Levodopa (Levodopum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Anti-Parkinsonics

Dopaminomimetics

Included in the formulation
АТХ:

N.04.B.A   Dopa and dopa derivatives

N.04.B.A.01   Levodopa

Pharmacodynamics:

Replenishes the deficiency of dopamine.The precursor of the dopamine mediator penetrates the blood-brain barrier and is converted to dopamine in the central nervous system.

Pharmacokinetics:

Absorbed in the gastrointestinal tract in an amount of 20-30% of the dose. The maximum concentration in blood plasma is achieved after 2-3 hours. It binds to plasma proteins by 10-30%.

Metabolized by the action of catechol-o-methyltransferase and dopa decarboxylase in all tissues to dopamine, norepinephrine, epinephrine and 3-O-methyldopa.

The elimination half-life is 0.6-1.3 hours. Elimination by the kidneys, partly with feces.

Indications:

It is used to treat Parkinson's disease and Parkinson's syndrome.

ICD-10

VI.G20-G26.G21   Secondary Parkinsonism

VI.G20-G26.G20   Parkinson's disease

Contraindications:
  • Liver failure.
  • Pheochromocytoma.
  • Closed-angle glaucoma.
  • Atraumatic acute rhabdomyolysis (including in the anamnesis).
  • Malignant neuroleptic syndrome.
  • Individual intolerance.
Carefully:

Cardiovascular and pulmonary insufficiency, bronchial asthma, endocrine diseases in the stage of decompensation, erosive-ulcerative lesions of the gastrointestinal tract,convulsions (including in the anamnesis), psychoses, open-angle glaucoma, depressive states with suicidal tendencies.

Pregnancy and lactation:

Recommendations for FDA - Category C. During pregnancy and lactation, the drug is contraindicated.

Dosing and Administration:

Inside regardless of the time of meal. The primary dose of 0.25 mg per day with an increase every 2-3 days to an average daily - 3 g.

The highest daily dose: 6 g.

The highest single dose: 200 mg.

Side effects:

Central and peripheral nervous system: headache, insomnia, nightmares, hallucinations, euphoria, paranoid thinking, cognitive dysfunction, ataxia, trismus, blepharospasm, bruxism.

The cardiovascular system: orthostatic hypotension, arrhythmia, arterial hypertension, phlebitis.

Respiratory system: dyspnea, pain in the chest.

The system of hematopoiesis: anemia, agranulocytosis, thrombocytopenia.

Digestive system: dryness, bitter aftertaste, burning sensation in the mouth, nausea, salivation, vomiting, hiccough, dysphagia, diarrhea, constipation, flatulence, hepatitis, duodenal ulcer development.

Sense organs: oculogic crises, diplopia, mydriasis, blurred vision.

Urinary system: urinary retention, priapism, change in urine color, urinary incontinence.

Dermatological reactions: hyperemia, hot flushes, hyperhidrosis, hair loss, hives.

Allergic reactions.

Overdose:

Symptoms: increased side effects.

Treatment: symptomatic.

Interaction:

Contraindicated simultaneous use with nonselective and selective MAO inhibitors types A and B.

Compatible with other antiparkinsonian drugs, antidepressants (imizin, moclobemide).

Antagonists of dopamine receptors, phenytoin, papaverine reduce the therapeutic effect of levodopa.

It is recommended to take iron preparations with a 2-3 hour interval, since levodopa is combined with iron ions, forming chelate complexes.

Compatible with vitamin B6, ibuprofen, diazepam.

Special instructions:

Not effective against extrapyramidal disorders caused by medication.

Causes drowsiness and short-term sudden falling asleep. When taking the drug, patients are forbidden to drive a car and work with moving machinery.

Instructions
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