Levodopa Medicines for Parkinson's Disease
How It Works
Levodopa is a medicine that the brain converts to dopamine.
Carbidopa is a medicine (called a decarboxylase inhibitor) that, when taken with levodopa, helps prevent the levodopa from converting to dopamine outside the brain. The combination of carbidopa and levodopa has several benefits:
Why It Is Used
Levodopa is a medicine used to control symptoms of Parkinson's disease and may be used at all stages of the disease.
How Well It Works
Levodopa is the most effective medicine for relieving symptoms of Parkinson's disease. It helps reduce tremor, stiffness, and slowness and helps improve muscle control, balance, and walking. It does not affect freezing, dementia, or problems with involuntary (autonomic) functions, such as constipation, urinary problems, impotence, or pain.1
Levodopa does not slow the disease process, but it improves muscle movement and delays severe disability. The use of levodopa allows people with Parkinson's disease to stay independent and able to function for longer periods of time. But the majority of people taking levodopa develop complications caused by long-term levodopa therapy within 5 to 10 years. Movement problems (motor fluctuations) are the most common and troublesome complication.1
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor if you have:
Common side effects of this medicine include:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
The decision about whether it is better to use levodopa or a dopamine agonist as the first treatment in Parkinson's disease is different for each person. Levodopa controls symptoms better than dopamine agonists in most people. And levodopa has fewer side effects than dopamine agonists. But concern about levodopa-related motor fluctuations is leading some experts to recommend initial treatment with dopamine agonists, especially for people who are younger than 60. As the disease progresses, your doctor may also prescribe levodopa along with a dopamine agonist. It is important to work with your doctor to find the medicines that work the best for you.
As motor fluctuations become more severe, it may be necessary to add another type of medicine to the levodopa treatment.
Levodopa may cause impulse-control disorders in some people. Impulse-control disorders include uncontrollable or problem gambling, sexual behavior, and shopping. Binge eating is another example.
People who have a higher risk for an impulse-control disorder:
Levodopa is less likely than dopamine agonists to cause impulse-control disorders. And the risk is even higher in people who take both a dopamine agonist and levodopa. If you are concerned about taking these medicines because of this risk, talk with your doctor.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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