Co beneldopa

CLINICAL USE

Treatment of Parkinsonism

DOSE IN NORMAL RENAL FUNCTION

150–800 mg daily in divided doses after meals (expressed as levodopa)

PHARMACOKINETICS

Molecular weight :Benserazide: 293.7 (as HCl), levodopa: 197.2

%Protein binding :Benserazide: 0, levodopa: 10–30

%Excreted unchanged in urine : Benserazide: 0 (64 as metabs), levodopa: <1

Volume of distribution (L/kg) :Benserazide: no data, levodopa: 0.36–1.6

half-life – normal/ESRD (hrs) :Benserazide: 1.5/Increased, levodopa: 1.5/Increased by 25%

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysed. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnaesthetics: risk of arrhythmias with volatile liquid anaesthetics such as halothaneAntidepressants: hypertensive crisis with MAOIs and linezolid (including moclobemide) – avoid for at least 2 weeks after stopping MAOIBupropion: increased risk of side effects of levodopaFerrous sulphate: reduces AUC of levodopa by 30–50%, clinically significant in some but not all patients

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

OTHER INFORMATION

Can be used to treat restless legs syndrome at a dose of 62.5–125 mgUrine may be red-tinged and turn dark on standing, due to metabolitesSerum uric acid and blood urea nitrogen levels are occasionally elevated

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