Common treatments for motor symptoms of Parkinson's disease

Dopamine Replacement Therapy
Although the dopamine deficiency causes the motor problems associated with PD, dopamine cannot cross the blood brain barrier (moving from the blood stream into the brain), and therefore it can’t be directly used as a medication to treat the disease. Levodopa is a precursor of the dopamine neurotransmitter and can be converted to dopamine once inside the brain.

Carbidopa/Levodopa: Levodopa is the gold standard medication for PD with the broadest antiparkinsonian effects of any treatment. In the brain, neurons typically convert levodopa to dopamine. Levodopa works by replacing the dopamine lost in PD. It is combined with carbidopa to prevent nausea and ensure levodopa is not metabolized before it enters the brain.

  • Carbidopa/Levodopa (Sinemet®)

Sinemet CR®25/100 (Controlled Release)
Sinemet CR®25/250 (Controlled Release)

Generic Carbidopa/Levodopa in immediate release form is available from a number of manufactures in the same dosages.

Rytary™ is an extended-release formulation of carbidopa/levodopa. It consists of capsules that contain beads of carbidopa and levodopa that dissolve and are absorbed at different rates. Following administration, therapeutic levodopa levels are relatively rapidly achieved (similar to carbidopa/levodopa immediate release [IR]) and are maintained for 4-5 hours. It is critically important to recognize that dosages of Rytary are not interchangeable with other carbidopa/levodopa products.

  • Carbidopa/Levodopa orally disintegrating (Parcopa®)

Parcopa® 10/100 mg
Parcopa® 25/100 mg
Parcopa® 25/250 mg

Now avialable in Generic Form in same dosage

  • Carbidopa/Levodopa+Entacapone (Stalevo®)

Stalevo®12.5/50/200 mg
Stalevo®25/100/200 mg
Stalevo®25/150/200 mg

Duopa™ is an enteral suspension of carbidopa and levodopa. Duopa is delivered continuously by a pump into the intestine for up to 16 hours daily. The maximum recommended daily dose of Duopa is 2000 mg of levodopa (i.e., one cassette per day) administered over 16 hours.

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