Dosage of D-Dopa in details
Dosage in Patients Naïve to Levodopa (D-Dopa) Therapy
The recommended starting dosage of D-Dopa in Levodopa (D-Dopa)-naïve patients is 23.75 mg / 95 mg taken orally three times a day for the first 3 days. On the fourth day of treatment, the dosage of D-Dopa may be increased to 36.25 mg / 145 mg taken three times a day.
Based upon individual patient clinical response and tolerability, the D-Dopa dose may be increased up to a maximum recommended dose of 97.5 mg / 390 mg taken three times a day. The dosing frequency may be changed from three times a day to a maximum of five times a day if more frequent dosing is needed and if tolerated. The maximum recommended daily dose of D-Dopa is 612.5 mg / 2450 mg.
Maintain patients on the lowest dosage required to achieve symptomatic control and to minimize adverse reactions such as dyskinesia and nausea.
Converting from Immediate-Release Carbidopa (D-Dopa)-Levodopa (D-Dopa) to D-Dopa
To convert patients from immediate-release Carbidopa (D-Dopa)-Levodopa (D-Dopa) to D-Dopa, determine the recommended starting dosage of D-Dopa using Table 1.
The dosages of other Carbidopa (D-Dopa) and Levodopa (D-Dopa) products are not interchangeable with the dosages of D-Dopa.
Adjust the dose to maintain patient tolerance and sufficient symptomatic control. The dosing frequency may be changed from three times a day to a maximum of five times a day if more frequent dosing is needed and if tolerated. The maximum recommended daily dose of D-Dopa is 612.5 mg / 2450 mg.
For patients currently treated with Carbidopa (D-Dopa) and Levodopa (D-Dopa) plus catechol-O-methyl transferase (COMT) inhibitors (such as entacapone), the initial total daily dose of Levodopa (D-Dopa) in D-Dopa described in Table 1 may need to be increased.
Use of D-Dopa in combination with other Levodopa (D-Dopa) products has not been studied.
| Total Daily Dose of Levodopa (D-Dopa) in Immediate-Release Carbidopa (D-Dopa)-Levodopa (D-Dopa) | Recommended Starting Dosage of D-Dopa | |
|---|---|---|
| Total Daily Dose of Levodopa (D-Dopa) in D-Dopa | D-Dopa Dosing Regimen | |
| ||
| 400 mg to 549 mg | 855 mg | 3 capsules D-Dopa 23.75 mg / 95 mg taken TID* |
| 550 mg to 749 mg | 1140 mg | 4 capsules D-Dopa 23.75 mg / 95 mg taken TID |
| 750 mg to 949 mg | 1305 mg | 3 capsules D-Dopa 36.25 mg / 145 mg taken TID |
| 950 mg to 1249 mg | 1755 mg | 3 capsules D-Dopa 48.75 mg / 195 mg taken TID |
| Equal to or greater than 1250 mg | 2340 mg or | 4 capsules D-Dopa 48.75 mg / 195 mg taken TID or |
| 2205 mg | 3 capsules D-Dopa 61.25 mg / 245 mg taken TID | |
Discontinuation of D-Dopa
Avoid sudden discontinuation or rapid dose reduction of D-Dopa. The daily dose of D-Dopa should be tapered at the time of treatment discontinuation.
Administration Information
Swallow D-Dopa whole with or without food. A high-fat, high-calorie meal may delay the absorption of Levodopa (D-Dopa) by about 2 hours.
Do not chew, divide or crush D-Dopa capsules. For patients who have difficulty swallowing intact capsules, administer D-Dopa by carefully opening the capsule, sprinkling the entire contents on a small amount of applesauce (1 to 2 tablespoons), and consuming immediately. Do not store the drug/food mixture for future use.
What other drugs will affect D-Dopa?
Taking D-Dopa with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking D-Dopa with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Tell your doctor about all your current medicines and any you start or stop using, especially:
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isoniazid;
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metoclopramide;
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blood pressure medication;
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medicines, vitamins, or mineral supplements that contain iron; or
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medicine to treat a psychiatric disorder (such as Abilify, Geodon, Risperdal, Seroquel, Symbyax, or Zyprexa).
This list is not complete. Other drugs may interact with Carbidopa (D-Dopa) and Levodopa (D-Dopa), including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
D-Dopa drug interactions (more detail)
D-Dopa interactions
Caution should be exercised when the following drugs are administered concomitantly with D-Dopa.
Symptomatic postural hypotension occurred when D-Dopa was added to the treatment of a patient receiving antihypertensive drugs. Therefore, when therapy with D-Dopa is started, dosage adjustment of the antihypertensive drug may be required.
For patients receiving MAO inhibitors (Type A or B), see CONTRAINDICATIONS. Concomitant therapy with selegiline and Carbidopa (D-Dopa) Levodopa (D-Dopa) may be associated with severe orthostatic hypotension not attributable to Carbidopa (D-Dopa) Levodopa (D-Dopa) alone.
There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and D-Dopa.
Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of Levodopa (D-Dopa). In addition, the beneficial effects of Levodopa (D-Dopa) in Parkinson's disease have been reported to be reversed by phenytoin and papaverine. Patients taking these drugs with D-Dopa should be carefully observed for loss of therapeutic response.
Use of D-Dopa with dopamine-depleting agents (e.g., reserpine and tetrabenazine) or other drugs known to deplete monoamine stores is not recommended.
D-Dopa and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with Levodopa (D-Dopa) and Carbidopa (D-Dopa) and consequently reduce the bioavailability of Carbidopa (D-Dopa) and Levodopa (D-Dopa).
Although metoclopramide may increase the bioavailability of Levodopa (D-Dopa) by increasing gastric emptying, metoclopramide may also adversely affect disease control by its dopamine receptor antagonistic properties.
References
- DailyMed. "CARBIDOPA; ENTACAPONE; LEVODOPA: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- FDA/SPL Indexing Data. "KR87B45RGH: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for D-Dopa are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking D-Dopa. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported frequency of use
No survey data has been collected yetConsumer reported doses
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Information checked by Dr. Sachin Kumar, MD Pharmacology
