Carbidopa + Levodopa
Find more information about this combination medication at the webpages for Carbidopa
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Advisory
- This medicine contains a combination of 2 drugs: Carbidopa and Levodopa.
- Based on evidence, Carbidopa and Levodopa are more effective when taken together.
Drug Status
Government Approvals
None
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Aromatic Amino Acid Decarboxylation Inhibitor
Controlled Drug Substance
NO
Summary
Carbidopa and Levodopa are used to treat Parkinson's disease, which is a disorder that affects movement, causing symptoms like tremors, stiffness, and slowness. They are also used for parkinsonism, which refers to similar symptoms caused by other conditions like exposure to certain toxins. These medications help manage these symptoms by increasing dopamine levels in the brain, which is a chemical that helps control movement.
Levodopa is converted into dopamine in the brain, which helps improve movement and control. Carbidopa prevents the breakdown of Levodopa before it reaches the brain, ensuring more Levodopa is available for conversion to dopamine. This combination allows for more effective symptom control with lower doses of Levodopa, reducing side effects like nausea.
The usual adult daily dose of Carbidopa when combined with Levodopa is typically 70 mg or more, with a maximum of 200 mg per day. For Levodopa, the dose varies but is often around 300-800 mg per day, depending on the patient's response and tolerance. These medications are taken orally, which means they are swallowed in pill form.
Common side effects of Carbidopa and Levodopa include nausea, dizziness, and involuntary movements, which are called dyskinesias. Carbidopa helps reduce nausea by preventing the breakdown of Levodopa outside the brain. Some patients may experience more serious effects like hallucinations, confusion, and mood changes, which should be reported to a healthcare provider.
Carbidopa and Levodopa should not be used in patients with known allergies to any component of the drug or in those with narrow-angle glaucoma, which is a type of eye condition. Nonselective MAO inhibitors, which are a type of antidepressant, should be stopped two weeks before starting treatment. Patients should be aware of the risk of sudden sleep onset and impulse control disorders.
Indications and Purpose
How does combination of Carbidopa and Levodopa work?
Carbidopa and Levodopa work together to manage Parkinson's disease symptoms by increasing dopamine levels in the brain. Levodopa is a precursor to dopamine and is converted into dopamine once it crosses the blood-brain barrier. Carbidopa inhibits the enzyme that breaks down Levodopa before it reaches the brain, ensuring more Levodopa is available for conversion to dopamine. This combination allows for more effective symptom control with lower doses of Levodopa, reducing side effects like nausea.
How effective is combination of Carbidopa and Levodopa?
The effectiveness of Carbidopa and Levodopa in treating Parkinson's disease is well-documented through clinical studies and patient outcomes. Levodopa is known to improve motor symptoms by increasing dopamine levels in the brain, while Carbidopa enhances its effectiveness by preventing premature breakdown. Clinical trials have shown that the combination reduces symptoms like tremors and rigidity more effectively than Levodopa alone. The combination also allows for lower doses of Levodopa, reducing side effects and improving patient compliance. This evidence supports its widespread use in managing Parkinson's disease.
Directions for Use
What is the usual dose of combination of Carbidopa and Levodopa?
The usual adult daily dose of Carbidopa when combined with Levodopa is typically 70 mg or more, with a maximum of 200 mg per day. For Levodopa, the dose varies but is often around 300-800 mg per day, depending on the patient's response and tolerance. Carbidopa is used to enhance the effectiveness of Levodopa by preventing its breakdown before reaching the brain, allowing for lower doses of Levodopa to be used effectively. The combination helps manage symptoms of Parkinson's disease by increasing dopamine levels in the brain.
How does one take combination of Carbidopa and Levodopa?
Carbidopa and Levodopa can be taken with or without food, but taking them with food may help reduce nausea. However, a high-protein diet can interfere with the absorption of Levodopa, so it's advisable to distribute protein intake evenly throughout the day. Patients should avoid taking iron supplements or multivitamins containing iron close to their medication, as iron can reduce the effectiveness of Levodopa. It's important to follow the dosing schedule prescribed by a healthcare provider and not to change the dosage without consultation.
For how long is combination of Carbidopa and Levodopa taken?
Carbidopa and Levodopa are typically used as long-term treatments for managing Parkinson's disease symptoms. The duration of use is often lifelong, as Parkinson's is a chronic and progressive condition. The combination helps manage symptoms over time, but the dosage may need adjustments based on the patient's response and disease progression. Regular monitoring by a healthcare provider is essential to ensure optimal treatment efficacy and manage any side effects.
How long does it take for combination of Carbidopa and Levodopa to work?
Carbidopa and Levodopa work together to manage symptoms of Parkinson's disease. Levodopa is converted to dopamine in the brain, which helps improve movement and control. Carbidopa prevents the breakdown of Levodopa before it reaches the brain, enhancing its effectiveness. The combination typically starts working within 30 minutes to 2 hours after ingestion, but the exact onset can vary based on individual patient factors and the specific formulation used. The combination allows for a more efficient use of Levodopa, reducing the required dose and minimizing side effects like nausea.
Warnings and Precautions
Are there harms and risks from taking combination of Carbidopa and Levodopa?
Common side effects of Carbidopa and Levodopa include nausea, dizziness, and involuntary movements (dyskinesias). Carbidopa helps reduce nausea by preventing the breakdown of Levodopa outside the brain. Significant adverse effects can include hallucinations, confusion, and mood changes. Some patients may experience sudden sleep onset or impulse control disorders. It's important for patients to report any severe or persistent side effects to their healthcare provider, as dosage adjustments may be necessary to manage these effects.
Can I take combination of Carbidopa and Levodopa with other prescription drugs?
Carbidopa and Levodopa can interact with several prescription drugs. Nonselective MAO inhibitors can cause severe reactions and should be discontinued two weeks before starting Levodopa. Antihypertensive drugs may require dosage adjustments due to potential interactions causing postural hypotension. Dopamine antagonists, such as certain antipsychotics, can reduce the effectiveness of Levodopa. Patients should inform their healthcare provider of all medications they are taking to manage potential interactions effectively.
Can I take combination of Carbidopa and Levodopa if I am pregnant?
Carbidopa and Levodopa are classified as Pregnancy Category C, indicating that there are no adequate and well-controlled studies in pregnant women. Levodopa crosses the placental barrier and is metabolized by the fetus, while Carbidopa concentrations in fetal tissue appear minimal. The combination should only be used during pregnancy if the potential benefits justify the potential risks to the fetus. Pregnant women should consult their healthcare provider to carefully consider the use of these medications.
Can I take combination of Carbidopa and Levodopa while breastfeeding?
The safety of Carbidopa and Levodopa during lactation is not well-established. It is unknown if Carbidopa is excreted in human milk, but Levodopa is known to pass into breast milk. Due to the potential for serious adverse reactions in nursing infants, a decision should be made to either discontinue the drug or stop breastfeeding, considering the importance of the medication to the mother. Consultation with a healthcare provider is essential to weigh the benefits and risks.
Who should avoid taking combination of Carbidopa and Levodopa?
Carbidopa and Levodopa should not be used in patients with known hypersensitivity to any component of the drug or in those with narrow-angle glaucoma. Nonselective MAO inhibitors are contraindicated and should be discontinued two weeks prior to starting treatment. Patients should be aware of the risk of sudden sleep onset and impulse control disorders. Regular monitoring for melanoma is advised due to an increased risk in Parkinson's patients. It's crucial to follow the prescribed dosage and report any severe side effects to a healthcare provider.
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