Carbidopa and Levodopa
- Atc Codes:N04BA01
- CAS Codes:38821-49-7#28860-95-9#59-92-7
- PHARMGKB ID:38821-49-7#28860-95-9#59-92-7
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Special Considerations
Brand Names
Europe
Austria: Duodopa, LevoCar, Sinemet; Belgium: Duodopa, Sinemet; Bulgaria: Sinepar; Cyprus: Duodopa, Credanil, Levomed, Levosynt, Sinemet; Czech Republic: Duodopa, Sinemet; Denmark: Duodopa, Levodopa/Carbidopa, Sinemet; Estonia: Duodopa, Sinemet; Finland: Duodopa, Kardopal, Sinemet; France: Carbidopa Levodopa, Duodopa, Sinemet; Germany: Dopadura C, Duodopa, Isicom, Levo-C AL, Levobeta C, LevoCarb, Levocomp, Levocorb, Levodopa Carbidopa, Nacom, Sinemet, Striaton; Greece: Duodopa, Levodopa+Carbidopa, Sinemet; Hungary: Duodopa; Ireland: Duodopa, Sinemet; Italy: Carbidopa-Levidopa, Sinemet; Latvia: Duodopa, Nakom, Sinemet; Lithuania: Duodopa, Nakom, Sinemet; Malta: Duodopa, Levomed, Sinemet; Netherlands: Levodopa/Carbidopa, Sinemet; Poland: Dopamar, Duodopa, Levodopa/Carbidopa, Nakom, Pardopa, Poldomet, Sinemet; Portugal: Duodopa, Ledopsan, Sinemet; Romania: Carbidopa/Levodopa, Credanil, Duodopa, Isicom, Nakom, Sinemet; Slovakia: Duodopa, Isicom, Levodopa/Carbidopa, Nakom, Sinemet; Slovenia: Duodopa, Nakom; Spain: Carbidopa Levodopa, Duodopa, Levodopa/Carbidopa, Sinemet; Sweden: Duodopa, Levodopa/Carbidopa, Sinemet; UK: Duodopa, Sinemet.
North America
Canada: Apo-Levocarb, Duodopa, Levocarbidopa, Nu-Lebocarb, Pro-Levocard, Sinemet; USA: Carbidopa and Levodopa, Parcopa, Sinemet.
Latin America
Argentina: Lebocar, Lecarge, Parkinel, Prikap, Sinemet; Brazil: Carbidol, Carbidopa/Levodopa, Cronomet, Levocarb, Parkidopa, Parklen, Sinemet; Mexico: Cloisone, Lemdopa, Racovel, Sinemet, Ternovag.
Asia
Japan: Carcopa, Dopacol, Leprinton, Menesit, Neodopaston, Parkiston.
North America
Canada: Levocarb, Levocarbidopa, Levodopa/Carbidopa, Sinemet; USA: Parcopa, Sinemet.
Latin America
Argentina: Lebocar, Lecarge, Parkinel, Prikap, Sinemet; Brazil: Carbidol, Carbidopa/Levodopa, Cronomet, Duodopa CR, Levocarb, Sinemet; Mexico: Cloisone, Lemdopa, Racovel, Sinemet, Ternovag.
Asia
Japan: Carcopa, Dopacol, Leprinton, Menesit, Neodopaston, Parkiston.
Drug combinations
Chemistry
Carbidopa: C~10~H~14~N~2~O~4~ H~2~O. Mw: 244.24. (1) Benzenepropanoic acid, α-hydrazino-3,4-dihydroxy-α-methyl-, monohydrate, (S)-; (2)(-)-L-α-Hydrazino-3,4-dihydroxy-α-methylhydrocinnamic acid monohydrate. CAS-38821-49-7; CAS-28860-95-9 (anhydrous)(1972).
Levodopa: C~9~H~11~NO~4~. Mw: 197.19. (1) L-Tyrosine, 3-hydroxy-; (2)(-)-3-(3,4-Dihydroxyphenyl)-L-alanine. CAS-59-92-7 (1969).
Drug Combination
Carbidopa and Levodopa.
Pharmacologic Category
Antiparkinsonian Agents; Dopamine Precursors. (ATC-Code: N04BA01 (levodopa)).
Mechanism of action
Levodopa circulates in the plasma to the blood-brain-barrier, where it crosses, to be converted by striatal enzymes to dopamine. Carbidopa inhibits the peripheral plasma breakdown of levodopa by inhibiting its decarboxylation, and thereby increases available levodopa at the blood-brain-barrier.
Therapeutic use
Idiopathic Parkinson’s disease. Postencephalitic parkinsonism. Symptomatic parkinsonism.
Pregnancy and lactiation implications
Teratogenic effects observed with levodopa and carbidopa in animal studies. There are case reports of levodopa crossing the placenta in humans. Excretion in breast milk unknown (use caution).
Unlabeled use
Restless legs syndrome.
Contraindications
Hypersensitivity to levodopa, carbidopa or any component of the formulation. Narrow-angle glaucoma. Use of MAO inhibitors within prior 14 days (however, may be administered concomitantly with the manufacturer’s recommended dose of an MAO inhibitor with selectivity for MAO type B). History of melanoma or undiagnosed skin lesions.
Warnings and precautions
May cause or exacerbate dyskinesias. May cause orthostatic hypotension. Use with caution in patients at risk of hypotension (such as those receiving antihypertensive drugs) or in cardiovascular or cerebrovascular disease. Somnolence might occur without significant warning signs (caution with concomitant sedating medication). Use with caution in patients receiving other CNS depressants or psychoactive agents. Effects with other sedative drugs or ethanol may be potentiated. Use with caution in cardiovascular disease, including history of myocardial infarction and arrhythmias. Use with caution in glaucoma, hepatic/renal impairment, respiratory disease, and in peptic ulcer disease. Use with extreme caution in psychotic disorders. Use with caution in the elderly (may be more sensitive to CNS effects of levodopa). Dopaminergic agents have been associated with a syndrome resembling neuroleptic malignant syndrome on abrupt withdrawal or significant dosage reduction after long-term use.