Carbidopa/Levodopa Orally Disintegrating Tabs Rx
Generic Name and Formulations:
Carbidopa, levodopa; 10mg/100mg, 25mg/100mg, 25mg/250mg; orally-disintegrating tabs; mint flavor; contains phenylalanine.
Various generic manufacturers
Indications for Carbidopa/Levodopa Orally Disintegrating Tabs:
Discontinue levodopa at least 12 hrs before starting carbidopa/levodopa. Dissolve tabs on tongue. ≥18yrs: initially one 25/100 tab 3 times daily, or one 10/100 tab 3–4 times daily; increase every 1–2 days up to either 2 tabs of 25/100 or 2 tabs of 10/100 4 times daily. Patients taking levodopa >1500mg/day: initially one 25/250 tab 3–4 times daily; usual max carbidopa 200mg/day.
<18yrs: not recommended.
During or within 14 days of nonselective MAOIs. Narrow-angle glaucoma. Undiagnosed skin lesions. History of melanoma.
Severe cardiovascular or pulmonary disease. Asthma. Renal, hepatic, or endocrine disorders. History of peptic ulcer or MI with residual arrhythmias. Suicidal tendencies. Psychosis. Orthostatic hypotension. Chronic wide-angle glaucoma. Monitor renal, hepatic and cardiovascular function, intraocular pressure, blood counts. May stain body fluids. Pregnancy (Cat.C). Nursing mothers.
Dopa-decarboxylase inhibitor + dopamine precursor.
See Contraindications. Antagonized by phenothiazines, butyrophenones, risperidone, phenytoin, papaverine, isoniazid; possibly iron, high protein diets, excessive gastric acidity. Orthostatic hypotension with selegiline, antihypertensives. May be affected by metoclopramide. Hypertension, dyskinesia with tricyclics. May cause false (+) urinary ketone or Coombs test or false (–) urinary glucose (glucose oxidase) test.
Dyskinesias, GI upset, CNS disturbances (eg, hallucinations, confusion, depression, dizziness, headache, insomnia, somnolence), syncope, hypo- or hypertension, dyspnea, on-off phenomena, blepharospasm (may indicate excess dose), urine discoloration, lab abnormalities; rare: neuroleptic malignant syndrome.
Formerly known under the brand name Parcopa.
Clinical Pain Advisor Articles
- Abuse-Deterrent Opioid Formulations: Barriers to Broader Use
- Women Frequently Prescribed High Doses of Opioids After Vaginal Delivery
- Notifications by PDMPs May Not Effectively Reduce Opioid Misuse
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Medical Cannabis Legalization Associated With Reduced Schedule III Opioid Prescriptions
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- Prioritizing Rest in Hospital Settings: Poor Sleep Increases Costs, Complications, and Mortality
- Pain Catastrophizing Decreases in Rheumatoid Arthritis After DMARD Initiation
- Addressing Commercial Incentives in the Medical Device Industry
- Cancer Patients Treated With Step III Opioids Often Have Sleep Disturbances
- Low Literacy Self-Management Program for Chronic Pain May Be Effective