D-Dopa Tablet

Dopamine replacement for:

• Parkinson's disease (the most effective treatment for stiffness and slowness)
• Parkinsonism not caused by drugs

Adults: start carbidopa/levodopa 25/100 mg half to one tablet three times daily; increase by half to one tablet every 1–3 days according to response; usual 3–8 tablets of 25/100 daily in divided doses (levodopa up to about 800 mg/day, more under specialist care).

• Controlled-release forms: as directed by the neurologist.
• Take about 30 minutes before meals if possible; high-protein meals reduce absorption; take with a light snack if nausea occurs.
• Never stop suddenly (risk of severe stiffness, fever — neuroleptic malignant-like syndrome).

• Narrow-angle glaucoma
• Use with non-selective MAO inhibitors (phenelzine) — stop 2 weeks before
• Suspicious undiagnosed skin lesions or history of melanoma
• Severe psychosis

Common: nausea, vomiting, loss of appetite, dizziness on standing, sleepiness, involuntary movements (dyskinesia) with long use, "wearing off" and on–off fluctuations, vivid dreams.

Less common: confusion, hallucinations, depression, dark urine/sweat (harmless).

Serious: sudden sleep attacks (during driving), impulse control disorders (gambling, shopping, binge eating, hypersexuality), psychosis, low blood counts.

• Do not drive if sudden sleepiness occurs.
• Tell the doctor about compulsive behaviours (family often notices first).
• Heart disease, irregular heartbeat, peptic ulcer, glaucoma, depression, psychiatric illness: caution.
• Regular skin checks.

Use in pregnancy only if clearly needed. Avoid while breastfeeding (suppresses milk production).

• Antipsychotics, metoclopramide (block the effect — avoid)
• Iron supplements (take 2 hours apart)
• Non-selective MAO inhibitors (hypertensive crisis)
• Antihypertensives (low blood pressure on standing)
• High-protein meals (reduced effect)

Agitation, confusion, involuntary movements, palpitations, low or high blood pressure. Supportive care.

Store below 30°C, protected from light and moisture.