Generic
Carbidopa + Levodopa
38 brands available in the market
At a glance
Carbidopa + Levodopa is a combination medication used in the treatment of Parkinson's disease. Levodopa is converted to dopamine in the brain, and Carbidopa prevents peripheral breakdown of levodopa, allowing more levodopa to reach the brain and relieve symptoms such as tremor, muscle stiffness, and difficulty moving.
Description
Carbidopa + Levodopa is a combination of levodopa and carbidopa used for Parkinson's disease. Levodopa is the metabolic precursor of dopamine; it crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa is a peripheral decarboxylase inhibitor that prevents the breakdown of levodopa, allowing more levodopa to enter the brain and increase dopamine levels.
This combination is highly effective in relieving symptoms of Parkinson's disease such as tremor, muscle stiffness, and difficulty moving. It should be taken on an empty stomach or as directed by a doctor.
Indications
- Parkinson's disease
- Parkinson-like disorders
Therapeutic class
Antiparkinson drugs
Pharmacological class
Dopamine Precursor + DDC Inhibitor Combination
Pharmacology
Levodopa is the metabolic precursor of dopamine; it crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa is a peripheral decarboxylase inhibitor that prevents the breakdown of levodopa, allowing more levodopa to enter the CNS and increase dopamine levels, helping to control Parkinson's symptoms.
Mechanism of action
Levodopa is converted to dopamine in the brain to replenish dopamine deficiency. Carbidopa prevents peripheral breakdown of levodopa, increasing its entry into the brain, relieving Parkinson's symptoms such as tremor, muscle stiffness, and difficulty moving.
Dosage
Adults (Immediate Release): Initial: 25 mg/100 mg every 8 hours OR 10 mg/100 mg every 6-8 hours. Levodopa may be increased by 100 mg/day every 1-2 days. Carbidopa: 70-100 mg/day (max 200 mg/day); Levodopa: max 800 mg/day.
Adults (CR Tablet): Initial: 50 mg/200 mg every 12 hours; may be increased up to 1600 mg/day of levodopa; doses must be given at least 6 hours apart.
Children: Safety and efficacy not established.
Hepatic impairment: Safety and efficacy not established; use with caution.
Renal impairment: Safety and efficacy not established; use with caution.
Note: Take on an empty stomach for maximum absorption. Avoid high-protein meals.
Administration
Take on an empty stomach (for maximum absorption). Swallow tablets whole; do not chew, crush, or break. Avoid high-protein meals (cheese, eggs, milk, protein powder). Take at a fixed time each day.
Missed dose
If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not double the dose.
Side effects
Common side effects: Nausea, vomiting, dry mouth, constipation, dizziness, sleepiness, headache, abnormal dreams, anxiety, insomnia, dyskinesia (abnormal voluntary movements), orthostatic hypotension (sudden drop in blood pressure on standing).
Serious (rare): Hallucinations, psychosis, neuroleptic malignant syndrome (fever, muscle stiffness, abnormal movements, sweating, confusion), dyskinesia (uncontrolled movements).
Urine may become red, brown, or black (harmless).
Precautions & warnings
- May cause dizziness, drowsiness, double vision; caution when driving or operating machinery.
- Avoid high-protein meals (meat, poultry, dairy products) as they reduce levodopa absorption.
- When starting the medication, get out of bed slowly (risk of dizziness, lightheadedness, or fainting).
- Do not stop suddenly (may cause serious syndrome: fever, muscle stiffness, abnormal movements, sweating, confusion).
- Inform your doctor if you develop hallucinations or behavioral changes.
- Caution during pregnancy and lactation.
Contraindications
- Lactation
- Narrow-angle glaucoma
- Melanoma
- Psychosis
- Severely decompensated endocrine disorders
- Hypersensitivity to any ingredient
Drug interactions
- Pyridoxine (Vitamin B6): Reverses levodopa effects.
- Type-B MAOIs: Synergistic effects.
- Phenothiazines, haloperidol, reserpine, pyridoxine, diazepam, oxazepam, chlordiazepoxide, phenobarbitone: Reduce effects.
- Amantadine, anticholinergics, amphetamine: Enhance levodopa effects.
- Sympathomimetic agents: Effects are enhanced.
- Bethanidine, bretylium, guanethidine: Enhanced hypotensive effects (potentially fatal).
- Furazolidone or MAO inhibitors: Hypertensive crises.
Food interactions
Avoid high-protein meals (meat, poultry, dairy products, eggs) as they reduce levodopa absorption. Alcohol consumption is unsafe.
Use in pregnancy
May be unsafe during pregnancy (Category C). Limited human studies available; animal studies have shown harmful effects on the developing baby. Your doctor will weigh benefits and risks before prescribing.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Probably safe during breastfeeding (if prescribed). Limited human data suggests the drug does not pose significant risk to the baby. Partial to complete suppression of lactation may occur during treatment, but returns to normal after stopping.
Pediatric use
Safety and efficacy in pediatric patients have not been established.
Geriatric use
No specific dose adjustment required for elderly, but consult your doctor.
Renal / hepatic impairment
Hepatic impairment: Safety and efficacy not established; use with caution.
Overdose effects
Overdose symptoms: Nausea, vomiting, uncontrolled movements, confusion, arrhythmia, hypertension. Treatment: Gastric lavage, supportive care, cardiac monitoring. Consult your doctor immediately if overdose is suspected.
Storage conditions
Store in a dry place below 30°C, away from light and moisture. Keep out of reach of children.
Chemical structure
Carbidopa + Levodopa