Anamet
Generic Name
Levodopa + Carbidopa
Manufacturer
Multiple manufacturers globally (e.g., Square Pharmaceuticals Ltd. in Bangladesh)
Country
Global
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Description
Overview of the medicine
Anamet is a combination medicine containing Levodopa and Carbidopa, used to treat Parkinson's disease and Parkinson-like symptoms. Levodopa is converted to dopamine in the brain, helping to reduce symptoms, while Carbidopa prevents the breakdown of Levodopa outside the brain, increasing its effectiveness and reducing side effects.
Uses & Indications
Dosage
Adults
Initial dose: 25 mg Carbidopa/100 mg Levodopa, 3 times daily. Dosage may be increased gradually based on patient response, usually by 1 tablet every 1-2 days, until a maximum of 200 mg Carbidopa/2000 mg Levodopa per day is reached.
Elderly
Similar to adult dosage, but titration should be done cautiously, considering potential sensitivity and renal/hepatic impairment.
Renal_impairment
No specific dose adjustment for mild to moderate renal impairment, but caution is advised. Severe impairment may require dose reduction.
How to Take
Take orally, preferably with a meal or snack to reduce nausea. Avoid high-protein meals as they may interfere with levodopa absorption. Do not crush or chew extended-release tablets.
Mechanism of Action
Levodopa, a precursor to dopamine, crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa inhibits peripheral decarboxylase, preventing the conversion of levodopa to dopamine outside the brain, thus allowing more levodopa to reach the brain and reducing peripheral side effects of dopamine.
Pharmacokinetics
Onset
Onset of action is typically within 30 minutes to an hour for immediate-release formulations.
Excretion
Excreted primarily through the kidneys as metabolites and unchanged drug.
Half life
The plasma half-life of levodopa is approximately 1-3 hours. Carbidopa extends the half-life of levodopa.
Absorption
Levodopa is rapidly absorbed from the small intestine, with peak plasma concentrations occurring within 0.5 to 2 hours. Carbidopa increases the bioavailability of levodopa.
Metabolism
Levodopa is extensively metabolized primarily by decarboxylation (inhibited by carbidopa) and O-methylation. Carbidopa is also metabolized.
Side Effects
Contraindications
- Hypersensitivity to levodopa, carbidopa, or any component of the formulation
- Narrow-angle glaucoma
- Concomitant use with non-selective monoamine oxidase (MAO) inhibitors (must be discontinued at least 2 weeks prior)
- Suspicious undiagnosed skin lesions or a history of melanoma
Drug Interactions
Phenytoin
May reduce the therapeutic effects of levodopa.
Iron salts
May reduce the bioavailability of levodopa/carbidopa.
MAO Inhibitors
Increased risk of hypertensive crisis. Concomitant use with non-selective MAO inhibitors is contraindicated.
Metoclopramide
May increase the risk of extrapyramidal side effects and diminish the antiparkinsonian effect.
Antipsychotics (e.g., phenothiazines, butyrophenones)
May reduce the therapeutic effects of levodopa/carbidopa due to dopamine receptor blockade.
Storage
Store at controlled room temperature (20°C to 25°C), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include abnormal involuntary movements (dyskinesia), agitation, confusion, insomnia, and sometimes cardiac arrhythmias. Treatment is supportive, including gastric lavage, appropriate general supportive measures, and careful monitoring of cardiac function.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding as levodopa is excreted in breast milk and may affect the infant.
Side Effects
Contraindications
- Hypersensitivity to levodopa, carbidopa, or any component of the formulation
- Narrow-angle glaucoma
- Concomitant use with non-selective monoamine oxidase (MAO) inhibitors (must be discontinued at least 2 weeks prior)
- Suspicious undiagnosed skin lesions or a history of melanoma
Drug Interactions
Phenytoin
May reduce the therapeutic effects of levodopa.
Iron salts
May reduce the bioavailability of levodopa/carbidopa.
MAO Inhibitors
Increased risk of hypertensive crisis. Concomitant use with non-selective MAO inhibitors is contraindicated.
Metoclopramide
May increase the risk of extrapyramidal side effects and diminish the antiparkinsonian effect.
Antipsychotics (e.g., phenothiazines, butyrophenones)
May reduce the therapeutic effects of levodopa/carbidopa due to dopamine receptor blockade.
Storage
Store at controlled room temperature (20°C to 25°C), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include abnormal involuntary movements (dyskinesia), agitation, confusion, insomnia, and sometimes cardiac arrhythmias. Treatment is supportive, including gastric lavage, appropriate general supportive measures, and careful monitoring of cardiac function.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding as levodopa is excreted in breast milk and may affect the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on the manufacturer and specific formulation.
Availability
Available in pharmacies and hospitals worldwide
Approval Status
Approved by major regulatory bodies worldwide
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of levodopa/carbidopa in treating Parkinson's disease, focusing on motor symptoms, quality of life, and long-term management.
Lab Monitoring
- Periodic evaluation of hepatic, renal, and hematopoietic system function is recommended during extended therapy. Monitor for signs of GI bleeding.
- Monitor for melanoma risk.
Doctor Notes
- Careful titration is crucial to optimize efficacy and minimize side effects.
- Monitor for signs of impulse control disorders (e.g., gambling, hypersexuality) and neuropsychiatric changes.
- Patients should be advised against abrupt discontinuation to avoid withdrawal symptoms.
Patient Guidelines
- Take exactly as prescribed by your doctor and do not stop taking the medicine suddenly.
- Report any unusual side effects or worsening of symptoms to your doctor immediately.
- Be cautious when standing up quickly due to the risk of dizziness and orthostatic hypotension.
- Avoid driving or operating machinery if you experience drowsiness or sudden sleep episodes.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Patients should be warned about the possibility of sudden onset of sleep and drowsiness and advised to avoid driving or operating machinery during treatment if affected.
Lifestyle Advice
- Maintain a balanced diet, but be aware of how high-protein meals might affect your medication's effectiveness.
- Engage in regular, moderate exercise as advised by your doctor.
- Stay hydrated.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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