Around 80% of patients with Parkinson's Disease will respond to levodopa medication. The benefit can be either a small change or a major change in symptoms of tremor, stiffness, and balance. The medication always comes with carbidopa - which blocks the levodopa in the stomach to prevent the levodopa induced nausea. The most common tablets are carbidopa - levodopa 25mg-100 mg. These tablets have 25 mg of the anti-nausea carbidopa and the active ingredient levodopa.
Levodopa is a synthetic amino acid. More will make it to the brain if you take it on an empty stomach. If you take it with food patients report approximately 30% less effectiveness. Try to take it 30 minutes before eating or 2 hours after eating if you can.
A low dose is started and the dose is slowly increased until either the best effect is seen or if side effects start. If you are having bad side effects and not seeing a response you can stop the titration at any time and report the level you reached.
Typical titration:
The medication is started by taking carbidopa-levodopa 25 mg - 100 mg tablets taken as 1 tablet 3 times a day.
If there is no response after 1 week the dose is increased to carbidopa-levodopa 25 mg - 100 mg tablets taken as 1.5 tablets 3 times a day.
If there is no response after 1 week the dose is increased to carbidopa-levodopa 25 mg - 100 mg tablets taken as 2 tablets 3 times a day.
If there is no response after 1 week the dose is increased to carbidopa-levodopa 25 mg - 100 mg tablets taken as 2.5 tablets 3 times a day.
If there is no response after 1 week the dose is increased to carbidopa-levodopa 25 mg - 100 mg tablets taken as 2.5 tablets 4 times a day.
When there is no response at a total of 10 tablets in divided doses we normally decided that you are a 'levodopa non-responder'.