Co-careldopa
Antiparkinsonism Preps · Dopa decarboxylase inhibitor
Indications
Idiopathic, post encephalitic and arteriosclerotic Parkinsonism.
Dosage
Parkinson's disease: Adults: Patients not receiving levodopa, initially carbidopa 12.5 mg plus levodopa 50 mg or carbidopa 25 mg plus levodopa 100 mg three times daily, increasing by 12.5/50 mg or 25/100 mg daily or on alternate days to 200/800 mg daily. Children: Not recommended.
Adverse Effects
Cardiac and CNS disturbances, GI upset, anorexia, BP change, psychiatric disorders, dystonia, wt change, anaemia, skin reactions, hyperhidrosis, alopecia, peripheral oedema, dry mouth, dyspnoea, oropharyngeal pain, aspiration pneumonia, dysgeusia, fatigue, asthenia, urinary retention and incontinence, neck pain, vit B6/B12 deficiency, increased blood homocysteine, complications of tube insertion. Urine discolouration.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Severe psychosis, narrow angle glaucoma, history of malignant melanoma. Precautions: Cardiovascular, hepatic, renal, pulmonary or endocrine disease, recent MI. History of psychosis. Monitor for mental changes, depression and suicidal ideation. Peptic ulceration, history of convulsions, wide angle glaucoma. Monitor blood values, hepatic, renal and cardiovascular function. Risk of sudden sleep onset and dopamine dysregulation syndrome. Monitor for impulse control disorders incl pathological gambling, hypersexuality, compulsive spending or eating. Withdraw gradually.
Interactions
Drugs affecting central amines. MAOIs. Antihypertensives and sympathomimetics, ferrous sulphate, TCADs, dopamine antagonists, anticholinergics.
Advice to Patient
Take atleast 30 minutes before meals. To reduce GI upset, take with meals. Take at the same time each day. Do not crush sustained release form. Contact prescriber if there is unrelieved constipation, vomiting, acute headache, dizziness, chest pain, irregular heartbeat, nervousness, loss of memory, hallucinations, seizures, painful or difficult urination, skin rash, increased muscle spasm, rigidity or involuntary movements, abdominal pain, blood in stool or if there is worsening of condition. Do not take OTC sedatives and CNS depressants without consulting prescriber. Avoid alcohol during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Change position slowly from sitting or lying to standing. For nasal congestion or dry skin, consult prescriber for relief. Avoid extremely hot and humid conditions to reduce risk of…
Pharmacokinetics
Absorption: Absorption of levodopa may be decreased with high-fat, high-calorie or high-protein meal. Metabolism: Levodopa has 2 major pathways (decarboxylation and O-methylation) and 2 minor pathways (transamination and oxidation) of metabolism; Carbidopa inhibits the decarboxylation of levodopa to dopamine in the peripheral tissue to allow greater levodopa distribution into the CNS. Bioavailability: Controlled and extended release: Levodopa: Bioavailability is approx. 70%-75% relative to availability from immediate release formulation; Carbidopa: Bioavailability is approx. 50%-58% relative to availability from immediate release formulation. Intestinal gel: Levodopa: Similar bioavailability relative to oral administration of tablet formulations (81%-98%). Intestinal suspension: Levodopa: 97% relative to oral immediate release tablets. Half-life elimination: Immediate release: Levodopa…
Unlicensed Use
Children: Dopamine-sensitive dystonias including Segawa syndrome and dystonias related to cerebral palsy: Expressed as levodopa. 3 mth-18 yr, initially 250 mcg/kg 2-3 times daily of a preparation containing 1:4 carbidopa:levodopa, increased according to response every 2-3 days to max 1 mg/kg three times daily. Treatment of defects in tetrahydrobiopterin synthesis and dihydrobiopterin reductase deficiency: Expressed as levodopa. Neonate, initially 250-500 mcg/kg 4 times daily of a preparation containing 1:4 carbidopa:levodopa, increased according to response every 4-5 days to maintenance dose of 2.5-3 mg/kg 4 times daily; at higher doses consider preparation containing 1:10 carbidopa:levodopa; review regularly, every 3-6 mth; 1 mth-18 yr, initially 250-500 mcg/kg 4 times daily of a preparation containing 1:4 carbidopa:levodopa, increased according to response every 4-5 days to…
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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