SINDOPA

Antiparkinsonian combined tool – combination karbidopы (aromatic amino acid decarboxylase inhibitor) and levodopa (the precursor of dopamine). Eliminates hypokinesia, rigidity, tremor, disfagiju, drooling. Antiparkinsonian effect of levodopa, due to its conversion to dopamine directly into the central nervous system, which leads to a shortfall of dopamine in the CNS. The resulting dopamine in peripheral tissues not involved in the implementation of antiparkinsonian effect of levodopa (It does not penetrate the CNS) and is responsible for most of the side effects of levodopa. Carbidopa – an inhibitor of peripheral dopa decarboxylase, reduces the production of dopamine in peripheral tissues, which indirectly leads to an increase in the amount of levodopa, entering the CNS. The optimal combination of levodopa and carbidopa 4:1 or 10:1. The action of the drug is during the first day since the beginning of the reception, sometimes – after the first dose. The full effect is reached within 7 d.

Parkinson's Disease, Parkinson's syndrome (except caused by antipsychotic drugs) – postencephalitic, amid cerebrovascular diseases, intoxication by toxic substances (incl. carbon monoxide or Mn).

Hypersensitivity, zakrыtougolynaya glaucoma, psychosis or severe psychoneurosis, melanoma and suspected her and skin disease of unknown etiology, pregnancy, lactation, Age to 12 let.C caution. Myocardial infarction arrhythmias (history), bronchial asthma, lung diseases, seizures (history), erosive and ulcerative lesions of the gastrointestinal tract, diabetes, etc.. decompensated endocrine diseases, severe liver and / or kidney failure, CHF.

Early treatment: nausea, vomiting, decreased appetite, epigastric pain, dysphagia, ulcerogenic action (in predisposed patients); in some cases – arrhythmias, orthostatic hypotension.

In the course of further treatment – spontaneous movement (hyperkinesis), dyskinesia. Gemoliticheskaya anemia, leukopenia, thrombocytopenia. Mental disorders, insomnia, hypererethism, depression. Tachycardia, constipation, weight gain (prolonged use).

Inside, by 1/4 tablets (250 mg / 25 mg) 2-3 once a day, then increase the dose 1/4 tablet every 2-3 day until the optimum effect. Typically, the optimal effect is observed at a dose of 1-2 tablets (by 250 mg / 25 mg) per day. The maximum daily dose – 1.5 Mr. levodopa and 150 mg carbidopa (6 tablets 250 mg / 25 mg).

It is unacceptable abrupt discontinuation of levodopa (at the abrupt cancellation of symptoms may develop, resembling neuroleptic malignant syndrome, including muscle rigidity, fever, deviations in the psyche and elevated serum CPK). Requires monitoring of patients, which it took a sudden reduce the dose or interrupt reception, especially if the patient is receiving antipsychotic drugs. Do not prescribe to eliminate extrapyramidal reactions, caused by drugs. During treatment requires monitoring of the mental status of the patient, peripheral blood. Foods high in protein can disrupt the absorption. Patients with glaucoma in patients receiving the drug should be monitored regularly intraocular pressure. It is recommended to be taken with food or with a small amount of liquid, Swallow whole capsule. During long-term treatment is appropriate periodic monitoring of liver function, hematopoiesis, kidney and CCC. Before the planned general anesthesia drug can be taken until, until the patient is allowed oral intake. After surgery, the usual dose can be reappointed, as soon as the patient is able to take the drug orally. During the period of treatment must be careful when driving and other lesson. potentially hazardous activities, require high concentration and speed of psychomotor reactions.

With simultaneous use of levodopa with beta-agonists, ditilinom and drugs for inhalation anesthesia, may increase the risk of heart rhythm disorders; tricyclic antidepressants – decrease the bioavailability of levodopa; diazepam, klozepinom, phenytoin, clonidine, Mr. holinoblokatorami, antipsychotic drugs (neuroleptics) – butyrophenone derivatives, dyfenylbutylpyperydyna, thioxanthen, phenothiazines, and pyridoxine, papaverine, reserpine may decrease protivoparkinsonicheskogo action; with preparations Li increases the risk of dyskinesias and hallucinations; with methyldopa – aggravation of side effects.

With simultaneous use of levodopa with MAO inhibitors (except MAO-B inhibitors) possible circulatory disorders (MAO inhibitors should be discontinued for 2 Sun). This is due to the accumulation under the influence of dopamine and norepinephrine levodopa, inactivation inhibited MAO inhibitors, and a high probability of excitation, increase blood pressure, tachycardia, facial flushing and dizziness.

Patients, receiving levodopa, when applying tubokurarina increased risk of significant decrease in blood pressure.