Crexont 70-280mg Capsules
It is used to treat Parkinson's disease.It is used to treat signs like Parkinson's disease caused by other health problems.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Anti-Parkinson Agent
Pharmacologic Class
Dopamine Precursor; DOPA Decarboxylase Inhibitor
Pregnancy Category
Category C
FDA Approved
Jan 2015
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication combines two drugs: carbidopa and levodopa. Levodopa is converted into dopamine in your brain, which helps control movement in Parkinson's disease. Carbidopa helps levodopa work better by preventing it from breaking down too quickly in your body, allowing more of it to reach your brain and reducing side effects. This extended-release form provides a more steady and prolonged effect.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions exactly. You can take this medication with or without food. Swallow the tablet whole - do not chew, break, or crush it. If you have trouble swallowing the tablet whole, some products can be opened and mixed with applesauce. However, you must swallow the mixture immediately without chewing. Check with your doctor or pharmacist to see if this is an option for your specific product.
When taking this medication with food, your doctor may recommend taking your first dose of the day 1 to 2 hours before eating. If you are already taking this medication, do not change your routine without consulting your doctor first.
Important Interactions to Consider
Some products should not be taken with alcohol, as this can increase the risk of side effects. Talk to your doctor before consuming alcohol while taking this medication. If you take an iron supplement or a multivitamin with iron, ask your doctor or pharmacist how to take it in relation to your medication, as iron may reduce the absorption of this drug.
A diet high in protein, fat, or calories, as well as consuming acidic foods, may also affect how well your body absorbs this medication. Discuss your diet with your doctor, especially if you plan to make any changes.
Continuing Your Medication
Continue taking this medication even when you are not experiencing symptoms. Keep a record of your symptoms to track your progress. Take your medication at the same time every day, as directed by your doctor or healthcare provider, even if you feel well.
Storing and Disposing of Your Medication
Store your medication at room temperature, protected from light and moisture. Do not store it in a bathroom. Keep all medications in a safe place, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. Check with your pharmacist for guidance on the best way to dispose of your medication, and ask about potential drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time or take extra doses.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions exactly. You can take this medication with or without food. Swallow the tablet whole - do not chew, break, or crush it. If you have trouble swallowing the tablet whole, some products can be opened and mixed with applesauce. However, you must swallow the mixture immediately without chewing. Check with your doctor or pharmacist to see if this is an option for your specific product.
When taking this medication with food, your doctor may recommend taking your first dose of the day 1 to 2 hours before eating. If you are already taking this medication, do not change your routine without consulting your doctor first.
Important Interactions to Consider
Some products should not be taken with alcohol, as this can increase the risk of side effects. Talk to your doctor before consuming alcohol while taking this medication. If you take an iron supplement or a multivitamin with iron, ask your doctor or pharmacist how to take it in relation to your medication, as iron may reduce the absorption of this drug.
A diet high in protein, fat, or calories, as well as consuming acidic foods, may also affect how well your body absorbs this medication. Discuss your diet with your doctor, especially if you plan to make any changes.
Continuing Your Medication
Continue taking this medication even when you are not experiencing symptoms. Keep a record of your symptoms to track your progress. Take your medication at the same time every day, as directed by your doctor or healthcare provider, even if you feel well.
Storing and Disposing of Your Medication
Store your medication at room temperature, protected from light and moisture. Do not store it in a bathroom. Keep all medications in a safe place, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. Check with your pharmacist for guidance on the best way to dispose of your medication, and ask about potential drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time or take extra doses.
Lifestyle & Tips
- Take capsules whole; do not crush, chew, or divide them.
- Can be taken with or without food, but taking with a low-protein snack may reduce nausea. Avoid high-protein meals close to dosing, as protein can interfere with absorption.
- Stay hydrated to help prevent constipation and orthostatic hypotension.
- Avoid sudden changes in position (e.g., standing up quickly) to minimize dizziness from orthostatic hypotension.
- Be aware of potential for sudden sleep attacks; avoid driving or operating machinery if this occurs.
- Do not stop taking this medication suddenly without consulting your doctor, as it can lead to a severe withdrawal syndrome.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Initial dose is typically 23.75 mg carbidopa/95 mg levodopa orally three times daily for patients not currently on levodopa, or adjusted based on prior levodopa dose for those converting. Doses are titrated based on clinical response and tolerability.
Dose Range:
95 - 2450 mg
Condition-Specific Dosing:
conversionFromIR:
For patients converting from immediate-release carbidopa/levodopa, the total daily levodopa dose of extended-release capsules should be approximately 10% to 30% higher than the total daily levodopa dose of immediate-release products. Administer 3 times daily.
deNovoPatients:
Initial dose 23.75 mg carbidopa/95 mg levodopa orally three times daily for 3 days, then increase to 36.25 mg carbidopa/145 mg levodopa three times daily. Titrate further based on response.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment recommended, but use with caution.
Moderate:
No specific dose adjustment recommended, but use with caution.
Severe:
No specific dose adjustment recommended, but use with caution. Monitor for adverse effects.
Dialysis:
Not well studied; use with caution. Levodopa is dialyzable.
Hepatic Impairment:
Mild:
No specific dose adjustment recommended, but use with caution.
Moderate:
No specific dose adjustment recommended, but use with caution.
Severe:
No specific dose adjustment recommended, but use with caution. Monitor for adverse effects.
Pharmacology
Mechanism of Action
Levodopa, a precursor of dopamine, crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa, an aromatic amino acid decarboxylase inhibitor, does not cross the blood-brain barrier and inhibits the peripheral conversion of levodopa to dopamine, thereby increasing the amount of levodopa available for transport to the brain and reducing peripheral side effects.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 70-80% (levodopa with carbidopa)
Tmax:
Levodopa: 1-2 hours (initial peak), 4-5 hours (second peak for ER); Carbidopa: 2-3 hours
FoodEffect:
High-fat, high-calorie meals can delay and decrease the absorption of levodopa, reducing peak plasma concentrations and increasing time to peak concentration.
Distribution:
Vd:
Levodopa: 0.9-1.6 L/kg; Carbidopa: 1.1 L/kg
ProteinBinding:
Levodopa: Approximately 10-30%; Carbidopa: Approximately 36%
CnssPenetration:
Levodopa: Yes; Carbidopa: Limited
Elimination:
HalfLife:
Levodopa: Approximately 1.5 hours (when co-administered with carbidopa); Carbidopa: Approximately 2-3 hours
Clearance:
Levodopa: 0.3-0.5 L/hr/kg
ExcretionRoute:
Primarily renal (urine)
Unchanged:
Levodopa: Small percentage; Carbidopa: Approximately 50% unchanged
Pharmacodynamics
OnsetOfAction:
Variable, typically within 30-60 minutes for initial effect, but full therapeutic effect may take days to weeks of titration.
PeakEffect:
Levodopa plasma concentrations peak at 1-2 hours and again at 4-5 hours for ER formulations, correlating with motor response.
DurationOfAction:
Extended-release formulations provide a more sustained levodopa plasma concentration, leading to a longer duration of effect (e.g., 4-6 hours or more per dose) compared to immediate-release.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Signs of high or low blood pressure, including:
+ Severe headache or dizziness
+ Fainting or changes in eyesight
New or worsening behavioral or mood changes, such as:
+ Depression or suicidal thoughts
Hallucinations (seeing or hearing things that are not there)
Confusion
Strong, uncontrollable urges (e.g., eating, gambling, sex, or spending money)
Skin lumps or growths
Changes in the color or size of a mole
New or worsening trouble controlling body movements
Eyelid twitching or muscle twitching
Stomach pain, black, tarry, or bloody stools, vomiting blood, or coffee ground-like vomit
Chest pain or pressure, rapid or irregular heartbeat
Fever, chills, sore throat, unexplained bruising or bleeding, or feeling extremely tired or weak
Dark urine, yellow skin or eyes
Changes in eyesight, eye pain, or severe eye irritation
Shortness of breath
Sudden, unexplained sleepiness or falling asleep during activities (e.g., driving, eating, or talking)
If you experience sudden sleepiness, do not drive or engage in activities that require alertness. Contact your doctor immediately if you experience this side effect or feel extremely sleepy.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Bad dreams
Constipation
Dizziness or drowsiness
Dry mouth
Headache
Trouble sleeping
Some products may cause a dark red, brown, or black color to appear in your saliva, urine, or sweat (harmless, but may discolor clothing)
* Upset stomach or vomiting
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Signs of high or low blood pressure, including:
+ Severe headache or dizziness
+ Fainting or changes in eyesight
New or worsening behavioral or mood changes, such as:
+ Depression or suicidal thoughts
Hallucinations (seeing or hearing things that are not there)
Confusion
Strong, uncontrollable urges (e.g., eating, gambling, sex, or spending money)
Skin lumps or growths
Changes in the color or size of a mole
New or worsening trouble controlling body movements
Eyelid twitching or muscle twitching
Stomach pain, black, tarry, or bloody stools, vomiting blood, or coffee ground-like vomit
Chest pain or pressure, rapid or irregular heartbeat
Fever, chills, sore throat, unexplained bruising or bleeding, or feeling extremely tired or weak
Dark urine, yellow skin or eyes
Changes in eyesight, eye pain, or severe eye irritation
Shortness of breath
Sudden, unexplained sleepiness or falling asleep during activities (e.g., driving, eating, or talking)
If you experience sudden sleepiness, do not drive or engage in activities that require alertness. Contact your doctor immediately if you experience this side effect or feel extremely sleepy.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Bad dreams
Constipation
Dizziness or drowsiness
Dry mouth
Headache
Trouble sleeping
Some products may cause a dark red, brown, or black color to appear in your saliva, urine, or sweat (harmless, but may discolor clothing)
* Upset stomach or vomiting
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- New or worsening involuntary movements (dyskinesia)
- Hallucinations (seeing or hearing things that aren't there)
- Delusions (false beliefs)
- Dizziness or lightheadedness, especially when standing up (orthostatic hypotension)
- Nausea or vomiting that is severe or persistent
- Unusual urges or behaviors (e.g., gambling, increased sexual urges, compulsive shopping)
- Sudden onset of sleep during daily activities
- Severe depression or suicidal thoughts
- Muscle stiffness, fever, or confusion (signs of neuroleptic malignant syndrome-like reaction if stopped suddenly)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
Certain health conditions, including:
+ Glaucoma
+ Skin lumps or growths
+ A history of skin cancer
Current or recent use of specific medications, such as:
+ Reserpine or tetrabenazine
+ Linezolid or methylene blue
+ Certain antidepressants or Parkinson's disease medications taken in the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline (as this may increase the risk of very high blood pressure)
Use of any other medication that contains the same active ingredient as this drug
* All your prescription and over-the-counter medications, natural products, vitamins, and health problems, as this is not an exhaustive list of potential interactions
To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health conditions before taking this drug. Do not start, stop, or change the dose of any medication without first discussing it with your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
Certain health conditions, including:
+ Glaucoma
+ Skin lumps or growths
+ A history of skin cancer
Current or recent use of specific medications, such as:
+ Reserpine or tetrabenazine
+ Linezolid or methylene blue
+ Certain antidepressants or Parkinson's disease medications taken in the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline (as this may increase the risk of very high blood pressure)
Use of any other medication that contains the same active ingredient as this drug
* All your prescription and over-the-counter medications, natural products, vitamins, and health problems, as this is not an exhaustive list of potential interactions
To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health conditions before taking this drug. Do not start, stop, or change the dose of any medication without first discussing it with your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This will help ensure your safety and prevent any potential interactions with other treatments.
To minimize the risk of accidents, avoid driving and engaging in activities that require your full attention until you understand how this medication affects you. Additionally, to reduce the likelihood of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when climbing stairs.
This medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug. Regular blood tests and eye exams, as recommended by your doctor, are also necessary to monitor your condition.
If you have diabetes (high blood sugar), consult with your doctor to determine the most suitable glucose tests to use. You may experience a decrease in the medication's effectiveness as the time for your next dose approaches, which can be bothersome. If this occurs, discuss it with your doctor.
Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may impair your reactions, consult with your doctor. It is also important to note that people with Parkinson's disease may have a higher risk of developing a type of skin cancer called melanoma, although it is unclear if this medication contributes to this risk. Regular skin exams are recommended, and you should discuss any concerns with your doctor.
Do not abruptly stop taking this medication or reduce your dosage without consulting your doctor, as this can lead to severe and potentially life-threatening side effects. These symptoms may include fever, muscle cramps or stiffness, dizziness, severe headache, confusion, changes in thinking, abnormal heartbeat, or excessive sweating. If you experience any of these symptoms, contact your doctor immediately.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
To minimize the risk of accidents, avoid driving and engaging in activities that require your full attention until you understand how this medication affects you. Additionally, to reduce the likelihood of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when climbing stairs.
This medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug. Regular blood tests and eye exams, as recommended by your doctor, are also necessary to monitor your condition.
If you have diabetes (high blood sugar), consult with your doctor to determine the most suitable glucose tests to use. You may experience a decrease in the medication's effectiveness as the time for your next dose approaches, which can be bothersome. If this occurs, discuss it with your doctor.
Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may impair your reactions, consult with your doctor. It is also important to note that people with Parkinson's disease may have a higher risk of developing a type of skin cancer called melanoma, although it is unclear if this medication contributes to this risk. Regular skin exams are recommended, and you should discuss any concerns with your doctor.
Do not abruptly stop taking this medication or reduce your dosage without consulting your doctor, as this can lead to severe and potentially life-threatening side effects. These symptoms may include fever, muscle cramps or stiffness, dizziness, severe headache, confusion, changes in thinking, abnormal heartbeat, or excessive sweating. If you experience any of these symptoms, contact your doctor immediately.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe dyskinesia (involuntary movements)
- Agitation, confusion, disorientation
- Insomnia
- Palpitations, irregular heartbeat (cardiac arrhythmias)
- Orthostatic hypotension
- Nausea, vomiting
What to Do:
Seek immediate medical attention. Call 911 or your local emergency number. For poison control, call 1-800-222-1222. Management is supportive, including gastric lavage, IV fluids, and careful monitoring of cardiac and respiratory function.
Drug Interactions
Contraindicated Interactions
- Nonselective Monoamine Oxidase (MAO) Inhibitors (e.g., phenelzine, tranylcypromine) - risk of hypertensive crisis. Must be discontinued at least 2 weeks prior to initiating carbidopa/levodopa.
Major Interactions
- Antipsychotics (e.g., haloperidol, chlorpromazine, risperidone, olanzapine) - may antagonize the effects of levodopa, worsening Parkinson's symptoms.
- Iron salts (ferrous sulfate, gluconate) - can chelate levodopa, reducing its absorption. Separate administration by at least 2 hours.
- High-protein diet - large neutral amino acids compete with levodopa for absorption in the gut and transport across the blood-brain barrier, reducing efficacy.
- Metoclopramide - can increase gastric emptying, potentially affecting absorption, and has dopamine receptor blocking effects that may antagonize levodopa.
Moderate Interactions
- Antihypertensives - additive hypotensive effects, especially orthostatic hypotension.
- Dopamine D2 receptor antagonists (e.g., some antiemetics like prochlorperazine) - may reduce levodopa efficacy.
- Phenytoin - may reduce levodopa efficacy.
- Papaverine - may reduce levodopa efficacy.
Minor Interactions
- Antacids - may slightly increase levodopa absorption.
Monitoring
Baseline Monitoring
Motor function assessment (e.g., UPDRS)
Rationale: To establish baseline severity of Parkinson's symptoms and track response to therapy.
Timing: Prior to initiation of therapy
Psychiatric evaluation
Rationale: To assess for pre-existing psychosis, depression, or cognitive impairment, which can be exacerbated.
Timing: Prior to initiation of therapy
Blood pressure (supine and standing)
Rationale: To assess for baseline orthostatic hypotension risk.
Timing: Prior to initiation of therapy
Renal and hepatic function tests
Rationale: To assess organ function, though no specific adjustments are typically needed, caution is advised in severe impairment.
Timing: Prior to initiation of therapy
Routine Monitoring
Motor fluctuations (e.g., 'wearing off', dyskinesia)
Frequency: At each clinical visit (e.g., every 1-3 months during titration, then every 3-6 months)
Target: Optimal motor control with minimal dyskinesia
Action Threshold: Increased 'off' time, troublesome dyskinesia, or unpredictable responses warrant dose adjustment or addition of adjunctive therapy.
Psychiatric symptoms (e.g., hallucinations, delusions, impulse control disorders)
Frequency: At each clinical visit
Target: Absence or minimal, manageable symptoms
Action Threshold: Emergence or worsening of symptoms requires dose reduction or consideration of atypical antipsychotics.
Blood pressure (supine and standing)
Frequency: Regularly, especially during dose titration and if symptoms of orthostatic hypotension occur.
Target: Stable blood pressure without symptomatic orthostasis
Action Threshold: Symptomatic orthostatic hypotension (e.g., dizziness, syncope) requires dose adjustment or management strategies.
Sleep patterns (e.g., sudden onset of sleep)
Frequency: At each clinical visit
Target: Normal sleep-wake cycle
Action Threshold: Reports of sudden sleep attacks require counseling on driving/operating machinery and potential dose adjustment.
Symptom Monitoring
- Dyskinesia (involuntary movements)
- Hallucinations or delusions
- Orthostatic hypotension (dizziness upon standing)
- Nausea/vomiting
- Dry mouth
- Insomnia or somnolence (including sudden sleep attacks)
- Changes in mood or behavior (e.g., depression, agitation, impulse control disorders)
- Gastrointestinal upset (constipation, diarrhea)
Special Patient Groups
Pregnancy
Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Levodopa has been shown to cause visceral and skeletal malformations in rabbits at doses similar to human therapeutic doses.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity observed in animal studies.
Second Trimester:
Limited human data; continued monitoring for maternal and fetal well-being.
Third Trimester:
Limited human data; continued monitoring for maternal and fetal well-being. Consider potential for neonatal withdrawal symptoms if discontinued abruptly.
Lactation
L3 (Moderate Risk). Levodopa is excreted into breast milk. Carbidopa is also likely excreted. Due to the potential for serious adverse reactions in breastfed infants (e.g., effects on CNS, endocrine system), a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Infant Risk:
Potential for central nervous system effects (e.g., somnolence, irritability), and interference with lactation (levodopa can inhibit prolactin secretion).
Pediatric Use
Safety and effectiveness in pediatric patients have not been established. Not indicated for use in children.
Geriatric Use
No overall differences in safety or effectiveness were observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Dose titration should be done carefully, starting with lower doses, due to increased risk of adverse effects like hallucinations and orthostatic hypotension.
Clinical Information
Clinical Pearls
- Extended-release formulations aim to reduce 'off' time and dyskinesia by providing more stable levodopa plasma concentrations compared to immediate-release forms.
- Patients should be instructed to swallow capsules whole and not to crush, chew, or divide them, as this will alter the extended-release properties.
- High-protein meals can significantly reduce the absorption and effectiveness of levodopa; advise patients to take doses at least 30 minutes before or 1 hour after a high-protein meal, or with a low-protein snack.
- Monitor for impulse control disorders (e.g., pathological gambling, hypersexuality, compulsive shopping, binge eating) which can occur with dopaminergic therapies.
- Patients should be warned about the possibility of sudden onset of sleep and advised against driving or operating machinery if this occurs.
- Abrupt discontinuation or rapid dose reduction can lead to a neuroleptic malignant syndrome-like reaction (fever, rigidity, altered mental status, autonomic instability); taper dose gradually if discontinuation is necessary.
Alternative Therapies
- Dopamine agonists (e.g., pramipexole, ropinirole, rotigotine)
- MAO-B inhibitors (e.g., selegiline, rasagiline, safinamide)
- COMT inhibitors (e.g., entacapone, opicapone)
- Amantadine (for dyskinesia and 'off' time)
- Adenosine A2A receptor antagonists (e.g., istradefylline)
- Anticholinergics (e.g., benztropine, trihexyphenidyl - for tremor, less common)
Cost & Coverage
Average Cost:
Varies widely by strength and pharmacy; typically several hundred to over a thousand USD per 30 capsules
Generic Available:
Yes
Insurance Coverage:
Tier 2 or Tier 3 (preferred or non-preferred brand/specialty drug)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.