Parkinson Disease Oral Issues — MFDS Part 1 MCQ

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ModerateHuman DiseaseParkinson Disease Oral IssuesMFDS Part 1

A 72-year-old patient with Parkinson disease is treated with co-careldopa. Which oral complication pattern is recognised in association with both the disease and levodopa/carbidopa therapy?

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Correct answer: E — Xerostomia with impaired saliva control and drooling

Option E is correct. In Parkinson disease, bradykinesia and oropharyngeal dysfunction reduce spontaneous swallowing and intra-oral saliva clearance, so saliva may pool and escape from the mouth without true hypersecretion. Xerostomia and reduced salivary flow are also common, meaning dry mouth and drooling can coexist. The UK SmPC for co-careldopa separately lists dry mouth, sialorrhoea and dysphagia as adverse effects. Gingival enlargement is more typical of medicines such as phenytoin, ciclosporin and some calcium-channel blockers. Candidosis can occur secondarily in a dry mouth but is not the characteristic complication. Parotid enlargement suggests salivary-gland disease or sialadenosis, whereas generalised intrinsic erosion indicates recurrent acid exposure rather than Parkinson disease or co-careldopa therapy.

Reference: Strides Pharma UK Ltd. Co-Careldopa 12.5 mg/50 mg tablets, Summary of Product Characteristics, section 4.8 Undesirable effects. Updated 2026. https://www.medicines.org.uk/emc/product/102157/smpc