Dopair
Generic Name
Levodopa + Carbidopa
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Dopair is a combination medication containing Levodopa and Carbidopa, primarily used to treat the symptoms of Parkinson's disease. Levodopa is converted to dopamine in the brain, helping to replenish its levels, while Carbidopa prevents the premature breakdown of Levodopa in the bloodstream, allowing more of it to reach the brain.
Uses & Indications
Dosage
Adults
Initial dose: 1 tablet (100 mg Levodopa / 10 mg Carbidopa) 3 times daily, gradually increased as per clinical response, not exceeding 8 tablets per day.
Elderly
Similar to adult dosage, careful titration is required due to increased sensitivity and potential for side effects.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment, but caution is advised in severe cases due to potential for accumulation.
How to Take
Oral administration, preferably with food to reduce gastrointestinal upset. Avoid taking with high-protein meals.
Mechanism of Action
Levodopa crosses the blood-brain barrier and is converted to dopamine by DOPA decarboxylase. Dopamine then acts on dopamine receptors in the striatum to alleviate Parkinsonian symptoms. Carbidopa, a peripheral DOPA decarboxylase inhibitor, prevents the peripheral conversion of levodopa to dopamine, increasing the amount of levodopa available to cross the blood-brain barrier and reducing peripheral side effects.
Pharmacokinetics
Onset
Within 30-60 minutes for motor effects (can vary)
Excretion
Mainly renal excretion of metabolites.
Half life
Levodopa: 1-3 hours (when given with Carbidopa); Carbidopa: ~2 hours
Absorption
Levodopa is rapidly absorbed from the small intestine. Carbidopa is also rapidly absorbed.
Metabolism
Levodopa is extensively metabolized via decarboxylation and O-methylation. Carbidopa is also metabolized, but the exact pathways are not fully elucidated.
Side Effects
Contraindications
- Hypersensitivity to levodopa or carbidopa
- Narrow-angle glaucoma
- Non-selective monoamine oxidase (MAO) inhibitors use within 14 days
- Suspicious undiagnosed skin lesions or a history of melanoma
Drug Interactions
Iron salts
May reduce the absorption of levodopa.
Antihypertensives
May cause postural hypotension; dosage adjustment may be needed.
Non-selective MAO inhibitors
May cause hypertensive crisis. Must be discontinued at least 2 weeks prior to starting levodopa/carbidopa.
Phenothiazines, Butyrophenones, Risperidone
May reduce the therapeutic effect 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 include involuntary movements, agitation, confusion, insomnia, and palpitations. Treatment involves symptomatic and supportive measures, including careful ECG monitoring.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. It is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to levodopa or carbidopa
- Narrow-angle glaucoma
- Non-selective monoamine oxidase (MAO) inhibitors use within 14 days
- Suspicious undiagnosed skin lesions or a history of melanoma
Drug Interactions
Iron salts
May reduce the absorption of levodopa.
Antihypertensives
May cause postural hypotension; dosage adjustment may be needed.
Non-selective MAO inhibitors
May cause hypertensive crisis. Must be discontinued at least 2 weeks prior to starting levodopa/carbidopa.
Phenothiazines, Butyrophenones, Risperidone
May reduce the therapeutic effect 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 include involuntary movements, agitation, confusion, insomnia, and palpitations. Treatment involves symptomatic and supportive measures, including careful ECG monitoring.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. It is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Generic available (original patents expired)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of levodopa/carbidopa in treating Parkinson's disease since its approval. Ongoing research continues to explore optimal dosing strategies and long-term outcomes.
Lab Monitoring
- Periodic evaluation of hepatic, renal, and hematopoietic system function is recommended during extended therapy.
Doctor Notes
- Monitor patients for signs of motor complications, especially after prolonged use.
- Carefully assess psychiatric history before initiation and monitor for new or worsening psychiatric symptoms.
- Educate patients on the importance of adherence and potential 'on-off' fluctuations.
Patient Guidelines
- Take medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine abruptly without consulting your doctor.
- Report any new or worsening involuntary movements or psychiatric symptoms immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
May cause drowsiness or sudden sleep episodes. Patients should be cautioned about operating machinery or driving until they are reasonably certain that levodopa/carbidopa therapy does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Maintain a balanced diet but be mindful of high-protein intake around dosage times.
- Stay hydrated.
- Regular exercise, as tolerated, can help manage Parkinson's symptoms.
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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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