(Also known as L-dopa)
Levodopa is not available as a product on its own.
Levodopa is an antiparkinsonism agent. Antiparkinsonism agents are drugs that relieve the symptoms of Parkinsonism and are effective in countering the involuntary muscle movement often associated with the disease.
In South Africa levodopa is registered for the treatment of Parkinson's disease.
Levodopa is rarely used on its own, and is usually combined with either carbidopa or bensarezide to increase the effect of levodopa in the brain and to reduce the drugs side-effects.
For this medication to be effective it has to be taken regularly, even if you do not notice an immediate effect. The decision to stop using this medication should only be made by your doctor as a sudden discontinuation of treatment may worsen the symptoms of Parkinson's disease.
Levodopa may cause your urine to appear dark or slightly reddish. This is normal and is no cause for concern.
It should be noted that because this drug may cause dizziness, light-headedness and/or sedation, driving and any hazardous tasks should be avoided until you know how this medication affects you.
How does levodopa work?
Levodopa increases dopamine levels in the brain, a chemical messenger in the brain of which a shortage causes Parkinson's disease.
Drug schedule: schedule 4
What does it do? Levodopa reduces the symptoms of Parkinson’s disease.
Overdose risk: medium
Dependence risk: low
Is levodopa available on prescription only? yes
Onset of effect: it may take several months for the full therapeutic response to be seen.
Duration of action: 6-12 hours
Dietary advice: levodopa should be taken shortly after a meal to reduce gastrointestinal side effects. High protein diets may however reduce the effect of this drug.
Stopping this medicine: do not stop taking this drug without consulting your doctor. A sudden discontinuation of treatment may cause worsening of Parkinson's disease.
Prolonged use: a decline in effect may be seen with prolonged use, warranting an increase in dose. This may cause an increase in side-effects to the extent that treatment with the drug may eventually have to be discontinued.
Consult your doctor before using this drug if:
- you are currently being, or in the last 14 days have been, treated with monoamine oxidase inhibitor antidepressants
- you have liver or kidney disease
- you have glaucoma
- you have skin cancer
- you have heart disease
- you have high blood pressure
- you have a stomach or duodenal ulcer
- you have depression
- you have a history of mental health problems
- you are younger than 25
- you have a history of seizures
- you are asthmatic or have been diagnosed with chronic obstructive pulmonary disease
- you have diabetes
Pregnancy: avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 12 years.
The elderly: caution is advised in the elderly as side effects are more likely to occur.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.
Possible side effects
Consult your doctor
Only if severe
In all cases
|loss of appetite|
|low blood pressure|
|antacids||risk of increased levodopa absorption|
|anticholinergic drugs||risk of reduced levodopa absorption|
|blood pressure medication||risk of enhanced drop in blood pressure|
|antipsychotics||may inhibit the effect of levodopa. it is advised to use antipsychotics such as clozapine, olanzapine and quetiapine which exert less of an effect on dopamine|
|benzodiazepines||may reduce the antiparkinsonian effect of levodopa|
|clonidine||may reduce the antiparkinsonian effect of levodopa|
|papaverine||may reduce the antiparkinsonian effect of levodopa|
|phenothiazines||may reduce the antiparkinsonian effect of levodopa|
|phenytoin||may reduce the antiparkinsonian effect of levodopa|
|iron salts||binds to levodopa and may reduce the antiparkinsonian effect of levodopa. Separate doses by at least 2 hours|
|abacavir||may reduce the antiparkinsonian effect of levodopa|
|pyridoxine||may reduce the antiparkinsonian effect of levodopa|
|taccrine||may reduce the antiparkinsonian effect of levodopa|
|tricyclic antidepressants||may reduce the antiparkinsonian effect of levodopa. rare increases in blood pressure have also been reported|
|bupropion||increased risk of side effects with levodopa|
|furazolidine||increased risk of side effects with levodopa|
|linezolid||increased risk of side effects with levodopa|
|metoclopramide||increased risk of side effects with levodopa|
|methyldopa||increased risk of side effects with levodopa|
|monoamine oxidase inhibitor antidepressants||risk of hypertensive crisis|
Consult your doctor before using this drug if you have liver or kidney disease, glaucoma, skin cancer, heart disease, high blood pressure, a stomach or duodenal ulcer, depression, a history of mental health problems, a history of seizures, or if you are asthmatic or have been diagnosed with chronic obstructive pulmonary disease.
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.
Dose: treatment should be initiated gradually. Treatment is usually started with 300 mg/day in 3 divided doses. This dose can be increased by 100 mg/day every 3-7 days until a response is seen, or a maximum daily dose of 8000 mg is reached.
Levodopa, co-administered with a peripheral DOPA decarboxylase inhibitor, has been tested as a possible treatment for restless leg syndrome.