Madopar

What is it?

A combined preparation of dopamine precursor (levodopa) and an enzyme which is a dopy decarboxylase inhibitor (benserazide as hydrochloride), available as capsules of different strengths. '62.5' blue/grey capsules contain 50mg of levodopa and 12.5mg of benserazide hydrochloride; '125' blue/pink capsules contain 100mg of levodopa and 25mg of benserazide hydrochloride. '250' blue/caramel capsules contain 200mg of levodopa and 50mg of benserazide hydrochloride. All capsules are marked ROCHE. Also, MADOPAR DISPERSIBLE TABLETS, available as white scored tablets in 2 different strengths: '62.5' contain 50mg of levodopa and 12.5mg of benserazide hydrochloride; '125' contain 100mg of levodopa and 25mg of benserazide hydrochloride. Tablets all marked with name, strength and ROCHE. Also, MADOPAR CR green/blue continuous-release capsules containing 100mg of levodopa and 25mg of benserazide (as hydrochloride), marked ROCHE.

Medical Uses

Parkinsonism.

Dosage

Madopar and Madopar dispersible, adults over 25 years of age not already receiving levodopa, lx '62.5' tablet 3 or 4 times each day at first taken after meals. Dose may be increased by lx '125' tablet each day once or twice a week. Usual maintenance dose is in the order of 4 to 8x '125' tablets each day in divided doses. Also, consult manufac turer's instructions. Elderly persons, lx '62.5' once or twice each day with additional '62.5' tablet every third or fourth day if increase is required. Madopar CR capsules, adults over 25 years not already taking levodopa, 1 capsule 3 times each day taken after meals at first, then adjusted according to individual need. Consult manufacturer's instructions.

Special Care

Stomach ulcer, wide angle glaucoma, liver, kidney, heart, lung, circulatory diseases or endocrine (hormonal) disorders. Also, psychiatric disorders, soft bones (osteomalacia). Regular blood checks and monitoring of liver, kidney, heart and circulatory function should be carried out.

Avoid Use

Children and young adults under 25 years of age, pregnancy, breastfeeding. Patients with history of malignant melanoma (tumours of melanocytes which form the skin pigment, melanin), narrow angle glaucoma, severe psychoses.

Possible Drug and Food Interactions

Sympathomimetics, COMT inhibitors, halothane, drugs affecting central amines, TCADs, antihypertensives, metoclopramide, opioids, ferrous sulphate, diazepam, MAOIs; antacids (Madopar CR only).

Known Side Effects

Gastrointestinal upsets, heart and psychiatric disturbance, involuntary movements, low blood pressure when rising up from lying down (postural hypotension), sweating, hot flushes, discoloured urine. Rarely, haemolytic anaemia, bleeding disorders (thrombocytopenia, leucopenia).