Dosage of Duopa suspension in details
Dosage in Patients Naïve to Levodopa (Duopa suspension) Therapy
The recommended starting dosage of Duopa suspension in Levodopa (Duopa suspension)-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 Duopa suspension may be increased to 36.25 mg / 145 mg taken three times a day.
Based upon individual patient clinical response and tolerability, the Duopa suspension 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 Duopa suspension 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 (Duopa suspension)-Levodopa (Duopa suspension) to Duopa suspension
To convert patients from immediate-release Carbidopa (Duopa suspension)-Levodopa (Duopa suspension) to Duopa suspension, determine the recommended starting dosage of Duopa suspension using Table 1.
The dosages of other Carbidopa (Duopa suspension) and Levodopa (Duopa suspension) products are not interchangeable with the dosages of Duopa suspension.
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 Duopa suspension is 612.5 mg / 2450 mg.
For patients currently treated with Carbidopa (Duopa suspension) and Levodopa (Duopa suspension) plus catechol-O-methyl transferase (COMT) inhibitors (such as entacapone), the initial total daily dose of Levodopa (Duopa suspension) in Duopa suspension described in Table 1 may need to be increased.
Use of Duopa suspension in combination with other Levodopa (Duopa suspension) products has not been studied.
| Total Daily Dose of Levodopa (Duopa suspension) in Immediate-Release Carbidopa (Duopa suspension)-Levodopa (Duopa suspension) | Recommended Starting Dosage of Duopa suspension | |
|---|---|---|
| Total Daily Dose of Levodopa (Duopa suspension) in Duopa suspension | Duopa suspension Dosing Regimen | |
| ||
| 400 mg to 549 mg | 855 mg | 3 capsules Duopa suspension 23.75 mg / 95 mg taken TID* |
| 550 mg to 749 mg | 1140 mg | 4 capsules Duopa suspension 23.75 mg / 95 mg taken TID |
| 750 mg to 949 mg | 1305 mg | 3 capsules Duopa suspension 36.25 mg / 145 mg taken TID |
| 950 mg to 1249 mg | 1755 mg | 3 capsules Duopa suspension 48.75 mg / 195 mg taken TID |
| Equal to or greater than 1250 mg | 2340 mg or | 4 capsules Duopa suspension 48.75 mg / 195 mg taken TID or |
| 2205 mg | 3 capsules Duopa suspension 61.25 mg / 245 mg taken TID | |
Discontinuation of Duopa suspension
Avoid sudden discontinuation or rapid dose reduction of Duopa suspension. The daily dose of Duopa suspension should be tapered at the time of treatment discontinuation.
Administration Information
Swallow Duopa suspension whole with or without food. A high-fat, high-calorie meal may delay the absorption of Levodopa (Duopa suspension) by about 2 hours.
Do not chew, divide or crush Duopa suspension capsules. For patients who have difficulty swallowing intact capsules, administer Duopa suspension 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 Duopa suspension?
Taking Duopa suspension with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Duopa suspension 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:
-
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 (Duopa suspension) and Levodopa (Duopa suspension), including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Duopa suspension drug interactions (more detail)
Duopa suspension interactions
Caution should be exercised when the following drugs are administered concomitantly with Duopa suspension.
Symptomatic postural hypotension occurred when Duopa suspension was added to the treatment of a patient receiving antihypertensive drugs. Therefore, when therapy with Duopa suspension 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 (Duopa suspension) Levodopa (Duopa suspension) may be associated with severe orthostatic hypotension not attributable to Carbidopa (Duopa suspension) Levodopa (Duopa suspension) alone.
There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and Duopa suspension.
Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of Levodopa (Duopa suspension). In addition, the beneficial effects of Levodopa (Duopa suspension) in Parkinson's disease have been reported to be reversed by phenytoin and papaverine. Patients taking these drugs with Duopa suspension should be carefully observed for loss of therapeutic response.
Use of Duopa suspension with dopamine-depleting agents (e.g., reserpine and tetrabenazine) or other drugs known to deplete monoamine stores is not recommended.
Duopa suspension and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with Levodopa (Duopa suspension) and Carbidopa (Duopa suspension) and consequently reduce the bioavailability of Carbidopa (Duopa suspension) and Levodopa (Duopa suspension).
Although metoclopramide may increase the bioavailability of Levodopa (Duopa suspension) 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 Duopa suspension 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 Duopa suspension. 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
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Information checked by Dr. Sachin Kumar, MD Pharmacology
