Inbrija (levodopa)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Levodopa is the levorotatory isomer of dihydroxyphenylalanine and the metabolic precursor of dopamine, and carbidopa is a decarboxylase inhibitor that inhibits the peripheral decarboxylation of levodopa to dopamine.
USES: This medication is used when needed to treat the return of Parkinson's symptoms (known as OFF episodes) in people with Parkinson's disease who are treated with carbidopa/levodopa medicines. Parkinson's disease tends to worsen over time, and you may need extra levodopa from time to time to keep symptoms (such as shakiness, stiffness, difficulty moving) from returning. This medication does not replace your regular carbidopa/levodopa medicine.
Keep taking your carbidopa/levodopa medicine regularly as directed by your doctor. Parkinson's disease is thought to be caused by too little of a naturally occurring substance (dopamine) in the brain. Levodopa changes into dopamine in the brain, helping to control movement.
Generic name: levodopa
Pronunciation: (LEE-voe-DOE-pa)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
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Indications
The following indications are listed for Inbrija:
- Idiopathic Parkinsonism
Also known as: Paralysis Agitans, Primary Parkinson's Disease.
Dosing
No dosing information is available for this tab.
Levodopa and carbidopa are administered orally as fixed-combination or single-entity (carbidopa only) conventional tablets, orally disintegrating tablets, extended-release tablets, or extended-release capsules. Levodopa also is commercially available as a powder for oral inhalation. Carbidopa-levodopa enteral suspension is administered by direct intestinal infusion through a nasojejunal (NJ) tube or a percutaneous endoscopic gastrojejunostomy (PEG-J) tube.
In patients with moderate to severe motor fluctuations, better global improvement may be achieved in some patients when extended-release rather than conventional tablet preparations of carbidopa-levodopa are used. However, some studies have not found a substantial difference in ''off'' time between extended-release and immediate-release tablet preparations in such patients. In patients without motor fluctuations, the preparations were comparably effective but less frequent dosing was required with the extended-release preparation. Use of the extended-release capsule formulation of carbidopa-levodopa has been shown to improve ''off'' time compared with immediate-release preparations in patients with advanced parkinson disease. (See Absorption under Pharmacokinetics.)
Patients receiving other antiparkinsonian agents may continue taking these drugs while carbidopa-levodopa is administered; however, dosage adjustments of these drugs may be necessary.
Whenever a general anesthetic is required, levodopa may be continued as long as the patient is able to take fluids and medication orally. If therapy is interrupted, the patient should be observed for neuroleptic malignant syndrome and the usual daily dose may be given as soon as the patient can take oral medication.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
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There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
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There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
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There are no adequate and well-controlled studies of levodopa and carbidopa in pregnant women. Reproduction studies in rodents using levodopa and carbidopa at dosages approximately 5 and 2 times greater than the maximum human dosage, respectively, have shown adverse effects on fetal and postnatal growth and viability, and studies in rabbits using the drug alone or in conjunction with carbidopa have shown visceral and skeletal malformations. Levodopa and carbidopa should be administered to pregnant women or women who might become pregnant only when the benefits to the mother outweigh the possible risks to the mother and fetus.
Levodopa is distributed into human milk. Carbidopa is distributed into milk in rats; it is not known whether carbidopa is distributed into human milk. Levodopa-carbidopa should be used with caution in nursing women. The known benefits of breast-feeding should be considered along with the mother's clinical need for the drug and any potential adverse effects on the infant from the drug or underlying maternal condition.
No enhanced messaging available.
No enhanced messaging available.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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