Parkinson's Movement
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Doubling the amount of levadopa??

My fathers doctor had prescribed stalevo with 50mg levadopa 3 times daily. That meant he took 150mg levadopa each day. However we saw no improvement in his slowness and walking etc. So then the doctor switched him to madaopar but 125mg 3 times a day this means he would take 300mg levadopa each day. So the doctor increased the dose of daily levadopa from 150mg to 300mg instead!"is this increase normal or is it too much???

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I am not a doctor but I take 250 mg (blue tablet) 4 times a day = 1000 mg so your husbands 300 mg per day sounds like it is in the ball park, not extreme .

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An average effective dose from the clinical literature is 702 ± 461 mg/day. 300 mg is not too much.

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Here are some conclusions from a 2010 review article I just read. First, in my own words, the conclusions are: Do not fear carbidopa/levodopa. Dopamine agonists, taken with CD/LD, have some benefits but some seriously BAD side effects. These conclusions echo what I have heard from this forum. Many of its members would tell you, with exclamation points, to start your dad on thiamine hydrochloride, along with the LD.

Here are the full review conclusions

“Despite all recent advances in the medical management of PD, LD has remained the therapeutic gold standard in controlling the cardinal motor features of this illness. There is no evidence to support withholding LD for fear of hastening the progression of PD, although current three times daily regimens of standard oral LD carry a definite risk of inducing potentially disabling drug-induced involuntary movements. While dyskinetic responses are common with sustained LD therapy, the proportion of patients actually developing disabling and severe dyskinesia has been below 10% in a recent four-year randomized trial and below 20% in a 10-year follow-up series. This should be taken into account when the physician discusses the potential use of LD with the patient, particularly in patients who require enhanced symptomatic control despite optimized treatment with DAs. Moreover, when making individual decisions on how to initiate dopaminergic treatment, the weighing of relative risks and benefits of starting with a DA or LD should not only consider dyskinesia risks but also risks for other side effects, including daytime somnolence, impulse-control disorders and, in the case of ergot-derived DAs, cardiac valvulopathy and other forms of potentially life-threatening fibrosis.27 In addition, individual needs for magnitude and speed of symptomatic improvement must be balanced against potential side effects. “

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Thank you so much thank you

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The prescribed amount of medicine relies on its effectiveness , but instead of only taking doses it is significant to add other complementary treatments such as physical activity and Diet patterns .

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Thank yoi

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300mg of levodopa is not a lot. It is the starting dose most commonly prescribed in the US, I believe.

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For Madopa, at least in Europe, the stating dose is 50mg/12.5, 3-4 times/day. In more advance stages initial dosage is 100/25. Of course actual dosage and frequency depend on the severity of symptoms and the patients' response. It is not uncommon for madopar to be prescribed with a MAO inhibitor or/and an agonist

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He prescribed madapar with motiliun ..is this normal?

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When levodopa is initially prescribed it may cause side effects such vomiting and nausea. Possibly your doctor prescribed motiliun to counteract such adverse reactions until tolerance to levodopa is built

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Thank you so much

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In these cases, the concept of "levodopa equivalent dose", LED, is useful. This is its dose multiplied by a scaling factor that takes into account its potency relative to levodopa/carbidopa (Sinemet). Stalevo has a scaling factor of 1.33. Madopar has a scaling factor of 1.

(The higher scaling factor of Stalevo is because it has an extra component, entacapone, that makes the dose last longer.)

Your father was in 3x50mg of Stalevo = 200mg LED.

This was changed to 3x125 of Madopar = 375mg LED.

I've found it useful to titrate slowly.

For other scaling factors and to see how levodopa equivalent levels vary during the day see:

parkinsonsmeasurement.org/t...

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Thank you

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Any increases in dosages should be gradual, not abrupt

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I take 3000 mg a day . I take 3 25/100 and 1 50/200 ext release every 4 hours 24/7. With no major side effects

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Thanks and may I ask you in what ways do you see levadopa benefits? What is it good for? Do you see its benefits? If yes how and in what specifically? My dad took it but we saw no benefits so im just willing to know

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i do not have tremor but every thing else. I have been taking Carbadopa levadopa for about 3 years. I have had PD for 12 years. The first day i took levadopa i was able to write my name for the first time in 3 years and i was back to normal that day. I could do any thing i could do before my PD had progressed. When i miss a dose i can not walk more than a few steps, i have pain in my hands i can not write my name, my legs are weak, i get depressed, my arms and hands are stiff i can not close my hands or even pick up anything,

Today i do most any thing i want. Some times about 3 hours into my dose cycle i feel the C/L start to wear off but i just push myself till the next dose kicks in. But most times the C/L works all day long.

Without C/L i would be in a wheelchair!

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Thank you for your reply thanks alot , best wishes

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