Doparkin 275 Tablet

Generic Name: Levodopa + Carbidopa

Manufacturer: General Pharmaceuticals Ltd.

Strength: Each tablet contains Levodopa USP 250 mg and Carbidopa 25 mg (as Carbidopa Monohydrate USP).

Indications:

• Doparkin is indicated for the treatment of Parkinson's disease, post-encephalitic Parkinsonism, and symptomatic Parkinsonism. It is useful in relieving many of the symptoms of parkinsonism, particularly rigidity and bradykinesia. This tablet is frequently helpful in the management of tremor, dysphagia, sialorrhea, and postural instability associated with Parkinson's disease and syndrome. Levodopa plus carbidopa before physiotherapy increases motor recovery after stroke.  

Dosage and Administration:

• Dosage must be determined by a physician based on individual patient needs and response.
• Usual Initial Dosage:
  • If Doparkin 110 (100mg Levodopa/10mg Carbidopa) is used, dosage may be initiated with one tablet three or four times a day. Dosage may be increased by one tablet every day or every other day until a total of eight tablets (2 tablets q.i.d.) is reached.
  • For patients starting with Doparkin 275, the initial dose is one half tablet taken once or twice daily. This may not provide the optimal amount of carbidopa for many patients. If necessary, add one-half tablet every day or every other day until optimal response is reached.  
  • The suggested starting dosage for most patients taking more than 1500 mg of levodopa a day is one tablet of Doparkin 275 three or four times a day.  
• Maintenance Dose: Therapy should be individualized and adjusted according to the desired therapeutic response. When more levodopa is required, Doparkin 275 should be substituted at a dosage of one tablet three or four times a day. If necessary, the dosage of Doparkin 275 may be increased by one-half or one tablet every other day to a maximum of eight tablets a day.
• Doparkin tablets can be taken with or without food. However, taking it with food may help reduce nausea. Avoid a high-protein diet as it may interfere with the absorption of levodopa.
• When starting the medication, get out of bed slowly, as it may cause dizziness or lightheadedness.

Contraindications:

• Nonselective monoamine oxidase (MAO) inhibitors are contraindicated for use with levodopa and carbidopa. These inhibitors must be discontinued at least two weeks prior to initiating therapy with Doparkin.
• Known hypersensitivity to any component of this drug.
• Narrow-angle glaucoma.
• Patients with suspicious, undiagnosed skin lesions or a history of melanoma.

Side Effects:

• Common: Nausea, vomiting, dry mouth, constipation, dizziness, sleepiness, headache, abnormal dreams, anxiety, insomnia (difficulty in sleeping).
• Less Common: Abnormality of voluntary movements (dyskinesias), orthostatic hypotension (sudden lowering of blood pressure on standing).
• Other reported side effects: Edema, agitation, confusion, daytime somnolence, decreased attention span, depression, hallucinations, palpitations, arrhythmias.

Precautions:

• Levodopa alone, as well as the combination, is associated with dyskinesias. The occurrence of dyskinesias may require dosage reduction.  
• It should be administered cautiously to patients with severe cardiovascular or pulmonary disease, bronchial asthma, renal, hepatic, or endocrine disease.  
• Symptomatic postural hypotension has occurred when carbidopa-levodopa is added to the treatment of a patient receiving antihypertensive medicines.⁸ Dosage adjustment of the antihypertensive medicine may be required.
• Use with caution in patients with a history of psychosis.
• Patients taking these medicines with carbidopa-levodopa should be carefully observed for loss of therapeutic response:
  • Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, and risperidone).
  • Dopamine-depleting agents (reserpine and tetrabenazine).
  • Isoniazid.
  • Phenytoin and papaverine.
• Concomitant therapy with selegiline and carbidopa-levodopa may be associated with severe orthostatic hypotension.
• Use with caution in patients with liver disease. Dose adjustment may be needed.
• It is unsafe to consume alcohol with Doparkin 275.
• Doparkin 275 may cause side effects that could affect your ability to drive.

Use in Pregnancy & Lactation:

• Pregnancy: Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.  
• Lactation:  Levodopa inhibits lactation. Caution should be exercised when administered to a nursing woman.

Storage:

• Store below 30° C and in a dry place, away from light.
• Keep out of reach of children.

Important Note: This information is for general knowledge and informational purposes only, and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication. They can assess your individual medical condition and provide the most appropriate advice.