Cardosia Plus
Generic Name
Carbidopa + Levodopa
Manufacturer
PharmaCorp Bangladesh
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cardosia plus 5 mg tablet | ৳ 4.52 | N/A |
Description
Overview of the medicine
Cardosia Plus is a combination medicine containing Carbidopa and Levodopa, primarily used to treat the symptoms of Parkinson's disease, such as tremors, stiffness, and slow movement. Carbidopa prevents the breakdown of Levodopa in the bloodstream, allowing more Levodopa to reach the brain where it is converted into dopamine, a chemical essential for movement.
Uses & Indications
Dosage
Adults
Initial dose: 25 mg Carbidopa/100 mg Levodopa, three times daily. Dose may be increased gradually every 1-2 days based on response, up to a maximum of 200 mg Carbidopa/2000 mg Levodopa per day.
Elderly
Similar to adults, but with careful monitoring and slower titration due to increased sensitivity and potential for side effects.
Renal_impairment
No specific dose adjustment for mild to moderate renal impairment, but use with caution. For severe impairment, close monitoring and dose reduction may be necessary.
How to Take
Take orally, preferably with a low-protein meal or after food to minimize gastrointestinal upset. Do not crush or chew extended-release tablets.
Mechanism of Action
Carbidopa inhibits peripheral dopa decarboxylase, an enzyme that converts Levodopa to dopamine outside the brain. This allows more Levodopa to cross the blood-brain barrier. Once in the brain, Levodopa is converted to dopamine, replenishing dopamine levels in the substantia nigra, which is deficient in Parkinson's disease.
Pharmacokinetics
Onset
Onset of action typically occurs within 30 minutes to 2 hours.
Excretion
Both Carbidopa and Levodopa and their metabolites are primarily excreted in the urine.
Half life
The plasma half-life of Levodopa is approximately 1-3 hours, and Carbidopa is about 2 hours.
Absorption
Levodopa is rapidly absorbed from the gastrointestinal tract, but absorption can be variable and influenced by food. Carbidopa is also absorbed rapidly.
Metabolism
Levodopa is extensively metabolized primarily by decarboxylation (to dopamine) and O-methylation. Carbidopa is not extensively metabolized.
Side Effects
Contraindications
- Hypersensitivity to Carbidopa or Levodopa
- Narrow-angle glaucoma
- Concomitant use with non-selective monoamine oxidase (MAO) inhibitors
- History of melanoma or suspicious undiagnosed skin lesions
Drug Interactions
Phenytoin
May decrease the effects of Levodopa.
Iron salts
May reduce the bioavailability of Levodopa.
Metoclopramide
May increase Levodopa absorption but can also cause extrapyramidal side effects.
Non-selective MAO inhibitors
May lead to hypertensive crisis; avoid concurrent use.
Antipsychotics (e.g., phenothiazines, butyrophenones)
May reduce the therapeutic effects of Levodopa.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dyskinesia, agitation, confusion, insomnia, and occasionally orthostatic hypotension. Management involves symptomatic and supportive measures, including gastric lavage if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Levodopa is excreted in breast milk; therefore, caution is advised during breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to Carbidopa or Levodopa
- Narrow-angle glaucoma
- Concomitant use with non-selective monoamine oxidase (MAO) inhibitors
- History of melanoma or suspicious undiagnosed skin lesions
Drug Interactions
Phenytoin
May decrease the effects of Levodopa.
Iron salts
May reduce the bioavailability of Levodopa.
Metoclopramide
May increase Levodopa absorption but can also cause extrapyramidal side effects.
Non-selective MAO inhibitors
May lead to hypertensive crisis; avoid concurrent use.
Antipsychotics (e.g., phenothiazines, butyrophenones)
May reduce the therapeutic effects of Levodopa.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dyskinesia, agitation, confusion, insomnia, and occasionally orthostatic hypotension. Management involves symptomatic and supportive measures, including gastric lavage if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Levodopa is excreted in breast milk; therefore, caution is advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies worldwide
Approval Status
Approved by regulatory authorities
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ongoing research continues to investigate new formulations and delivery methods of Carbidopa/Levodopa for improved patient outcomes and reduced side effects in Parkinson's disease.
Lab Monitoring
- Periodic monitoring of liver function tests
- Renal function tests
- Blood counts (especially hemoglobin and hematocrit)
Doctor Notes
- Emphasize slow and careful titration of dosage to find the optimal therapeutic window with minimal side effects.
- Educate patients about the 'on-off' phenomenon and potential for dyskinesia.
- Monitor for psychiatric side effects and impulse control disorders.
Patient Guidelines
- Take the medicine regularly as prescribed by your doctor.
- Do not stop taking the medicine abruptly without consulting your doctor, as this can lead to severe withdrawal symptoms.
- Report any unusual or severe side effects, especially new or worsening involuntary movements or changes in behavior.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your regular dosing schedule. Do not double the dose.
Driving Precautions
Cardosia Plus may cause dizziness, drowsiness, or sudden onset of sleep. Avoid driving or operating heavy machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain regular physical activity suitable for your condition.
- Stay hydrated by drinking plenty of fluids.
- Be cautious when changing positions (e.g., standing up from sitting) to avoid dizziness due to orthostatic hypotension.
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Global Brand Names
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