levodopa at a glance
Medicine class
Dopamine precursor and anti-Parkinson treatment
Licensed role
Intermittent treatment of OFF episodes in adults already taking levodopa with a dopa-decarboxylase inhibitor
Route
The selected formulation is inhaled through its dedicated device; the capsules must not be swallowed
Driving
Do not drive or operate machinery if dizziness, marked sleepiness or sudden sleep episodes occur
What is levodopa used for?
The selected inhaled product is licensed for:
Intermittent treatment of episodic motor or non-motor OFF symptoms in adults with Parkinson’s disease who are already treated with levodopa plus a dopa-decarboxylase inhibitor such as carbidopa or benserazide.
How does levodopa work?
Levodopa enters the brain and is converted into dopamine, helping restore signalling in pathways controlling movement. Carbidopa or benserazide limits levodopa breakdown outside the brain, allowing more to reach its target and reducing peripheral effects.
levodopa preparations and strengths
Capsule
Route: Oral
Strengths: 33 mg
How to take levodopa
Follow the device training and instructions supplied with the inhaled product.
Use the capsules only with the Inbrija inhaler; never swallow them.
Keep hands and the device dry, and remove a capsule from its blister only immediately before use.
Load the capsule, inhale through the mouthpiece and hold your breath briefly. The capsule should make a whirling sound.
If the capsule does not whirl, a deeper, longer inhalation or cleaning the mouthpiece with a dry swab may be needed. Do not rinse or wet the inhaler.
levodopa side effects
Common or expected effects
- Cough
- New or increased involuntary movements
- Nausea or vomiting
- Throat irritation
- Respiratory infection or discoloured mucus
- Falls
Get urgent medical advice
- Allergic swelling or difficulty breathing or swallowing
- Severe rigidity or muscle breakdown symptoms with fever, confusion or unstable pulse or blood pressure
- Gastrointestinal bleeding, such as black stools or blood in vomit
- Severe or worsening breathing problems
- Hallucinations, psychosis, suicidal thoughts or major behavioural change
- Sudden sleep episodes
- New compulsive gambling, spending, eating or sexual behaviour
- Fast or irregular heartbeat, fainting or seizure
levodopa in pregnancy
Information about levodopa exposure in pregnancy is limited. The selected inhaled product is not recommended during pregnancy or for someone who could become pregnant and is not using contraception. Discuss pregnancy or plans for pregnancy promptly with the Parkinson’s specialist; do not stop treatment abruptly without advice.
levodopa while breastfeeding
Levodopa enters breast milk and may reduce milk production. The selected inhaled product requires breastfeeding to be discontinued during treatment. Advice for other levodopa combinations can differ, so seek product-specific specialist or pharmacist advice.
levodopa interactions
Check all prescribed, non-prescribed and herbal products with a pharmacist or prescriber. Important interactions include:
Non-selective MAO inhibitors, such as phenelzine or isocarboxazid
Concomitant use is contraindicated because a serious interaction may occur.
Selective MAO-B inhibitors, such as rasagiline, selegiline or safinamide
The combination may increase postural hypotension and requires monitoring.
Dopamine D2 antagonists, including some antipsychotics and metoclopramide
They may reduce levodopa’s effect and worsen Parkinson’s symptoms.
Common questions about levodopa
Answers are fully visible for fast scanning and source review.
Is levodopa the same as dopamine?
No. Levodopa is a precursor that can enter the brain, where it is converted into dopamine.
What is an OFF episode?
It is a period when regular Parkinson’s treatment no longer controls symptoms adequately and movement or non-motor symptoms return or worsen.
Does inhaled levodopa replace regular Parkinson’s tablets?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.