Prior to taking this medication for the first time, it is essential to tell your physician or pharmacist whether you have allergic reactions to levodopa and carbidopa, any other medications or any of the elements present in the levodopa-carbidopa tablets. If you are not sure about the ingredients present in this combination drug, consult your pharmacist or ask for a list of the same.

Before starting therapy with levodopa-carbidopa, inform your physician if you are taking tranylcypromine (Parnate) or phenelzine (Nardil) or if you have discontinued these medications two weeks back. In case you are still taking these medications, your physician will most possibly not allow you to take levodopa and carbidopa. Also tell your physician regarding all the other prescription and non-prescription (over-the-counter) drugs, herbal products, nutritional supplements and vitamins you are taking currently or you intend to take. Especially, tell your physician if you are taking antihistamines, antidepressants, vitamins enclosing iron, iron pills, medicines for irritable bowel syndrome (IBS), high blood pressure (hypertension), motion sickness, mental ailment, ulcers, nausea, and/ or urinary problems. In case you are taking any of the above mentioned medications or minerals, your physician might be requiring altering the dosage of your medicines or supervising you carefully to see if you have any side effects from taking these medications or levodopa and carbidopa.

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Prior to starting treatment with levodopa-carbidopa, you should also inform your doctor about your entire medical history, especially if you have ever had or still have melanoma (skin cancer), glaucoma or any skin growth that is yet to be diagnosed. Even in these cases your physician is likely to advise you against taking this combination drug. In addition, also ensure to tell your physician if you have or had ever endured asthma, hormone disorders, diabetes, mental ailment, emphysema (a persistent, irreversible ailment of the lungs), heart attacks, abnormal heartbeat, ulcers and/ or ailments of the heart, blood vessels, liver, kidneys or the lungs.

Women patients intending to take the combination drug levodopa-carbidopa should essentially tell their physician beforehand whether they are pregnant, intend to become pregnant shortly or are breast feeding. In case any woman becomes pregnant while being treated with levodopa and carbidopa, she ought to immediately contact her physician and ask him what she should do next. If people taking levodopa and carbidopa need to undergo a surgery or a dental operation, they should tell their surgeon/ dentist that they are taking this combination drug.

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Patients taking levodopa-carbidopa ought to be aware that while they are being treated with this combination prescription drug, the color of their urine, saliva and/ or sweat may become dark (brown, red or even black). They should know that though this is harmless, this dark color, especially of the sweat, might stain their clothes. In the event of you enduring phenylketonuria (PKU) - a medical condition requiring the patient to follow a special diet to avoid mental impedance, you ought to be aware that levodopa-carbidopa tablets, which disintegrate orally, enclose aspartame that develops phenylalanine.

Usage

The combination drug levodopa-carbidopa has been indicated for treating Parkinson's disease as well as syndromes akin to the Parkinson's disease that are likely to occur after a damage to or contagion of the central nervous system. In addition, such conditions may also happen due to injury to the blood vessels inside the brain or the patient's exposure to specific toxic substances. This combination drug helps in improving or easing symptoms like sluggishness, rigidity, shuddering as well as loss of ease of movement.

How to use levodopa

Levodopa-carbidopa is an oral medication available in tablet as well as extended-release tablet forms. This combination prescription drug is generally taken three to four times every day or as prescribed by your physician. In case you have been taking levodopa with no carbidopa and are taking the combination drug for the very first time, you ought to wait for a minimum of 12 hours after you have taken your last dose of levodopa and then take this combination drug. Normally, you might want to take your first dosage of this medication in the morning. Generally, your physician will lower the dosage of levodopa when you are beginning to take this combination drug to avoid any side effects of using an excessive amount of dopamine. People taking this combination drug to cure Parkinson's disease or syndromes similar to Parkinson's disease ought to strictly follow their physician's instructions.

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The combination drug levodopa-carbidopa is available in a number of strengths having different measures of levodopa and carbidopa in every tablet. Prior to taking this medication, ensure that your tablet has the appropriate strength of the two drugs. In some cases, physicians may also recommend taking carbidopa separately along with this combination drug.

It is advisable that you take tablets of this combination drug along with a light snack every time, as this will help reduce the feeling of nausea. Nevertheless, you should keep away from snacks that are rich in protein content since they are likely to thwart the absorption of this medicine. In case you are also taking iron supplements or products containing iron, such as multivitamins with minerals, it is advisable that you should space your dosage of levodopa-carbidopa by as many hours as possible from taking those supplements. You ought to be aware that iron may lower the quantity of levodopa and carbidopa available to your body.

In order to obtain the utmost benefit of using this combination drug, it should be used on a regular basis. Moreover, to help you bear in mind when you should take the dosage of this medication, take it at the same time(s) every day. By and large, the dosage of levodopa-carbidopa depends on the medical condition of the patient as well as his/ her response to the treatment.

It may be noted that some patients might experience a decline in the efficacy of this combination drug just prior to the due time for the next dose. In case this happens and is vexing, contact your physician and tell him/ her about the problem. While you are being treated with levodopa-carbidopa, you should not alter the dosage of this medication or any other medication you might be taking without consulting your physician beforehand. If your condition does not improve or in case it deteriorates further even after taking this combination drug for a while, notify your physician.

How levodopa works

Parkinson's disease is an advancing, neurodegenerative (association with the degeneration of the nerve) malady of the extra-pyramidal (nerves located outside the descending nerve tracts except the pyramidal tracts) nervous system that has an effect on the mobility as well as control of the skeletal muscular system. The typical characteristics comprise rigidity, resting tremor and brady-kinetic movements.

It may be noted that existing evidence hints that Parkinson's disease symptoms deal with exhaustion of dopamine in the corpus striatum (mass of gray matter under the cortex). Giving dopamine is not an effective treatment for Parkinson's disease obviously owing to the fact that it does not pass through the 'blood-brain barrier'. Nevertheless, levodopa, known to be the metabolic forerunner of dopamine, succeeds in crossing this 'blood-brain barrier' and is apparently transformed into dopamine inside the brain. This is believed to be the modus operandi by which levodopa alleviates the signs of Parkinson's disease.

Side effects

Serious
Common
  • an unpredictable therapeutic response
  • quirky involuntary muscle movements
Less common
  • confusion
  • dark saliva
  • dark sweat
  • dark urine
  • delirium

Possible interactions

Like most other drugs, even the combination prescription drug levodopa-carbidopa is known to interact with certain medications, including herbal products and minerals and, therefore, they ought not to be taken in conjugation. For instance, it is unsafe when calabar bean is taken orally and people enduring Parkinson's disease should never take it for it contains an active ingredient called physostigmine.

When levodopa is taken individually, without carbidopa, find out if there is any itchiness or tingling of the extremities - a medical condition known as peripheral neuritis (inflammation of one or many peripheral nerve(s)). In such cases, taking a small dosage (10 mg or even less) of pyridoxine (also called vitamin B6) may help to alleviate the condition. However, taking larger dosages of the supplement is likely to lessen the efficiency of levodopa. If you are taking Sinemet, you need not take the supplement pyridoxine - it is not needed. People taking levodopa and carbidopa have rarely reported that taking vitamin C or ascorbic acid decreases queasiness and other side effects of this combination drug.

People taking levodopa and carbidopa should follow some restrictions regarding their dietary habits. Such people should make every effort to avoid taking foods rich in protein content at the same time as this combined prescription drug. You ought to know that proteins may prevent or inhibit the absorption of this medication. Moreover, you should be aware that smoking marijuana in conjunction with levodopa and carbidopa is likely to enhance the side effects of the medications, such as weariness and exhaustion. In addition, smoking marijuana may also heighten orthostatic hypotension (a fall in blood pressure).

Patients taking levodopa-carbidopa should be careful to avoid exposure to heat, as when exposed to warm conditions, this combination drug may result in flushing and extreme sweating. Precisely speaking, people taking levodopa-carbidopa are susceptible to heat exhaustion. Besides, using this medication may also result in some unrelated ailments. For instance, the patients may develop dark-colored lesions on their skin and if this occurs, they should be carefully examined by their physician. They may turn out to be serious - develop into malignant melanoma (skin cancer). In case you develop any infection while taking this medication, your white blood cell count should be monitored carefully.

Discontinuation

It is not advisable to abruptly stop taking the combination prescription drug levodopa-carbidopa. Prior to discontinuing the use of this medication, it is essential to consult your physician. It may be noted here that some conditions may deteriorate if the dosage of this drug is lowered or if it is stopped altogether all of a sudden. Before stopping the use of this drug, it may be necessary to lower the dosage gradually.

Storage instructions

Levodopa-carbidopa tablets ought to be always stored at room temperature ranging between 59°F and 86°F (15°C and 30°C) and kept in a place away from light and moisture.

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