Paridopa Tablets 100/25/200Mg (1 Strip = 10 Tablets)

Requires Prescription (YES/NO)

Yes

Generics

Levodopa , Carbidopa , Entacapone

Used For

Anti-Parkinson

How it works

Levodopa: The symptoms of Parkinson’s disease are related to depletion of dopamine in the corpus striatum. Levodopa, the metabolic precursor of dopamine, crosses the blood brain barrier and relieves the symptoms of the disease. Carbidopa: When levodopa is administered orally, it is rapidly decarboxylated to dopamine in extracerebral tissues so that only a small portion of a given dose is transported unchanged to the central nervous system. Carbidopa inhibits the decarboxylation of peripheral levodopa, making more levodopa available for delivery to the brain. Entacapone: Entacapone is a selective and reversible inhibitor of catechol-O-methyltransferase (COMT). When decarboxylation of levodopa is prevented by carbidopa, COMT becomes the major metabolizing enzyme for levodopa, catalyzing its metabolism to 3-methoxy-4-hydroxy-L-phenylalanine (3-OMD).

Dosage

Levodopa , Carbidopa , Entacapone

Side Effects

Very common: Dyskinesia, diarrhoea, nausea, muscle pain, musculoskeletal and connective tissue pain and chromaturia. Common: Anaemia, weight decreased, decreased appetite, depression, hallucination, confusional state, abnormal dreams, anxiety, insomnia, parkinsonism aggravated (e.g. bradykinesia), tremor, on and off phenomenon, dystonia, mental impairment (e.g. memory impairment, dementia), somnolence, dizziness, headache, blurred vision, ischemic heart disease events other than myocardial infarction (e.g. angina pectoris), irregular heart rhythm, orthostatic hypotension, hypertension, dyspnea, constipation, vomiting, dyspepsia, abdominal pain and discomfort, dry mouth, rash, hyperhidrosis, muscle spasms, arthralgia, urinary tract infection, chest pain, peripheral oedema, fall, gait disturbance, asthenia and fatigue. Uncommon: Thrombocytopenia, psychosis, agitation, myocardial infarction, gastrointestinal haemorrhage, colitis, dysphagia, hepatic function test abnormal, discolourations other than urine (e.g. skin, nail, hair, sweat), urinary retention and malaise. Not known: Suicidal behaviour, dopamine dysregulation syndrome, neuroleptic malignant syndrome, hepatitis with mainly cholestatic features, urticaria and rhabdomyolysis . Rare: Angioedema.

Drug Interactions

Drugs metabolized by COMT, such as isoproterenol, epinephrine, norepinephrine, dopamine, dobutamine, alpha-methyldopa, apomorphine, isoetherine and bitolterol , Dopamine receptor antagonists (e.g. some antipsychotics and antiemetics), phenytoin and papaverine , Dopamine D2 Receptor Antagonists , Isoniazid , Papaverine , Drugs Known to Interfere with Biliary Excretion, Glucuronidation and Intestinal Beta-glucuronidase , Drugs Metabolized via CYP2C9 (e.g., coumadin ) .

Indication

• Levodopa + Carbidopa + Entacapone is indicated for the treatment of Parkinson’s disease. Levodopa + Carbidopa + Entacapone can be used: • To substitute (with equivalent strengths of each of the three components) carbidopa, levodopa and entacapone previously administered as individual products. • To replace carbidopa/levodopa therapy (without entacapone) when patients experience the signs and symptoms of end-of-dose “wearing-off” and when they have been taking a total daily dose of levodopa of 600mg or less and have not been experiencing dyskinesias.

When not to Use

Levodopa + Carbidopa + Entacapone is contraindicated in patients: • With known hypersensitivity to the active substances or to any of the excipient of the product. • With severe hepatic impairment. • With narrow-angle glaucoma. • With pheochromocytoma. • Taking concominantly non-selective monoamine oxidase (MAO-A and MAO-B) inhibitors (e.g. phenelzine, tranylcypromine) & selective MAO-A inhibitor and selective MAO-B inhibitor. • With a previous history of Neuroleptic Malignant Syndrome (NMS) and/or non-traumatic rhabdomyolysis. • With suspicious undiagnosed skin lesions or a history of malignant melanoma, because levodopa may activate malignant melanoma. • With clinical or laboratory evidence of uncompensated cardiovascular, endocrine, hematologic, pulmonary (including bronchial asthma) or renal disease.

Precaution

Levodopa + Carbidopa + Entacapone is not recommended for the treatment of drug-induced extrapyramidal reactions.

Warning 1

Levodopa + Carbidopa + Entacapone may induce orthostatic hypotension. Therefore, Levodopa + Carbidopa + Entacapone should be given cautiously to patients who are taking other medicinal products which may cause orthostatic hypotension .

Warning 2

Any abrupt dose reduction or withdrawal of levodopa should be carefully observed, particularly in patients who are also receiving neuroleptics. When considered necessary, the replacement of Levodopa + Carbidopa + Entacapone with levodopa and DDC inhibitor without entacapone or other dopaminergic treatment should proceed slowly and an increase in levodopa dose may be necessary.

Warning 3

Dopamine Dysregulation Syndrome (DDS) is an addictive disorder resulting in excessive use of the product seen in some patients treated with carbidopa/levodopa. Before initiation of treatment, patients and caregivers should be warned of the potential risk of developing DDS.

Pregnancy category

Always consult your physician before using any medicine.

Storage (YES/NO)

Store this medicine at room temperature, away from direct light and heat.