Dopair
Generic Name
Levodopa 250 mg and Carbidopa 25 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dopair 250 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Dopair 250 mg tablet is a combination of Levodopa and Carbidopa, primarily used to treat Parkinson's disease. Levodopa converts to dopamine in the brain, helping to reduce symptoms, while Carbidopa prevents the breakdown of Levodopa in the periphery, allowing more to reach the brain and reducing side effects.
Uses & Indications
Dosage
Adults
Initial dose is typically 1 tablet (Levodopa 250 mg/Carbidopa 25 mg) two or three times daily, with meals. Dosage should be individualized and gradually increased by 1 tablet every one or two days as tolerated until optimal response is achieved. Maximum dose is usually 8 tablets per day.
Elderly
Similar to adults, but with careful and slower titration due to increased sensitivity to side effects.
Renal_impairment
No specific dosage adjustment is usually required for mild to moderate renal impairment, but caution is advised. For severe impairment, close monitoring is necessary.
How to Take
Take orally, preferably with food to minimize gastrointestinal upset. Do not crush or chew extended-release formulations if applicable.
Mechanism of Action
Levodopa crosses the blood-brain barrier and is converted to dopamine in the brain, supplementing depleted dopamine levels. Carbidopa, a decarboxylase inhibitor, prevents the peripheral metabolism of levodopa, increasing its availability to the brain and reducing peripheral side effects.
Pharmacokinetics
Onset
Within 30-60 minutes after oral administration.
Excretion
Primarily excreted in the urine as metabolites.
Half life
Levodopa: approximately 1-3 hours; Carbidopa: approximately 2-3 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract, especially Levodopa. Food, particularly high-protein meals, can decrease absorption.
Metabolism
Levodopa is extensively metabolized in the periphery and to a lesser extent in the brain. Carbidopa is minimally 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, or within 14 days of discontinuing them.
- Suspicious undiagnosed skin lesions or a history of melanoma.
Drug Interactions
Phenytoin
May reduce the therapeutic effect of Levodopa.
Iron salts
May reduce the bioavailability of Levodopa.
MAO Inhibitors
May lead to hypertensive crisis; contraindicated.
Metoclopramide
Can increase the bioavailability of Levodopa but may also increase dyskinesia.
Antipsychotics (e.g., Haloperidol)
May reduce the therapeutic effects of Levodopa.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include involuntary movements (dyskinesia), agitation, confusion, insomnia, and cardiac arrhythmias. Management involves gastric lavage, general supportive measures, and careful monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is unknown if Levodopa or Carbidopa is excreted in human milk; caution should be exercised when administering to a nursing mother.
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, or within 14 days of discontinuing them.
- Suspicious undiagnosed skin lesions or a history of melanoma.
Drug Interactions
Phenytoin
May reduce the therapeutic effect of Levodopa.
Iron salts
May reduce the bioavailability of Levodopa.
MAO Inhibitors
May lead to hypertensive crisis; contraindicated.
Metoclopramide
Can increase the bioavailability of Levodopa but may also increase dyskinesia.
Antipsychotics (e.g., Haloperidol)
May reduce the therapeutic effects of Levodopa.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include involuntary movements (dyskinesia), agitation, confusion, insomnia, and cardiac arrhythmias. Management involves gastric lavage, general supportive measures, and careful monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is unknown if Levodopa or Carbidopa is excreted in human milk; caution should be exercised when administering to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Levodopa/Carbidopa in the treatment of Parkinson's disease. Ongoing research continues to explore optimized delivery systems and combination therapies.
Lab Monitoring
- Periodic monitoring of liver function, renal function, and hematopoietic system (CBC) is advisable during long-term therapy. Intraocular pressure should be checked regularly in patients with chronic wide-angle glaucoma.
- Monitor for signs of GI bleeding.
Doctor Notes
- Careful titration is crucial to achieve optimal symptomatic control while minimizing side effects, especially dyskinesia.
- Educate patients on the 'wearing off' phenomenon and 'on-off' fluctuations, and how to manage them.
- Regular monitoring for psychiatric side effects and impulse control disorders is important.
Patient Guidelines
- Take your medication exactly as prescribed by your doctor. Do not stop taking it abruptly without consulting your doctor.
- Report any new or worsening side effects, especially involuntary movements or psychiatric changes.
- Be aware of the potential for sudden onset of sleep and orthostatic hypotension, which can affect driving and operating machinery.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause dizziness, drowsiness, or sudden sleep episodes. Patients should be warned about engaging in activities requiring complete mental alertness, such as driving or operating machinery, until they know how the medication affects them.
Lifestyle Advice
- Maintain adequate hydration. Avoid sudden changes in posture to minimize orthostatic hypotension.
- Discuss any changes in diet, especially high-protein diets, with your doctor as they can affect medication absorption.
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International brand names for this medicine. Click a brand to search for detailed information.
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