Fully thaw in refrigerator at 2°C to 8°C (36°F to 46°F) prior to use; protect from light. Use of a DDI (eg, carbidopa) with levodopa will essentially eliminate the risk of this interaction.Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents.Sapropterin: May enhance the adverse/toxic effect of Levodopa-Containing Products.Solriamfetol: May enhance the adverse/toxic effect of Anti-Parkinson Agents (Dopamine Agonist).Spiramycin: May decrease the serum concentration of Carbidopa. There was a decrease in the number of live pups delivered by rats receiving approximately two times the maximum recommended human dose of carbidopa and approximately five times the maximum recommended human dose of levodopa during organogenesis. A significant proportion of rats are expected to die after treatment with similar doses of carbidopa. Carbidopa may increase the serum concentration of Droxidopa. Carbidopa, an inhibitor of aromatic amino acid decarboxylation, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.25. Its characteristic features include resting tremor, rigidity, and bradykinetic movements. Patients who have experienced somnolence and/or an episode of sudden sleep onset must refrain from driving or operating machines (see Epidemiological studies have shown that patients with Parkinson’s disease have a higher risk (2- to approximately 6-fold higher) of developing melanoma than the general population. Patient should be instructed to swallow the mixture without biting down or chewing.Avoid high protein diets (>2 g/kg) which may decrease the efficacy of levodopa via competition with amino acids in crossing the blood-brain barrier. The possibility that the patient may have taken other drugs as well as carbidopa and levodopa tablets should be taken into consideration. Patients with dyskinesia or receiving more than 800 mg levodopa daily, introduce entacapone before transferring to Stalevo ® (levodopa dose may need to be reduced by 10–30% initially). Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. Administer as a 16-hour infusion through either a nasojejunal tube (temporary administration) or through a percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tube (long-term administration) connected to the CADD-Legacy 1400 pump. Once thawed, the individual cartons may be packed in a closer configuration within the refrigerator. When levodopa is taken orally, it crosses into the brain through the "blood- brain barrier." Prescribers should ask patients about the development of new or increased gambling urges, sexual urges or other urges while being treated with carbidopa and levodopa.
Swallow capsules whole; do not chew, divide, or crush capsules. Monitor for decreased therapeutic effects of levodopa during concomitant therapy, particularly if doses cannot be separated.Isoniazid: May diminish the therapeutic effect of Levodopa-Containing Products.Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents.Macimorelin: Levodopa-Containing Products may diminish the diagnostic effect of Macimorelin. Papaverine may diminish the therapeutic effect of Levodopa-Containing Products.Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents.Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Carbidopa has not been shown to enhance the intrinsic efficacy of levodopa in parkinsonian syndromes.In considering whether to give this combination product to patients already on levodopa who have nausea and/or vomiting, the practitioner should be aware that, while many patients may be expected to improve, some do not. There is insufficient information to suggest that dose reductions will eliminate these symptoms. Each dose then begins working in … Because carbidopa permits more levodopa to reach the brain and more dopamine to be formed, certain adverse CNS effects, e.g., dyskinesias (involuntary movements), may occur at lower dosages and sooner with carbidopa and levodopa than with levodopa alone.Levodopa alone, as well as carbidopa and levodopa, is associated with dyskinesias.
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