Dispersible tablets (Madopar high-speed tablets / dispersible / "125") should be dissolved in a quarter cup of water (25-50 ml); the tablet is completely dissolved after a few minutes to form a milky white suspension, which should be taken no later than half an hour after dissolving the tablet. Since a precipitate can form rapidly, it is recommended to mix the solution before use.
Parkinson's disease
Inside, not less than 30 minutes before or 1 hour after meals.
Standard dosing regimen
Treatment should be started gradually, individually picking up the dose to the optimum effect.
Initial therapy
At the early stage of Parkinson's disease, it is recommended to begin treatment with Madopar from taking 62.5 mg (50 mg of levodopa + 12.5 mg of benserazide) 3-4 times a day. If the initial dosage scheme is tolerated, the dose should be slowly increased depending on the patient's response.
The optimal effect is usually achieved with a daily dose of 300-800 mg of levodopa + 75-200 mg of benserazide taken in three or more doses.To achieve the optimum effect, it can take from 4 to 6 weeks. If it is necessary to further increase the daily dose, this should be done at intervals of 1 month.
Supportive therapy
The average maintenance dose is -125 mg (100 mg of levodopa + 25 mg of benserazide) 3-6 times a day. The number of receptions (at least three) and their distribution during the day should provide the optimal effect.
To optimize the effect, you can replace Madopar 125 capsules and Madopar 250 tablets with Madopar high-speed tablets / dispersible / 125 or Madopar GSO 125 capsules.
Syndrome of "restless legs"
The maximum allowable dose per day is 500 mg Madopara (400 mg levodopa + 100 mg benserazide).
1 hour before bedtime with a small amount of food. Before applying the drug Madopar should refrain from eating a meal rich in protein.
Idiopathic syndrome of restless legs with disturbed sleep
It is recommended that Madopar 125 capsules or Madopar 250 tablets be prescribed. Initial dose: 62.5 mg (50 mg of levodopa + 12.5 mg of benserazide) - 125 mg (100 mg of levodopa + 25 mg of benserazide) Madopar. If the effect is insufficient, you should increase the dose to 250 mg (200 mg of levodopa + 50 mg of benserazide) Madopar.
Idiopathic syndrome of restless legs with disturbed sleep and sleep
The initial dose: 1 capsule Madopar GSS "125" and 1 capsule Madopar "125" for 1 hour before bedtime. If the effect is insufficient, it is recommended to increase the dose of Madopar GSS "125" to 250 mg (2 capsules).
Idiopathic syndrome of "restless legs" with disturbances of falling asleep and sleep, as well as with disturbances during the day
In addition: 1 tablet dispersible or 1 capsule Madopar "125", the maximum permissible daily dose is 500 mg (400 mg of levodopa + 100 mg of benserazide) Madopara.
Syndrome of "restless legs" in patients with chronic renal failure receiving dialysis
125 mg Madopara (1 tablet dispersible or 1 Madopar capsule "125") 30 minutes before the start of dialysis.
Dosing in special cases
Parkinson's disease
Madopar can be combined with other antiparkinsonian means, as the treatment continues, it may be necessary to reduce the dose of other drugs or their gradual cancellation.
Madopar fast acting tablets / dispersible / "125" - special dosage form for patients with dysphagia or akinesia in the early morning and in the afternoon or phenomena "depletion effect of a single dose" or "increase in the latent period before the onset of clinical effect of the drug."
If during the day the patient exhibits pronounced motor fluctuations (the phenomenon of "depletion of the single-dose effect", the phenomenon of "on-off"), it is recommended either a more frequent intake of correspondingly smaller single doses, or - which is preferable - the use of Madopar GSS "125".
It is better to start the transition to Madopar SCA "125" from the morning dose, keeping the daily dose and the Madopar "125" or Madopara "250" reception scheme.
After 2-3 days, the dose is gradually increased by approximately 50%. The patient should be warned that his condition may temporarily worsen. Due to its pharmacokinetic properties Madopar SSA "125" begins to act somewhat later. Clinical effect can be achieved more quickly by appointing Madopar GSS "125" together with Madopar "125 capsules" or tablets dispersible. This can be especially useful in the case of the first morning dose, which should be slightly higher than the subsequent ones. Individual dose of Madopar GSS "125" should be selected slowly and carefully, the interval between dose changes should be at least 2-3 days.
In patients with nocturnal symptoms, a positive effect was achieved by gradually increasing the evening dose of Madopar GSS "125" to 250 mg (2 capsules) before going to bed.
To eliminate the pronounced effect of Madopar GSS "125" (dyskinesia), it is more effective to increase the intervals between doses than to decrease the single dose. If Madopar GSA "125" is not effective enough, it is recommended to return to the previous treatment with Madopar "125", Madopar "250" and Madopar high-speed tablets / dispersible / "125".
In patients with mild or moderate renal insufficiency, dose adjustment is not required.
Madopar is well tolerated by patients on hemodialysis. With long-term treatment, there may appear fluctuations - episodes of "congealing", weakening of the effect by the end of the period of the dose, the phenomenon of "on-off". To eliminate these symptoms or reduce their severity, dose adjustment should be performed, possibly by administering smaller doses, but more often. Subsequently, you can try to increase the dose again to enhance the therapeutic effect.
Syndrome of "restless legs"
To avoid the increase in symptoms of the restless legs syndrome (early appearance during the day, increased severity and involvement of other parts of the body), the daily dose should not exceed the recommended maximum dose of 500 mg (400 mg levodopa + 100 mg benserazide) Madopara.
With the increase in clinical symptoms should reduce the dose of levodopa or gradually cancel levodopa and prescribe another therapy.