What is the recommended dosage for levodopa and a dopa decarboxylase inhibitor in the management of Parkinson disease (PD)?

Updated: Jan 24, 2019
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Levodopa in combination with a dopa decarboxylase inhibitor is started at a low dose and slowly titrated to control clinical symptoms. Most patients experience a good response on a daily levodopa dosage of 300-600 mg/day (usually divided 3 or 4 times daily) for 3-5 years or longer. Doses higher than those necessary to control symptoms adequately should be avoided, because higher doses increase the risk for the development of dyskinesia. [50] If nausea occurs, the levodopa dose can be taken immediately following a meal. Additional measures to alleviate nausea include adding extra carbidopa or introducing domperidone (available outside the United States). Other side effects include dizziness and headache. In elderly patients, confusion, delusions, agitation, hallucinations, and psychosis may be more commonly seen.


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