carbidopa monohydrate + levodopa at a glance
Medicine class
Levodopa with a peripheral dopa-decarboxylase inhibitor
Main role
Improves movement symptoms such as slowness, stiffness and tremor
Formulations
Immediate-release tablets, modified-release tablets and specialist intestinal gel
What is carbidopa monohydrate + levodopa used for?
Selected products are licensed for:
Parkinson’s disease and Parkinsonian syndrome, using immediate-release tablets.
Idiopathic Parkinson’s disease, particularly to shorten “off” periods in people previously treated with levodopa, using modified-release tablets.
Advanced levodopa-responsive Parkinson’s disease with severe motor fluctuations and hyperkinesia or dyskinesia when available medicine combinations have not provided satisfactory control, using Duodopa intestinal gel.
How does carbidopa monohydrate + levodopa work?
Levodopa enters the brain and is converted to dopamine, supporting movement signalling. Carbidopa mainly prevents levodopa breakdown outside the brain, allowing more to reach the brain while reducing peripheral effects such as nausea and cardiac effects. Intestinal gel provides less variable levodopa exposure than oral treatment.
carbidopa monohydrate + levodopa preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 100 mg + 25 mg, 200 mg + 50 mg
Tablet
Route: Oral
Strengths: 12.5 mg + 50 mg, 25 mg + 100 mg
How to take carbidopa monohydrate + levodopa
Use at the prescribed times because delays can substantially worsen symptoms. Take oral tablets consistently in relation to food; protein-rich meals can reduce levodopa absorption in some people. Duodopa is administered through an intestinal pump and tube by trained users.
Swallow Lecado modified-release tablets whole; do not break or chew them.
The score on the selected immediate-release Orion tablet helps swallowing but does not divide it into equal amounts.
If swallowing becomes difficult, obtain prompt advice. Modified-release co-careldopa must not be crushed.
Report recurring motor fluctuations or worsening immobility during Duodopa treatment because the pump or tube may not be working correctly.
carbidopa monohydrate + levodopa side effects
Common or expected effects
- Nausea or vomiting
- Uncontrolled movements, including dyskinesia or dystonia
- Dizziness, faintness or a fall in blood pressure on standing
- Sleepiness, disturbed sleep or abnormal dreams
- Hallucinations or confusion
- Reduced appetite
- Palpitations or irregular heartbeat
- With Duodopa: abdominal discomfort and pump-, tube- or stoma-related problems
Get urgent medical advice
- Severe allergic reaction
- Marked stiffness, fever and confusion after abrupt withdrawal
- Sudden sleep episodes
- Severe psychiatric changes, suicidal thoughts, harmful impulses or compulsive overuse
- Fainting, chest pain or a significant abnormal heartbeat
- Unexplained infections, bruising, bleeding or mouth ulcers
- With Duodopa: severe abdominal symptoms, sepsis, intestinal obstruction or perforation, or serious tube complications
carbidopa monohydrate + levodopa in pregnancy
Human pregnancy information is limited. Selected product information advises avoiding or not recommending use unless a specialist considers the expected maternal benefit to outweigh possible fetal risk; Lecado advises against use. Contact the prescriber promptly if pregnant or planning pregnancy, and do not stop treatment suddenly.
carbidopa monohydrate + levodopa while breastfeeding
Levodopa passes into human milk and may suppress milk production. Information about infant effects and carbidopa transfer is inadequate. Duodopa and Lecado information advises avoiding or discontinuing breastfeeding, while Orion requires an individual decision between breastfeeding and treatment. Specialist advice is essential.
carbidopa monohydrate + levodopa interactions
Check prescribed, over-the-counter and complementary products with a pharmacist or prescriber. Important examples include:
Non-selective monoamine oxidase inhibitors and selective MAO-A inhibitors
These combinations are contraindicated.
Iron salts
Ferrous sulfate and ferrous gluconate can reduce absorption and clinical response.
Common questions about carbidopa monohydrate + levodopa
Answers are fully visible for fast scanning and source review.
Is carbidopa monohydrate + levodopa the same as co-careldopa?
Yes. Co-careldopa is the commonly used name for levodopa with carbidopa; carbidopa may be supplied as carbidopa monohydrate.
Can it cause sudden sleep?
Yes. Excessive daytime sleepiness and sudden sleep episodes can occur. Anyone affected must not drive or use machinery and should contact their prescriber promptly.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.