pharmacopeia
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/api/v1/drug/carbidopa

Mechanism of action

Sourced from openFDA

Mechanism-of-action classes: DOPA Decarboxylase Inhibitors; Dopamine Receptor Interactions; Enzyme Inhibitors; Monoamine Oxidase Inhibitors.

DOPA DecarboxylaseEnzymeMonoamine Oxidase

Indications

Sourced from openFDA
  • Carbidopa tablets are indicated for use with carbidopa-levodopa or with levodopa in the treatment of the symptoms of idiopathic Parkinson’s disease (paralysis agitans), postencephalitic parkinsonism, and symptomatic parkinsonism, which may follow injury to the nervous system by carbon monoxide intoxication and/or manganese intoxication. Carbidopa tablets are for use with carbidopa-levodopa in patients for whom the dosage of carbidopa-levodopa provides less than adequate daily dosage (usually 70 mg daily) of carbidopa.

Contraindications

Sourced from openFDA
  • Carbidopa tablets are contraindicated in patients with known hypersensitivity to any component of this drug. Nonselective monoamine oxidase (MAO) inhibitors are contraindicated for use with levodopa or carbidopa-levodopa combination products with or without carbidopa.contraindicated

Dosage & administration

Sourced from openFDA

Whether given with carbidopa-levodopa or with levodopa, the optimal daily dose of carbidopa must be determined by careful titration. Most patients respond to a 1:10 proportion of carbidopa and levodopa, provided the daily dosage of carbidopa is 70 mg or more a day. The maximum daily dosage of carbidopa should not exceed 200 mg, since clinical experience with larger dosages is limited. If the patient is taking carbidopa-levodopa, the amount of carbidopa in carbidopa-levodopa should be considered when calculating the total amount of carbidopa to be administered each day. Patients Receiving Carbidopa-Levodopa Who Require Additional Carbidopa Some patients taking carbidopa-levodopa may not have adequate reduction in nausea and vomiting when the dosage of carbidopa is less than 70 mg a day, and the dosage of levodopa is less than 700 mg a day. When these patients are taking carbidopa-levodopa, 25 mg of carbidopa may be given with the first dose of carbidopa-levodopa each day. Additional doses of 12.5 mg or 25 mg may be given during the day with each dose of carbidopa-levodopa. Carbidopa may be given with any dose carbidopa-levodopa as required for optimum therapeutic response. The maximum daily dosage of carbidopa, given as carbidopa and as carbidopa-levodopa), should not exceed 200 mg. Patients Requiring Individual Titration of Carbidopa and Levodopa Dosage Although carbidopa-levodopa is the most frequently used of carbidopa and levodopa administration, there may be an occasional patient who requires individually titrated doses of these two drugs.

Warnings & precautions

Sourced from openFDA

Carbidopa has no antiparkinsonian effect when given alone. It is indicated for use with carbidopa-levodopa or levodopa. Carbidopa does not decrease adverse reactions due to central effects of levodopa. When carbidopa is to be given to carbidopa-naive patients who are being treated with levodopa alone, the two drugs should be given at the same time. At least twelve hours should elapse between the last dose of levodopa and initiation of therapy with carbidopa and levodopa in combination. Start with no more than one-fifth (20%) to one-fourth (25%) of the previous daily dosage of levodopa when given without carbidopa. See the DOSAGE AND ADMINISTRATION section before initiating therapy. The addition of carbidopa with levodopa or carbidopa-levodopa reduces the peripheral effects (nausea, vomiting) due to decarboxylation of levodopa; however, carbidopa does not decrease the adverse reactions due to the central effects of levodopa. Because carbidopa permits more levodopa to reach the brain and more dopamine to be formed, certain adverse central nervous system (CNS) effects, e.g., dyskinesias (involuntary movements), may occur at lower dosages and sooner with levodopa in combination with carbidopa than with levodopa alone. Falling Asleep During Activities of Daily Living and Somnolence Patients taking carbidopa-levodopa products alone or with other dopaminergic drugs have reported suddenly falling asleep without prior warning of sleepiness while engaged in activities of daily living (includes operation of motor vehicles). Some of these episodes resulted in automobile accidents.

Adverse reactions

Sourced from openFDA

Carbidopa has not been demonstrated to have any overt pharmacodynamic actions in the recommended doses. The only adverse reactions that have been observed have been with concomitant use of carbidopa with other drugs such as levodopa, and with carbidopa-levodopa combination products. When carbidopa is administered concomitantly with levodopa or carbidopa-levodopa combination products, the most common adverse reactions have included dyskinesias such as choreiform, dystonic, and other involuntary movements, and nausea. Other adverse reactions reported with carbidopa when administered concomitantly with levodopa alone or carbidopa-levodopa combination products were psychotic episodes including delusions, hallucinations, and paranoid ideation, depression with or without development of suicidal tendencies, and dementia. Convulsions also have occurred; however, a causal relationship with concomitant use of carbidopa and levodopa has not been established. The following other adverse reactions have been reported with levodopa and carbidopa-levodopa combination products. These same adverse reactions may also occur when carbidopa is administered with these products. Body as a Whole: abdominal pain and distress, asthenia, chest pain, fatigue. Cardiovascular: cardiac irregularities, hypertension, myocardial infarction, hypotension including orthostatic hypotension, palpitation, phlebitis, syncope.

Use in specific populations

Sourced from openFDA

Information for Patients It is important that carbidopa with levodopa be taken at regular intervals according to the schedule outlined by the health care provider. Caution patients not to change the prescribed dosage regimen and not to add any additional antiparkinson medications, including other carbidopa-levodopa preparations without first consulting a physician. Advise patients that sometimes a ‘wearing-off’ effect may occur at the end of the dosing interval. Tell patients to notify the prescriber if such response poses a problem to lifestyle. Patients should be advised that occasionally dark color (red, brown, or black) may appear in saliva, urine, or sweat after ingestion of carbidopa and levodopa. Although the color appears to be clinically insignificant, garments may become discolored. The patient should be advised that a change in diet to foods that are high in protein may delay the absorption of levodopa and may reduce the amount taken up in the circulation. Excessive acidity also delays stomach emptying thus delaying the absorption of levodopa. Iron salts (such as in multivitamin tablets) may also reduce the amount of levodopa available in the body. The above factors may reduce the clinical effectiveness of the carbidopa and levodopa therapy.

Overdosage

Sourced from openFDA

No reports of overdose with carbidopa have been received. Management of overdosage with carbidopa is the same as that with levodopa or carbidopa-levodopa preparations. In the event of overdosage, general supportive measures should be employed, along with immediate gastric lavage. Intravenous fluids should be administered judiciously, and an adequate airway maintained. Electrocardiographic monitoring should be instituted and the patient carefully observed for the development of arrhythmias; if required, appropriate antiarrhythmic therapy should be given. The possibility that the patient may have taken other drugs as well as carbidopa should be taken into consideration. To date, no experience has been reported with dialysis; hence, its value in overdosage is not known. Pyridoxine is not effective in reversing the actions of carbidopa. Based on studies in which high doses of levodopa and/or carbidopa were administered, a significant proportion of rats and mice given single oral doses of levodopa of approximately 1500 to 2000 mg/kg are expected to die. A significant proportion of infant rats of both sexes are expected to die at a dose of 800 mg/kg.

Approval history

Sourced from openFDA
  • May 2, 1975NDANDA017555Organon
  • Apr 25, 1977NDANDA017830Aton
  • Aug 28, 1992ANDAANDA073589Dr Reddys Labs Sa
  • Jun 11, 2003NDANDA021485Orion Pharma
  • Jan 7, 2015NDANDA203312Impax
  • Jan 9, 2015NDANDA203952Abbvie
  • Nov 12, 2021NDANDA214869Avion Pharms
  • Aug 7, 2024NDANDA217186Impax

FAERS reports

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Reference statistics only. FAERS reports are voluntarily submitted and are not incidence rates, safety signals, or causal evidence. Counts reflect reporting volume — how often a reaction was reported, not how often it occurs. For decision-grade use, consult openFDA and the FAERS Public Dashboard directly.
51,887 total reports matchedLatest report Share = reports listing the reaction ÷ total matched reports. Rows can sum to >100% because a single report often lists multiple reactions.
  1. 1Fall4,8519.3%
  2. 2Drug Ineffective4,5928.9%
  3. 3Hallucination4,4528.6%
  4. 4Tremor3,5036.8%
  5. 5Death3,3276.4%
  6. 6Dyskinesia3,1076.0%
  7. 7Dizziness2,7935.4%
  8. 8Parkinson^s Disease2,7815.4%
  9. 9Nausea2,6265.1%
  10. 10Confusional State2,4144.7%
  11. 11Fatigue2,2954.4%
  12. 12Gait Disturbance2,2224.3%
  13. 13Somnolence2,1894.2%
  14. 14Asthenia2,0233.9%
  15. 15Urinary Tract Infection1,6263.1%

Literature

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Recent PubMed references pinned to Carbidopa as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.

Clinical trials

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The 10 most recently updated of 286 ClinicalTrials.gov registrations naming Carbidopa as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.

Frequently asked questions

How does Carbidopa work?
Mechanism-of-action classes: DOPA Decarboxylase Inhibitors; Dopamine Receptor Interactions; Enzyme Inhibitors; Monoamine Oxidase Inhibitors.
What is Carbidopa used for?
According to FDA labeling, Carbidopa carries indications including: Carbidopa tablets are indicated for use with carbidopa-levodopa or with levodopa in the treatment of the symptoms of idiopathic Parkinson’s disease (paralysis agitans), postencephalitic parkinsonism, and symptomatic parkinsonism, which may follow injury to the nervous system by carbon monoxide intoxication and/or manganese intoxication. Carbidopa tablets are for use with carbidopa-levodopa in patients for whom the dosage of carbidopa-levodopa provides less than adequate daily dosage (usually 70 mg daily) of carbidopa.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
What class of drug is Carbidopa?
Carbidopa is classified as Aromatic Amino Acid Decarboxylation Inhibitor, DOPA Decarboxylase Inhibitors, Dopamine Receptor Interactions, Enzyme Inhibitors, Monoamine Oxidase Inhibitors, Increased Central Nervous System Dopamine Activity.
What are the brand names for Carbidopa?
Carbidopa is marketed under brand names including Crexont, Dhivy, Duopa, Lodosyn, Rytary, Sinemet, Stalevo, Vyalev.
What are the contraindications for Carbidopa?
Carbidopa labeling lists contraindications including: Carbidopa tablets are contraindicated in patients with known hypersensitivity to any component of this drug. Nonselective monoamine oxidase (MAO) inhibitors are contraindicated for use with levodopa or carbidopa-levodopa combination products with or without carbidopa.. Always consult the full prescribing information and a clinician.
Note. Data for carbidopa is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.

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