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Levodopa
L 3 4 Dihydroxyphenylalanine

Images

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WIKIDATA, CC0 1.0

Presentation

We present a case of camptocormia with a sustained excellent response to levodopa in a patient with negative dopamine transporter and no DYT 5 genetic mutations. [ncbi.nlm.nih.gov]

Many of the adverse effects that are present with Levodopa are due to the fact that it is not combined with a partner drug. [physio-pedia.com]

Entire Body System

  • Falling

    Nausea, vomiting, falling blood pressure upon standing, worsening of glaucoma, dyskinesia, hallucination, psychosis. [parkinson.org]

    Low levodopa dosing and antioxidants in the rotigotine patch matrix prevented cysteinyl-glycine fall. [ncbi.nlm.nih.gov]

    This may be why some patients with balance difficulty fall more frequently: as gait speeds-up, because of levodopa, and as balance doesn't improve proportionately, patients fall. CONCLUSIONS: Gait improved more than balance on levodopa. [n.neurology.org]

    Sleepiness and falling asleep suddenly can happen as late as a year after treatment is started. Tell your healthcare provider if you experience the following side effects: falling asleep during normal daily activities with or without warning. [acorda.com]

    Levodopa+Carbidopa may make you drowsy or may cause you to suddenly fall asleep during your daily activities. You might not feel drowsy or notice any other warning signs before suddenly falling asleep. [1mg.com]

  • Anorexia

    […] inhibitor, suspected melanoma, or known hypersensitivity to this drug prohibits its use. adverse effects Among the more serious adverse effects are severe GI disturbances, hypotension, various movement disorders, emotional changes, cardiac arrhythmia, and anorexia [medical-dictionary.thefreedictionary.com]

    Adverse effects Carbidopa-levodopa Sinemet *nausea, vomiting, anorexia, orthostatic hypotension, abnormal movements, cardiac arrhythmias, bruxism (grinding teeth) and ballismus (violent movement of the limbs, sometime only on one side of the body.) [quizlet.com]

    […] its therapeutic benefit is needed and contributes significantly to drug related side effects, in particular gastrointestinal (GI) side effects.4 In fact, up to 80% of patients will experience clinically relevant nausea and vomiting which may lead to anorexia [ebmconsult.com]

    Additional risks are associated with the gastrointestinal tract, and the peripheral as well as the central nervous system. 2.2 Summary of clinical effects Nausea and anorexia commonly occur and may be accompanied by vomiting. [inchem.org]

  • Epilepsy

    Expert Opin Pharmacother. 2009, 10 (14): 2317e28- View Article Google Scholar Berg MJ, Gross RA, Haskins LS, Zingaro WM, Tomaszewski KJ: Generic substitution in the treatment of epilepsy: patient and physician perceptions. [bmcpharmacoltoxicol.biomedcentral.com]

    American Epilepsy Society, and American Neuropsychiatric Association Disclosure: Nothing to disclose. [medscape.com]

    […] problems or Melanoma (a type of skin cancer) (or history of) or Mental illness—Levodopa may make the condition worse Kidney disease or Liver disease—Higher blood levels of levodopa may occur, increasing the chance of side effects Seizure disorders, such as epilepsy [drugs.com]

  • Anemia

    Hematologic: Hemolytic and nonhemolytic anemia, thrombocytopenia, agranulocytosis. Metabolic: Abnormal liver function tests, abnormal BUN. [robholland.com]

    Hematologic: hemolytic and non-hemolytic anemia, leukopenia, thrombocytopenia, agranulocytosis. Hypersensitivity: angioedema, urticaria, pruritus, Henoch-Schonlein purpura, bullous lesions (including pemphigus-like reactions). [drugs.com]

Gastrointestinal

  • Loss of Appetite

    - Loss of appetite. - Insomnia. - Agitation. - Postural hypotension. - Dizziness. - Tachycardia and arrhythmias. - Discoloration of urine. - Psychiatric symptoms. - Headaches. - Increased sweating. - Change in sense of taste. - Gastrointestinal bleeding [nursingtimes.net]

    Common side-effects are nausea, vomiting, loss of appetite, and involuntary facial movements; high doses may cause weakness, faintness, and dizziness. [medicine.academic.ru]

    • Gastrointestinal: Nausea, vomiting and loss of appetite. • Central Nervous System: Decreased attention, memory loss, nervousness, abnormal dreams, sleeplessness, headaches, weakness, dark-colored sweat, increased sweating, fatigue, dizziness, lighteadedness [medindia.net]

    Other information Side effects of levodopa include nausea, vomiting, dry mouth, dizziness, low blood pressure, loss of appetite, and psychological and sleep problems. In some individuals, levodopa may cause confusion, hallucinations, or psychosis. [parkinsonsnewstoday.com]

  • Diarrhea

    Like all medicines Madopar can cause side effects, including: Common side effects: loss of appetite nausea, vomiting diarrhea dizziness tiredness pale skin palpitations changes to your liver or blood feeling excited, anxious, agitated, depressed, aggressive [undoctorenlinea.com]

    Entacapone (Stalevo®) 12.5/50/200 mg 18.75/75/200 mg 25/100/200 mg 31.25/125/200 mg 37.5/150/200 mg 50/200/200 mg 12.5/50/200 mg Nausea, vomiting, falling blood pressure upon standing, worsening of glaucoma, dyskinesia, hallucination, psychosis, dyskinesia, diarrhea [parkinson.org]

    Call your doctor at once if you have: uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); worsening of tremors (uncontrolled shaking); severe or ongoing vomiting or diarrhea; confusion [drugs.com]

    Sinemet Side Effects Common Side Effects of Sinemet Tell your doctor if any of the following side effects become severe or don't go away: Nausea Dizziness Vomiting, diarrhea, or constipation Loss of appetite Dry mouth Change in taste Confusion or forgetfulness [everydayhealth.com]

Cardiovascular

  • Hypertension

    DUOPA is contraindicated in patients who are currently taking or have taken (within 2 weeks) a nonselective monoamine oxidase (MAO) inhibitor, as concurrent use can cause hypertension. [duopapro.com]

    Side Effects Adverse effects associated with the use of Duopa may include, but are not limited to. the following: complication of device insertion nausea depression peripheral edema hypertension upper respiratory tract infection oropharyngeal pain incision [centerwatch.com]

    The most common side effects of DUOPA include: complications of tubing placement procedure, swelling of legs and feet, nausea, high blood pressure (hypertension), depression, and mouth and throat pain. [duopa.com]

    Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure). It is also used to treat or prevent heart attack. acetaminophen oral/rectal (Tylenol) Acetaminophen is a pain reliever and a fever reducer. [emedicinehealth.com]

  • Heart Disease

    Lowering your cholesterol can help prevent heart disease and hardening of the arteries, conditions that can lead to heart attack, stroke, and vascular disease. simvastatin (Zocor) Simvastatin is a cholesterol-lowering medication that blocks the production [emedicinehealth.com]

    Some people with a history of or risk factors for heart disease have experienced heart problems while taking RYTARY. [rytary.com]

    ‘He added that the findings imply that patients being treated with levodopa should ask their neurologists to monitor the level of homocysteine in their blood, particularly if they are at risk for heart disease.’ [en.oxforddictionaries.com]

    • Caution should be exercised in patients with history of heart disease, liver or kidney disease, lung disease, endocrine disorders, seizure, mental illness, increased eye pressure, osteomalacia, ulcer, during pregnancy and breastfeeding. • It may cause [medindia.net]

  • Tachycardia

    - Tachycardia and arrhythmias. - Discoloration of urine. - Psychiatric symptoms. - Headaches. - Increased sweating. - Change in sense of taste. - Gastrointestinal bleeding. [nursingtimes.net]

    Doses of a few grams may result in CNS disturbances, with an increasing likelihood of cardiovascular disturbance (e.g., hypotension, tachycardia) and more severe psychiatric problems at higher doses. [rytaryhcp.com]

    […] and ventricular extrasystoles, atrial flutter and fibrillation, and ventricular tachycardia have been reported. [inchem.org]

Skin

  • Ulcer

    Hypersensitivity Narrow-angle glaucoma (tablets) Concurrent administration of nonselective monoamine oxidase inhibitors (MAOIs) or use within last 14 days Cautions Use caution in history of MI with residual atrial, nodal, or ventricular arrhythmias, peptic ulcer [reference.medscape.com]

    - Peptic ulceration. - Cardiovascular disease. - Diabetes. - Open-angle glaucoma. - History of melanoma - Psychiatric illness. [nursingtimes.net]

    Amoxicillin is also sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. [emedicinehealth.com]

    • Caution should be exercised in patients with history of heart disease, liver or kidney disease, lung disease, endocrine disorders, seizure, mental illness, increased eye pressure, osteomalacia, ulcer, during pregnancy and breastfeeding. • It may cause [medindia.net]

  • Alopecia

    Thus, levodopa decrease the secretion of prolactin while dopaminergic antagonists have an opposite effect (Goodman & Gilman, 1986). 9.4.8 Dermatological Some patients developed diffuse alopecia (Martindale, 1989). 9.4.9 Eye, ear, nose throat: local effects [inchem.org]

    Skin: flushing, increased sweating, malignant melanoma (see CONTRAINDICATIONS ), rash, alopecia, dark sweat. Special Senses: oculogyric crises, diplopia, blurred vision, dilated pupils. [drugs.com]

Psychiatrical

  • Anxiety Disorder

    Sertraline is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). atorvastatin (Lipitor) Atorvastatin is a cholesterol-lowering [emedicinehealth.com]

Urogenital

  • Urinary Incontinence

    We report a 55-year-old woman with a long history of a gait disturbance that was followed by dysarthria and urinary incontinence. She underwent brain MRI, SPECT with TRODAT imaging and whole-exome sequencing, revealing the diagnosis of SPG7. [ncbi.nlm.nih.gov]

    incontinence – this can be treated with exercises to strengthen the pelvic floor muscles, medication or surgery in severe cases; read more about treating urinary incontinence dementia – this can be treated with cognitive therapies and medication in some [nhs.uk]

    They include abdominal pain, diarrhoea, constipation and activation of peptic ulcer. 9.4.5 Hepatic Increased blood LDH, bilirubin and alkaline phosphatase levels are rare. 9.4.6 Urinary 9.4.6.1 Renal Polyuria, incontinence and difficulty in micturition [inchem.org]

    Urogenital: dark urine, priapism, urinary frequency, urinary incontinence, urinary retention, urinary tract infection. [drugs.com]

Neurologic

  • Confusion

    Carbidopa/levodopa Immediate Release Tablets (Sinemet) Available Doses: 10/100 mg, 25/100 mg, 25/250 mg Typical Treatment Regimen: 150–1000 mg of levodopa total/day (divided 3-4 times) Common Side Effects: Low blood pressure, nausea, confusion, dyskinesia [parkinson.org]

    Hallucinations may be accompanied by confusion, insomnia, and excessive dreaming. [rytaryhcp.com]

    Chances of falling asleep during normal activities increases if you take medicine that cause sleepiness. withdrawal-emergent hyperpyrexia and confusion (fever, stiff muscles, or changes in breathing and heartbeat) if you suddenly stop using INBRIJA or [acorda.com]

    - Care should be taken to avoid confusion with the antihypertensive medication methyldopa. - Levodopa can cause false results in urine tests for sugar and ketones. [nursingtimes.net]

  • Involuntary Movements

    Abstract Patients with Parkinson's disease (PD) receiving long-term L-Dopa therapy eventually develop motor complications with unpredictable "on-off" response fluctuations and involuntary movements, leading to progressive disability. [ncbi.nlm.nih.gov]

    Involuntary movements (dyskinesia) With long-term use of levodopa you may experience involuntary movements (dyskinesia). [parkinsons.org.uk]

    Other problems that can arise include the induction of involuntary movements (dyskinesias) that, once initiated, never remit. [parkinsonsmi.org]

    Report promptly abnormal involuntary movement such as facial grimacing, exaggerated chewing, protrusion of tongue, rhythmic opening and closing of mouth, bobbing of head, jerky arm and leg movements, and exaggerated respiration. [robholland.com]

  • Headache

    - Headaches. - Increased sweating. - Change in sense of taste. - Gastrointestinal bleeding. [nursingtimes.net]

    Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury. citalopram (Celexa) Citalopram is an antidepressant in a group of drugs called [emedicinehealth.com]

    • Central Nervous System: Decreased attention, memory loss, nervousness, abnormal dreams, sleeplessness, headaches, weakness, dark-colored sweat, increased sweating, fatigue, dizziness, lighteadedness, and faintness. • Miscellaneous: Muscle spasms, [medindia.net]

    Advanced Parkinson’s Disease: Most common adverse reactions (incidence ≥ 5 % and greater than oral immediate-release carbidopa-levodopa) are nausea and headache. [rytaryhcp.com]

  • Abnormal Involuntary Movement

    Tell your healthcare provider if abnormal involuntary movements appear or get worse during treatment with RYTARY. [rytary.com]

    The effect of rTMS on abnormal involuntary movements (AIMs) was assessed. [ncbi.nlm.nih.gov]

    ‘Although levodopa remains the optimal treatment for Parkinson's disease, ropinirole provides similar improvements in functional abilities while minimising abnormal involuntary movements.’ [en.oxforddictionaries.com]

  • Irritability

    May cause falling asleep during daily activities dyskinesias. hallucinations/ psychosis/ confusion; depression A mood disorder whose symptoms can include a persistent sad or empty mood, feelings of hopelessness or pessimism, irritability and loss of interest [parkinson.org]

    Atrovent or Combivent (Ipratropium) Azilect (rasagiline) Dilantin (phenytoin) Eldepryl (selegiline) Haldol (haloperidol) INH or Nydrazid ( isoniazid ) Iron pills and vitamins containing iron Marplan (isocarboxazid) Medications for high blood pressure, irritable [everydayhealth.com]

    […] changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability [my.clevelandclinic.org]

    The longitudinally ribbed pod, is densely covered with persistent pale-brown or grey trichomes that cause irritating blisters. Seeds are black ovoid and 12 mm long (Sastry and Kavathekar 1990; Agharkar 1991; Verma et al. 1993). [hort.purdue.edu]

    Other changes might be confusion, worsening of depression, visual hallucinations (seeing things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability. [verywellhealth.com]

Workup

Workup, including brain, cervical, thoracic, and lumbar spine magnetic resonance imaging and paraspinal muscle electromyography, was unremarkable. Serum ceruloplasmin level was normal. [ncbi.nlm.nih.gov]

Treatment

Treatment Parkinson's Disease (PD) 1 2 Recruiting Treatment ASD 1 2 Recruiting Treatment Age-Related Macular Degeneration (ARMD) 1 2 Recruiting Treatment Albinism / Albinism, Oculocutaneous 1 2 Recruiting Treatment Idiopathic Parkinson's Disease 1 2 [drugbank.ca]

Fourteen patients (36.8%) maintained the LCAS treatment after 12months, and were categorized as the treatment-retention group. [ncbi.nlm.nih.gov]

Prognosis

Prognosis Disease progression rate and severity is highly variable. The main predictor of prognosis is the rate of decline in pulmonary function with sporadic LAM generally more severe than TSC-LAM. [orpha.net]

Article in Polish | MEDLINE | ID: mdl-21678282 Similar Index: MEDLINE Main subject: Tuberculosis, Pulmonary / Tuberous Sclerosis / Lymphangioleiomyomatosis Type of study: Case report Clinical aspect: Diagnosis / Prognosis Limits: Adult / Female / Humans [pesquisa.bvsalud.org]

9.1.1 Ingestion 9.1.2 Inhalation 9.1.3 Skin exposure 9.1.4 Eye contact 9.1.5 Parenteral exposure 9.1.6 Other 9.2 Chronic poisoning 9.2.1 Ingestion 9.2.2 Inhalation 9.2.3 Skin exposure 9.2.4 Eye contact 9.2.5 Parenteral exposure 9.2.6 Other 9.3 Course, prognosis [inchem.org]

Diagnosis Aims are to communicate information about the disease, help the patient accept the diagnosis, reduce distress and minimise symptoms and, ultimately, improve prognosis. [patient.info]

Etiology

Despite extensive investigations, the etiology of her basal ganglia lesions remained nebulous. The patient's dystonia responded to Trihexyphenidyl and to tetrabenazine, but these medications needed to be stopped because of side effects. [ncbi.nlm.nih.gov]

Still the only major text on the subject, the completely revised and updated second edition of Parkinson's Disease: Diagnosis and Clinical Management comes at a time when specialists have made important advances in our understanding of the etiology, pathogenesis [books.google.com]

Epidemiology

Author information 1 Neurosciences, Alfred Hospital, Melbourne, Victoria, Australia. 2 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 3 Clinical Haematology [ncbi.nlm.nih.gov]

Goitre epidemiology: Thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden. Acta Endocrinol 1 12:494501. ‎ [books.google.ro]

Summary Epidemiology Sporadic LAM affects around 1/500,000-1/125,000 adult women in Europe. TSC is present in 1 in 6,000 births. Pulmonary LAM is present in up to 30-40% of adult TSC cases. LAM affects almost exclusively females. [orpha.net]

Epidemiology of Parkinson’s disease. Parkinsonism Relat Disord. 1997;3(4):175–86. CrossRef PubMed Google Scholar 8. Zhang ZX, Roman GC, Hong Z, Wu CB, Qu QM, Huang JB, Zhou B, Geng ZP, Wu JX, Wen HB, Zhao H, Zahner GE. [link.springer.com]

Melanoma Epidemiological studies have shown that patients with Parkinson’s disease have a higher risk (2- to approximately 6-fold higher) of developing melanoma than the general population. [drugs.com]

Pathophysiology

Gait analysis proves to be an effective tool to understand the pathophysiology of this patient, the therapeutic effects and mild residual gait defects in order to plan further rehabilitation strategy for this DRD patient. [ncbi.nlm.nih.gov]

The pathophysiology of levodopa-induced motor complications is likely due to a combination of disease-related factors, as well as the pharmacokinetics of levodopa itself. [brain.oxfordjournals.org]

Gastrointestinal dysfunction in Parkinson's disease: frequency and pathophysiology. [scielo.br]

Postprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med. 122 : 286 -295. 3 Meco G, Pratesi L, Bonifati V, 1991. Cardiovascular reflexes and autonomic dysfunction in Parkinson's disease. [academic.oup.com]

Prevention

This inhibitor prevents the metabolisation of the L-dopa before entering the CNS. [flexikon.doccheck.com]

Author information 1 Neurosciences, Alfred Hospital, Melbourne, Victoria, Australia. 2 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 3 Clinical Haematology [ncbi.nlm.nih.gov]

Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures. Alendronate is used to treat or prevent postmenopausal osteoporosis and steroid-induced osteoporosis. [emedicinehealth.com]

The combination of levodopa and carbidopa prevents the loss of levodopa effect produced by exogenous pyridoxine. [jamanetwork.com]

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