Levodopa is used alone or in combination with carbidopa to treat Parkinson's disease, sometimes referred to as shaking palsy or paralysis agitans. Some patients require the combination of medicine, while others benefit from levodopa alone. By improving muscle control, this medicine allows more normal movements of the body.
Levodopa alone or in combination is available only with your doctor's prescription. It is available in the following dosage forms:
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For levodopa and for carbidopa and levodopa combination, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to levodopa alone or in combination with carbidopa. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Since protein may interfere with the body's response to levodopa, high protein diets should be avoided. Intake of normal amounts of protein should be spaced equally throughout the day.
For patients taking levodopa by itself:
Studies have not been done in pregnant women. However, studies in animals have shown that levodopa affects the baby's growth both before and after birth if given during pregnancy in doses many times the human dose. Also, studies in rabbits have shown that levodopa, alone or in combination with carbidopa, causes birth defects.
Levodopa and carbidopa pass into the breast milk and may cause unwanted side effects in the nursing baby. Also, levodopa may reduce the flow of breast milk.
Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of levodopa or carbidopa in children with use in other age groups.
Elderly people are especially sensitive to the effects of levodopa. This may increase the chance of side effects during treatment.
Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking levodopa or carbidopa and levodopa combination, it is especially important that your health care professional know if you are taking any of the following:
Taking levodopa while you are taking or within 2 weeks of taking monoamine oxidase (MAO) inhibitors may cause sudden extremely high blood pressure; at least 14 days should be allowed between stopping treatment with one medicine and starting treatment with the other medicine
The presence of other medical problems may affect the use of levodopa. Make sure you tell your doctor if you have any other medical problems, especially:
It is best not to take this medicine with or after food, especially high-protein food, since food may decrease levodopa's effect.
However, to lessen possible stomach upset, your doctor may want you to take food shortly after taking this medicine (about 15 minutes after). If stomach upset is severe or continues, check with your doctor.
Take this medicine only as directed. Do not take more or less of it, and do not take it more often than your doctor ordered.
For patients taking carbidopa and levodopa extended-release tablets: Swallow the tablet whole without crushing or chewing, unless your doctor tells you not to. If your doctor tells you to, you may break the tablet in half.
Some people must take this medicine for several weeks or months before full benefit is received. Do not stop taking it even if you do not think it is working. Instead, check with your doctor.
The dose of levodopa or carbidopa and levodopa combination will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of levodopa or carbidopa and levodopa combination. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on your special needs.
For oral dosage form (capsules and tablets):
For oral tablet dosage form:
For oral extended-release tablet dosage form:
If you miss a dose of this medicine, take it as soon as possible. However, if your next scheduled dose is within 2 hours, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
To store this medicine:
Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine.
This medicine may cause test results for urine sugar or ketones to be wrong. Check with your doctor before depending on home tests using the paper-strip or tablet method.
This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.
Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.
Pyridoxine (vitamin B6) has been found to reduce the effects of levodopa when levodopa is taken by itself. This does not happen with the combination of carbidopa and levodopa. If you are taking levodopa by itself, do not take vitamin products containing vitamin B6 during treatment, unless prescribed by your doctor.
Large amounts of pyridoxine are also contained in some foods such as avocado, bacon, beans, beef liver, dry skim milk, oatmeal, peas, pork, sweet potato, tuna, and certain health foods. Check with your doctor about how much of these foods you may have in your diet while you are taking levodopa. Also, ask your health care professional for help when selecting vitamin products.
As your condition improves and your body movements become easier, be careful not to overdo physical activities. Injuries resulting from falls may occur. Physical activities must be increased gradually to allow your body to adjust to changing balance, circulation, and coordination. This is especially important in the elderly.
After taking this medicine for long periods of time, such as a year or more, some patients suddenly lose the ability to move. Their muscles do not seem to work. This loss of movement may last from a few minutes to several hours. The patient then is able to move as before. This condition may unexpectedly occur again and again. If you should have this problem, sometimes called the "on-off" effect, check with your doctor.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
(more common when levodopa is used alone)
(not more common when levodopa is used alone)
Check with your doctor if any of the following side effects continue or are bothersome:
This medicine may sometimes cause the urine and sweat to be darker in color than usual. The urine may at first be reddish, then turn to nearly black after being exposed to air. Some bathroom ceaning products will produce a similar effect when in contact with urine containing this medicine. This is to be expected during treatment with this medicine.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
