Indications for: LODOSYN
Parkinsonism (in combination with Sinemet or levodopa).
≥18yrs: Concomitant Sinemet 10-100: give Lodosyn 25mg with first dose of Sinemet each day; additional 12.5mg or 25mg doses may be given with each dose of Sinemet. Concomitant Sinemet 25-100 or 25-250: give Lodosyn 25mg with any dose of Sinemet as required for optimum therapeutic response. Max total daily dose of carbidopa: 200mg. Patients requiring individual titration of carbidopa and levodopa: initially Lodosyn 25mg 3–4 times daily with concomitant levodopa, starting with max 20-25% of previous or recommended daily dosage of levodopa when given without carbidopa; if patient already receiving levodopa therapy, allow 12hrs to elapse before initiating carbidopa with levodopa. May give Vit. B6 supplement. See full labeling for dosage adjustments, interruption of therapy.
<18yrs: not recommended.
During or within 14 days of nonselective MAOIs. Narrow-angle glaucoma.
With levodopa: Severe cardiovascular or pulmonary disease. Asthma. Renal, hepatic, or endocrine disorders. History of peptic ulcer or MI with residual arrhythmias. Suicidal tendencies. Psychosis. Orthostatic hypotension. Chronic wide-angle glaucoma. Monitor renal, liver, cardiovascular function, intraocular pressure, blood counts during extended therapy. May stain body fluids. Sleep disorders. Impulse control/compulsive behaviors; consider dose reduction or discontinue if occurs. Monitor for melanomas; perform skin exams. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
With levodopa: See Contraindications. Orthostatic hypotension with selegiline, rasigiline, or antihypertensives; may need to adjust dose of antihypertensive. Antagonized by phenothiazines, butyrophenones, risperidone, phenytoin, papaverine. Hypertension, dyskinesia with tricyclic antidepressants. May be antagonized by iron, high protein diets. May cause false (+) urinary ketone test or false (–) urinary glucose (glucose oxidase) test.
With levodopa: Dyskinesia, nausea, hallucinations, confusion, psychological disturbances, depression, dizziness, headache, dream abnormalities, somnolence, sleepiness, dystonia, cardiac arrhythmias, hypotension, dyspnea, on-off phenomenon, back pain, blepharospasm (may indicate excess dosage), hypertension, anticholinergic effects, anorexia, insomnia, leukopenia, renal and liver function disorders, neuroleptic malignant syndrome.