Carbidopa/Levodopa

DEA Class;  Rx

Common Brand Names; Sinemet, Rytary, Duopa, Dhivy, Sinemet CR (DSC)

Duopa

• Complication of device insertion (57%)
• Nausea (30%)
• Constipation (22%)
• Incision site erythema (19%)
• Dyskinesia (14%)
• Depression (11%)
• Post procedural discharge (11%)
• Peripheral edema (8%)
• Hypertension (8%)
• Upper respiratory tract infection (8%)
• Oropharyngeal pain (8%)
• Atelectasis (8%)
• Confusional state (8%)
• Anxiety (8%)
• Dizziness (8%)
• Hiatal hernia (8%)
• Postoperative ileus (5%)
• Sleep disorder (5%)
• Pyrexia (5%)
• Excessive granulation tissue (5%)
• Rash (5%)
• Bacteriuria (5%)
• White blood cells urine positive (5%)
• Hallucination (5%)
• Psychotic disorder (5%)
• Diarrhea (5%)
• Dyspepsia (5%)

Avoid sudden discontinuation or rapid dose reduction; if discontinuing therapy, taper dose to reduce risk of hyperpyrexia and confusion

Monitor patients with a history of myocardial infarction who have residual atrial, nodal, or ventricular arrhythmia, cardiac function in an intensive cardiac care facility during the initial dosage adjustment

Hallucinations and psychotic-like behavior have been reported; do no treat patients with major psychotic disorder

May experience an urge to gamble, increased sexual urges, intense urges to spend money, binge eating, and/or other intense urges, and inability to control these urges while taking 1 or more of the medications that increase central dopaminergic tone and that are generally used for the treatment of Parkinson disease; consider dosage reduction or stopping the medication if a patient develops such urges

May exacerbate dyskinesia; reduce dose to control symptoms

Treated patients with a history of peptic ulcer may increase the possibility of upper gastrointestinal hemorrhage

Monitor intraocular pressure in patients with glaucoma

Carefully observe patients for developing depression with concomitant suicidal tendencies

Orthostatic hypotension may occur (more common with IR formulation)

Peripheral neuropathy reported with use; evaluate patients for history of neuropathy and known risk factors prior to initiating therapy; assess for peripheral neuropathy periodically during therapy

There are no adequate data on development risk associated with use in pregnant females

Levodopa has been detected in human milk after administration of carbidopa-levodopa