What is Levodopa/Carbidopa ratiopharm retard?
Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) combination is used to treat Parkinson's disease, sometimes called shaking palsy or paralysis agitans. Parkinson's disease is a disorder of the central nervous system (brain and spinal cord).
Extended-release Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) (Levodopa/Carbidopa ratiopharm retard®) is also used to treat parkinsonism caused by encephalitis, or parkinsonism caused by carbon monoxide or manganese poisoning.
Dopamine is a naturally occurring substance in the brain that helps provide control of movement and activities such as walking and talking. In patients with Parkinson's disease, there is not enough dopamine in some parts of the brain. Levodopa (Levodopa/Carbidopa ratiopharm retard) enters the brain and helps replace the missing dopamine, which allows people to function better. By increasing the amount of dopamine in the brain, Levodopa (Levodopa/Carbidopa ratiopharm retard) helps control symptoms and helps you to perform daily activities such as dressing, walking, and handling utensils.
Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) is available only with your doctor's prescription.
Levodopa/Carbidopa ratiopharm retard indications
Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets are indicated in the treatment of the symptoms of idiopathic Parkinson’s disease (paralysis agitans), postencephalitic parkinsonism, and symptomatic parkinsonism which may follow injury to the nervous system by carbon monoxide intoxication and/or manganese intoxication. Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets are indicated in these conditions to permit the administration of lower doses of Levodopa (Levodopa/Carbidopa ratiopharm retard) with reduced nausea and vomiting, with more rapid dosage titration, with a somewhat smoother response, and with supplemental pyridoxine (vitamin B6).
In some patients, a somewhat smoother antiparkinsonian effect results from therapy with Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) than with Levodopa (Levodopa/Carbidopa ratiopharm retard). However, patients with markedly irregular (“on-off”) responses to Levodopa (Levodopa/Carbidopa ratiopharm retard) have not been shown to benefit from Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) therapy.
Although the administration of Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) permits control of parkinsonism and Parkinson’s disease with much lower doses of Levodopa (Levodopa/Carbidopa ratiopharm retard), there is no conclusive evidence at present that this is beneficial other than in reducing nausea and vomiting, permitting more rapid titration, and providing a somewhat smoother response to Levodopa (Levodopa/Carbidopa ratiopharm retard).
Certain patients who responded poorly to Levodopa (Levodopa/Carbidopa ratiopharm retard) have improved when Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) was substituted. This is most likely due to decreased peripheral decarboxylation of Levodopa (Levodopa/Carbidopa ratiopharm retard) which results from administration of Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) rather than to a primary effect of Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) on the nervous system. Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) has not been shown to enhance the intrinsic efficacy of Levodopa (Levodopa/Carbidopa ratiopharm retard) in parkinsonian syndromes.
In considering whether to give Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets to patients already on Levodopa (Levodopa/Carbidopa ratiopharm retard) who have nausea and/or vomiting, the practitioner should be aware that, while many patients may be expected to improve, some do not. Since one cannot predict which patients are likely to improve, this can only be determined by a trial of therapy. It should be further noted that in controlled trials comparing Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) with Levodopa (Levodopa/Carbidopa ratiopharm retard), about half of the patients with nausea and/or vomiting on Levodopa (Levodopa/Carbidopa ratiopharm retard) improved spontaneously despite being retained on the same dose of Levodopa (Levodopa/Carbidopa ratiopharm retard) during the controlled portion of the trial.
How should I use Levodopa/Carbidopa ratiopharm retard?
Use Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) by mouth with or without food.
- If you take an iron product or a multivitamin that contains iron, ask your doctor or pharmacist how to take it with Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard). Iron may decrease your body's ability to absorb Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard).
- Diets that are high in some contents (eg, protein, fat, calories) may decrease your body's ability to absorb Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard). Discuss any questions or concerns with your doctor. Tell your doctor if you have a diet that is high in protein, fat, or calories or if you will be changing your diet.
- Carefully follow the dosing schedule given to you by your health care provider.
- Take Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) on a regular schedule to get the most benefit from it. Taking Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) at the same times each day will help you to remember to take it.
- Continue to take Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) even if you feel well. Do not miss any doses.
- If you have been taking Levodopa (Levodopa/Carbidopa ratiopharm retard), do not start taking Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) until at least 12 hours after your final dose of Levodopa (Levodopa/Carbidopa ratiopharm retard).
- Do not suddenly stop taking Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) or lower your dose without checking with your doctor. Side effects may occur. Discuss any questions or concerns with your doctor.
- If you miss a dose of Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard).
Uses of Levodopa/Carbidopa ratiopharm retard in details
This medication is used to treat symptoms of Parkinson's disease (such as shakiness, stiffness, difficulty moving).
Parkinson's disease is thought to be caused by too little of a naturally occurring substance (dopamine) in the brain. Levodopa (Levodopa/Carbidopa ratiopharm retard) changes into dopamine in the brain, helping to control movement. Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) prevents the breakdown of Levodopa (Levodopa/Carbidopa ratiopharm retard) in the bloodstream so more Levodopa (Levodopa/Carbidopa ratiopharm retard) can enter the brain. Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) can also reduce some of Levodopa (Levodopa/Carbidopa ratiopharm retard)'s side effects such as nausea and vomiting.
By giving this medication as a continuous infusion, it can help reduce the amount of "off" time (periods of slow movement or stiffness).
How to use Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard) via j-tube
Read the Medication Guide and the Instructions for Use provided by your health care professional before you start using this medication and each time you get a refill. If you have any questions, ask your health care professional.
Give this medication as directed as a continuous infusion into the small intestine using an infusion pump. It is usually given over 16 hours a day and stopped at bedtime. At bedtime, take your dose of immediate-release Levodopa/Carbidopa ratiopharm retard tablets by mouth as directed.
When you first start using this medication, it is given through a tube through the nose into the small intestine. After a few days, if the doctor decides that this product is right for you, then the medication will be given through a tube through the abdomen into the small intestine. Getting the tube through the abdomen will require surgery.
Follow all instructions from your health care professional about how to properly use this medication and the infusion pump. Take a cassette containing the medication from the refrigerator and leave it at room temperature for 20 minutes before using. Do not use a cassette for longer than 16 hours or re-use it, even if there is medication left in it. Learn how to store and discard medical supplies safely. Also learn how to properly care for the small hole in your abdomen and the skin area around the tube, and how to avoid infection.
The dosage is based on your medical condition and response to treatment. Your daily dose is made up of a morning dose, a continuous dose, and extra doses. An extra dose is a small dose of this medication that can be given as needed during the day to treat sudden "off" symptoms. Extra doses should not be given more often than one every 2 hours to avoid causing or worsening movements you cannot control.
Do not suddenly decrease the dose or suddenly stop using this medication because doing either may lead to a serious condition. If you must stop this medication, slowly reduce the dose as directed by your doctor. Contact your doctor right away if your infusion is interrupted. You may need to take the tablet form of Levodopa/Carbidopa ratiopharm retard by mouth.
If you plan to be disconnected from the pump for a short period of time (less than 2 hours, for example, to shower), ask your doctor ahead of time if you should use an extra dose of this medication before you disconnect. If you plan to be disconnected from the pump for longer than 2 hours, ask your doctor what you should do and discuss how you should take Levodopa/Carbidopa ratiopharm retard tablets by mouth during this time.
Avoid high-protein diets because they may reduce how much of the medication you can absorb.
Tell your doctor if your condition does not improve or if it worsens.
Levodopa/Carbidopa ratiopharm retard description
The naturally occurring form of dihydroxyphenylalanine and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonian disorders and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system.
Levodopa/Carbidopa ratiopharm retard dosage
Dosage in Patients Naïve to Levodopa (Levodopa/Carbidopa ratiopharm retard) Therapy
The recommended starting dosage of Levodopa/Carbidopa ratiopharm retard in Levodopa (Levodopa/Carbidopa ratiopharm retard)-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 Levodopa/Carbidopa ratiopharm retard may be increased to 36.25 mg / 145 mg taken three times a day.
Based upon individual patient clinical response and tolerability, the Levodopa/Carbidopa ratiopharm retard 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 Levodopa/Carbidopa ratiopharm retard 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 (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard) to Levodopa/Carbidopa ratiopharm retard
To convert patients from immediate-release Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard) to Levodopa/Carbidopa ratiopharm retard, determine the recommended starting dosage of Levodopa/Carbidopa ratiopharm retard using Table 1.
The dosages of other Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) products are not interchangeable with the dosages of Levodopa/Carbidopa ratiopharm retard.
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 Levodopa/Carbidopa ratiopharm retard is 612.5 mg / 2450 mg.
For patients currently treated with Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) plus catechol-O-methyl transferase (COMT) inhibitors (such as entacapone), the initial total daily dose of Levodopa (Levodopa/Carbidopa ratiopharm retard) in Levodopa/Carbidopa ratiopharm retard described in Table 1 may need to be increased.
Use of Levodopa/Carbidopa ratiopharm retard in combination with other Levodopa (Levodopa/Carbidopa ratiopharm retard) products has not been studied.
| Total Daily Dose of Levodopa (Levodopa/Carbidopa ratiopharm retard) in Immediate-Release Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard) | Recommended Starting Dosage of Levodopa/Carbidopa ratiopharm retard | |
|---|---|---|
| Total Daily Dose of Levodopa (Levodopa/Carbidopa ratiopharm retard) in Levodopa/Carbidopa ratiopharm retard | Levodopa/Carbidopa ratiopharm retard Dosing Regimen | |
| ||
| 400 mg to 549 mg | 855 mg | 3 capsules Levodopa/Carbidopa ratiopharm retard 23.75 mg / 95 mg taken TID* |
| 550 mg to 749 mg | 1140 mg | 4 capsules Levodopa/Carbidopa ratiopharm retard 23.75 mg / 95 mg taken TID |
| 750 mg to 949 mg | 1305 mg | 3 capsules Levodopa/Carbidopa ratiopharm retard 36.25 mg / 145 mg taken TID |
| 950 mg to 1249 mg | 1755 mg | 3 capsules Levodopa/Carbidopa ratiopharm retard 48.75 mg / 195 mg taken TID |
| Equal to or greater than 1250 mg | 2340 mg or | 4 capsules Levodopa/Carbidopa ratiopharm retard 48.75 mg / 195 mg taken TID or |
| 2205 mg | 3 capsules Levodopa/Carbidopa ratiopharm retard 61.25 mg / 245 mg taken TID | |
Discontinuation of Levodopa/Carbidopa ratiopharm retard
Avoid sudden discontinuation or rapid dose reduction of Levodopa/Carbidopa ratiopharm retard. The daily dose of Levodopa/Carbidopa ratiopharm retard should be tapered at the time of treatment discontinuation.
Administration Information
Swallow Levodopa/Carbidopa ratiopharm retard whole with or without food. A high-fat, high-calorie meal may delay the absorption of Levodopa (Levodopa/Carbidopa ratiopharm retard) by about 2 hours.
Do not chew, divide or crush Levodopa/Carbidopa ratiopharm retard capsules. For patients who have difficulty swallowing intact capsules, administer Levodopa/Carbidopa ratiopharm retard 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.
Levodopa/Carbidopa ratiopharm retard interactions
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What other drugs will affect Levodopa/Carbidopa ratiopharm retard?
Monoamine Oxidase (MAO) Inhibitors
The use of nonselective MAO inhibitors with Levodopa/Carbidopa ratiopharm retard is contraindicated. Discontinue use of any nonselective MAO inhibitors at least two weeks prior to initiating Levodopa/Carbidopa ratiopharm retard.
The use of selective MAO-B inhibitors (e.g., rasagiline and selegiline) with Levodopa/Carbidopa ratiopharm retard may be associated with orthostatic hypotension. Monitor patients who are taking these drugs.
Antihypertensive Drugs
The concurrent use of Levodopa/Carbidopa ratiopharm retard with antihypertensive medications can cause symptomatic postural hypotension. A dose reduction of the antihypertensive medication may be needed after starting or increasing the dose of Levodopa/Carbidopa ratiopharm retard.
Dopamine D2 Receptor Antagonists And Isoniazid
Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone, metoclopramide, papaverine) and isoniazid may reduce the effectiveness of Levodopa (Levodopa/Carbidopa ratiopharm retard). Monitor patients for worsening Parkinson's symptoms.
Iron Salts
Iron salts or multi-vitamins containing iron salts can form chelates with Levodopa (Levodopa/Carbidopa ratiopharm retard), Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard), and can cause a reduction in the bioavailability of Levodopa/Carbidopa ratiopharm retard. If iron salts or multi-vitamins containing iron salts are co-administered with Levodopa/Carbidopa ratiopharm retard, monitor patients for worsening Parkinson's symptoms.
High-Protein Diet
Because Levodopa (Levodopa/Carbidopa ratiopharm retard) competes with certain amino acids for transport across the gut wall, the absorption of Levodopa (Levodopa/Carbidopa ratiopharm retard) may be decreased in patients on a high-protein diet. Advise patients that a high-protein diet may reduce the effectiveness of Levodopa/Carbidopa ratiopharm retard.
Levodopa/Carbidopa ratiopharm retard side effects
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What are the possible side effects of Levodopa/Carbidopa ratiopharm retard?
The following serious adverse reactions are discussed below and elsewhere in the labeling:
- Falling asleep during activities of daily living and somnolence
- Withdrawal-emergent hyperpyrexia and confusion
- Cardiovascular ischemic events
- Hallucinations/psychosis
- Impulse control/compulsive behaviors
- Dyskinesia
- Peptic Ulcer Disease
- Glaucoma
- Melanoma
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
The safety population consisted of a total of 978 Parkinson's disease patients who received at least one dose of Levodopa/Carbidopa ratiopharm retard, and had an average duration of exposure of 40 weeks.
Adverse Reactions In Early Parkinson's Disease
In a placebo-controlled clinical study in patients with early Parkinson's disease (Study 1), the most common adverse reactions with Levodopa/Carbidopa ratiopharm retard (in at least 5% of patients and more frequently than in placebo) were nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, and orthostatic hypotension.
Table 2 lists adverse reactions occurring in at least 5% of Levodopa/Carbidopa ratiopharm retard-treated patients and at a higher rate than placebo in Study 1.
Table 2: Adverse Reactions in Study 1 in Patients with Early Stage Parkinson's Disease
| Placebo | Levodopa/Carbidopa ratiopharm retard 36.25 mg Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) 145 mg Levodopa (Levodopa/Carbidopa ratiopharm retard) TID | Levodopa/Carbidopa ratiopharm retard 61.25 mg Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) 245 mg Levodopa (Levodopa/Carbidopa ratiopharm retard) TID | Levodopa/Carbidopa ratiopharm retard 97.5 mg Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) 390 mg Levodopa (Levodopa/Carbidopa ratiopharm retard) TID | |
| (N=92) % | (N=87) % | (N=104) % | (N=98) % | |
| Nausea | 9 | 14 | 19 | 20 |
| Dizziness | 5 | 9 | 19 | 12 |
| Headache | 11 | 7 | 13 | 17 |
| Insomnia | 3 | 2 | 9 | 6 |
| Abnormal Dreams | 0 | 2 | 6 | 5 |
| Dry Mouth | 1 | 3 | 2 | 7 |
| Dyskinesia | 0 | 2 | 4 | 5 |
| Anxiety | 0 | 2 | 3 | 5 |
| Constipation | 1 | 2 | 6 | 2 |
| Vomiting | 3 | 2 | 2 | 5 |
| Orthostatic | ||||
| Hypotension | 1 | 1 | 1 | 5 |
Adverse Reactions Leading to Discontinuation in Study 1
In Study 1, 12% of patients discontinued Levodopa/Carbidopa ratiopharm retard early due to adverse reactions; a higher proportion of patients in the 61.25 mg / 245 mg Levodopa/Carbidopa ratiopharm retard-treated group (14%) and in the 97.5 mg / 390 mg Levodopa/Carbidopa ratiopharm retard-treated group (15%) experienced adverse reactions leading to early discontinuation compared to (4%) in the placebo group. The most common adverse reactions resulting in early discontinuation were nausea, dizziness, and vomiting.
Adverse Reactions In Advanced Parkinson's Disease
In an active-controlled clinical study in patients with advanced Parkinson's disease (Study 2), the most common adverse reactions with Levodopa/Carbidopa ratiopharm retard that occurred during dose conversion or maintenance (in at least 5% of patients and more frequently than on oral immediate-release Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard)) were nausea and headache.
Table 3 lists adverse reactions occurring in at least 5% of Levodopa/Carbidopa ratiopharm retard-treated patients and at a higher rate than oral immediate-release Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard) in Study 2.
Table 3: Adverse Reactions in Study 2 in Patients with Advanced Parkinson's Disease
| Period | Levodopa/Carbidopa ratiopharm retard (N=201) | Immediate-Release Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard)-Levodopa (Levodopa/Carbidopa ratiopharm retard) (N=192) | ||
| Dose Convers ion* | Maintenance | Dose Convers ion* | Maintenance | |
| % | % | % | % | |
| Nausea | 4 | 3 | 6 | 2 |
| Headache | 5 | 1 | 3 | 2 |
| *All patients were converted to Levodopa/Carbidopa ratiopharm retard in the open label Dose Conversion period and then received randomized treatment during maintenance. |
Adverse Reactions Leading to Discontinuation in Study 2
In Study 2, 5% of patients discontinued treatment due to adverse reactions during conversion to Levodopa/Carbidopa ratiopharm retard. The common adverse reactions leading to discontinuation during dose conversion were dyskinesia, anxiety, dizziness, and on and off phenomenon.
Levodopa/Carbidopa ratiopharm retard contraindications
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What is the most important information I should know about Levodopa/Carbidopa ratiopharm retard?
Nonselective monoamine oxidase (MAO) inhibitors are contraindicated for use with Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets. These inhibitors must be discontinued at least two weeks prior to initiating therapy with Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets. Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets may be administered concomitantly with the manufacturer’s recommended dose of an MAO inhibitor with selectivity for MAO type B (e.g., selegiline HCI).
Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets are contraindicated in patients with known hypersensitivity to any component of this drug, and in patients with narrow-angle glaucoma.
Because Levodopa (Levodopa/Carbidopa ratiopharm retard) may activate a malignant melanoma, Carbidopa (Levodopa (Levodopa/Carbidopa ratiopharm retard)/Carbidopa ratiopharm retard) and Levodopa (Levodopa/Carbidopa ratiopharm retard) orally disintegrating tablets should not be used in patients with suspicious, undiagnosed skin lesions or a history of melanoma.
Active ingredient matches for Levodopa/Carbidopa ratiopharm retard:
Carbidopa/Levodopa in Netherlands.
List of Levodopa/Carbidopa ratiopharm retard substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Levodopa/Carbidopa/Entacapone Sandoz (Poland) | |
| Levofamil (Chile) | |
| Tablet; Oral; Carbidopa 25 mg; Levodopa 250 mg (Andromaco) | |
| Levohexal (Australia) | |
| Levokom (Lithuania) | |
| Levomed (Hong Kong, Malaysia, Malta, India) | |
| 500 mg x 5's (Mediez) | $ 0.48 |
| Levomed 10 x 10's (Mediez) | |
| Levomed 500mg TAB / 5 (Mediez) | $ 0.48 |
| LEVOMED 250 MG TABLET 1 strip / 5 tablets each (Mediez) | $ 0.12 |
| LEVOMED 500 MG TABLET 1 strip / 5 tablets each (Mediez) | $ 0.19 |
| LEVOMED tab 500 mg x 5's (Mediez) | $ 0.48 |
| Levomed 250mg Tablet (Mediez) | $ 0.02 |
| Levomed 500mg Tablet (Mediez) | $ 0.04 |
| Levomed 25/100/Levomed 25/250 (Thailand) | |
| Levomet (Hong Kong, Singapore, Thailand) | |
| Levomet 10 x 10's (Unison) | |
| Levomet 10 x 10's (Unison) | |
| Levomet 250/25 mg 10 x 10's (Unison) | |
| Levomet 100/25 mg tab 10 x 10's (Unison) | |
| Levomet 100/25 tab 10 x 10's (Unison) | |
| Levomet 250/25 tab 10 x 10's (Unison) | |
| Levopa (Bangladesh) | |
| Levopa-C (India) | |
| Levopa-C Carbidopa 25mg, Levodopa250mg TAB / 10 (Wallace) | $ 0.37 |
| 10's (Wallace) | $ 0.37 |
| Levopa-C Levodopa 250 mg, Carbidopa 25mg. TAB / 10 (Wallace) | $ 0.37 |
| Levopa-C Carbidopa 25mg, Levodopa 250mg TAB / 10 (Wallace) | $ 0.37 |
| LEVOPA-C tab 10's (Wallace) | $ 0.37 |
| Levosynt (Cyprus) | |
| Licebral (Paraguay, Uruguay) | |
| Licebral CR (Paraguay) | |
| Licebral CR 50/200 (Uruguay) | |
| Menesit (Japan) | |
| Mint-Levocarb (Canada) | |
| Nacom (Germany) | |
| Tablet; Oral Carbidopa 100 mg; Levodopa 250 mg (Bms) | |
| Tablet; Oral Carbidopa 200 mg; Levodopa 500 mg (Bms) | |
| Nacom Retard (Germany) | |
| Tablet, Retard; Oral; Carbidopa 100; Levodopa 250 mg | |
| Nakom (Bosnia & Herzegowina, Croatia (Hrvatska), Czech Republic, Estonia, Georgia, Latvia, Lithuania, Poland, Romania, Russian Federation, Serbia, Slovakia, Slovenia) | |
| Tablet; Oral; Carbidopa 25 mg; Levodopa 250 mg (Lek) | |
| Nakom Mite (Poland, Slovenia) | |
| Tablet; Oral; Carbidopa 25 mg; Levodopa 100 mg | |
| Nakom R (Slovenia) | |
| Neodopaston (Japan) | |
| Nervocur (Argentina) | |
| Neudopa (Pakistan) | |
| Nu-Levocarb (Canada) | |
| Tablet; Oral; Carbidopa 10 mg; Levodopa 100 mg (Nu-pharm) | |
| Tablet; Oral; Carbidopa 25 mg; Levodopa 100 mg (Nu-pharm) | |
See 481 substitutes for Levodopa/Carbidopa ratiopharm retard | |
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).
- PubChem. "levodopa". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- PubChem. "carbidopa". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Levodopa/Carbidopa ratiopharm retard 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 Levodopa/Carbidopa ratiopharm retard. 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 useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
No survey data has been collected yetConsumer reported age
No survey data has been collected yetConsumer reviews
There are no reviews yet. Be the first to write one! |
Information checked by Dr. Sachin Kumar, MD Pharmacology
