Carbidopa / Levadopa

Levadopa was the first medication proven effective for treating a chronic degenerative neurologic disease. When levodopa is in pill form, it is absorbed into the blood stream. It travels through the blood from the small intestine to the brain. Once it is in the brain, it is converted into dopamine. Dopamine cannot be given to treat PD because of its chemical structure. It is used to treat:

• Slowness

• Stiffness

• Tremor

• Swallowing Difficulties

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Levadopa treatment alone has proven to cause nausea and vomiting. Carbidopa is a drug that improves the effect of levodopa and when combined, allows an 80% decrease in the original side effects for better digestion and acceptance of the medication.

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Carbidopa/levodopa is a common medication therapy now available in generic and branded formats. Medications can come in a variety of formats to help you with finding the best balance for quality motor treatment management. These include immediate release tablets, orally disintegrating tablets, controlled release tablets, and extended-release tablets.

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It is very important to work with your medical professional to ensure the most appropriate dosage and strategy. Keeping a journal that is clearly dated and tracks symptoms will help to provide the documentation your doctor needs to best understand the times of day you may experience the greatest challenges of symptom management. This will also help to determine the best strategy for managing "on" and "off" times. While it is most common to take the medication in pill format, liquids, inhalation powder, and surgically placed pumps are also options based on tolerance levels.

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Carbidopa/levadopa enteral suspension is a gel that is slowly and consistently pumped into the intestine through a surgically placed tube. For those that do not tolerate a pill form well, this is an additional option that could offer smooth absorption of the medicine and aid with motor fluctuations and dyskinesia.  The most common side effects of carbidopa levodopa are:

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• Confusion

• Lightheadedness

• Loss of appetite

• Lowered blood pressure

• Nausea

• Vomiting

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When trying any new medication, it is important to give it a couple of weeks to level out. Your doctor will work with you on how to start your medication, easing into dosage levels to find the most appropriate dose and timing. Should you decide to stop taking medication, it is very important to ween off the medication slowly, just as you increased the medication when trying to avoid adverse effects.

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If you have any of the following conditions, you should discuss them with your physician prior to starting Carbidopa/Levadopa:

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• Narrow-angle glaucoma, history of melanoma, unexplained skin spots

• Whether you have taken a monoamine oxidase inhibitor (phenelzine, tranylcypromine, isocarboxazid) in the last 14 days.

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