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INTRODUCTION
LCD 125 is a combination of Carbidopa and Levodopa which belongs to the group of medicines called Antiparkinsonian drugs. It is used to improve the signs of Parkinsonism. Parkinsonism is a long-term illness caused due loss of nerve cells in the part of the brain which is responsible for producing dopamine. Dopamine is a chemical messenger that controls body balance and movements. Symptoms of parkinsonism include slow and unsteady movements, muscle tightness, shaking or trembling, difficulty in walking, balance, and coordination.
Levodopa is a dopamine precursor which converts itself into a material called ‘dopamine’, a chemical messenger that controls balance and movement in the body. Carbidopa is a peripheral decarboxylase inhibitor which prevents the breakdown of levodopa outside the brain, thereby allowing greater proportion of levodopa to enter the brain.
LCD 125 must be used with caution among patients having any form of glaucoma (increased pressure in the eyes), as it can lead to further damage to the eye. LCD 125 is not recommended for use in women who are pregnant or breastfeeding and in children and adolescents (aged below 18 years). It is important for caregivers to notice and report doctor immediately that if the patient develops any addictive symptoms like craving for large doses of LCD 125, unusual behavior, gambling, excessive eating or spending, an abnormally high sex drive or any other activities that could harm themselves or others. Other side effects include nausea, vomiting and abnormal muscle movements.
USES OF LCD 125
- used to improve the signs of Parkinsonism
HOW LCD 125 WORKS
LCD 125 effectively controls the signs of parkinsonism, where levodopa acts by converting itself into a substance called dopamine (a chemical messenger that controls body movement) and carbidopa acts by preventing the breakdown of levodopa outside the brain, thereby allowing greater proportion of levodopa to enter the brain. Collectively they supplement the brain with sufficient dopamine levels which ultimately results in improving the signs of parkinsonism.
DIRECTIONS FOR USE
Take LCD 125 as advised by your physician. Swallow the medicine as a whole and do not crush or chew the medicine. Continue to take LCD 125 unless your doctor tells you to stop because sudden withdrawal of LCD 125 can cause symptoms like mental changes, fever and muscle tightness.
SIDE EFFECTS OF LCD 125
COMMON
- abnormal body movements (dyskinesia, chorea, dystonia)
- nausea, vomiting, dry mouth, bitter taste
- loss of appetite
- confusion, dizziness, nightmares, drowsiness, tiredness, sleeplessness
- feeling euphoria (an extremely strong feeling of happiness)
- sudden changes in Parkinson’s symptoms
UNCOMMON
- weight loss or weight gain
- difficulty in speaking or making abnormal sounds while speaking
- constipation, diarrhea, bloating
- increased saliva secretion, difficulties in swallowing
- fluid accumulation
- muscle spasms
- dark urine
- weakness
- hot flushes
RARE
Stop taking LCD 125 and contact your doctor immediately if you experience any of the following side effects:
- signs of addiction (such as unusual behavior, addictive gambling, excessive sweating, or spending, an abnormally high sex drive or an increase in sexual thoughts or any other activities that could harm themselves or others)
- cravings for large doses of the medicine than required to control the motor symptoms
- signs of allergic reactions (such as skin rash, itching, swelling
of your face, lips, tongue, or throat, which may cause difficulty in breathing or swallowing) - chest pain, uneven heartbeat, feeling dizzy while standing up quickly
- signs of bleeding in the stomach which may be shown as blood in faeces or darkened faeces
- signs of low blood counts (such as pale skin, fever, tiredness, sore throat or mild bruising or prolonged bleeding after injury)
- muscle stiffness with high fever
- mental changes including hallucinations, delusions and depression
- fits (convulsions)
HOW TO MANAGE SIDE EFFECTS
Nausea and vomiting:
Try to take LCD 125 with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food.
Diarrhea:
Drink lots of fluids, such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for treating diarrhea. Consult your doctor if the symptom does not improve.
Constipation:
Eat fiber rich foods such as fresh fruits, vegetables and cereals and drink plenty of water. Try to exercise more regularly. Consult your doctor if the symptom does not improve on its own.
WARNING & PRECAUTIONS
PREGNANCY
LCD 125 is not recommended for use in pregnant women and in women who think that they might be pregnant. Consult your doctor before taking.
BREASTFEEDING
LCD 125 is not recommended for use in breastfeeding women. Consult your doctor before taking.
DRIVING AND USING MACHINES
Do not drive or operate any heavy tools or machines, as LCD 125 may cause sudden sleep attacks or can make you feel sleepy suddenly.
ALCOHOL
Avoid consumption of alcohol while taking LCD 125, as it could make you feel dizzier or drowsier.
KIDNEY
LCD 125 should be taken with caution among patients who have or had any kidney diseases in the past. Consult your doctor before taking.
LIVER
LCD 125 should be taken with caution among patients who have or had any liver diseases in the past. Consult your doctor before taking.
ALLERGY
Talk to your doctor if you are allergic to Levodopa or Carbidopa.
HEART DISEASE
LCD 125 should be taken with caution among patients with heart disease (such as previous history of heart attack, heartbeat problems, circulation or breathing problems). Consult your doctor before taking.
OTHERS
LCD 125 is not recommended for use in patients who:
- have ever had any forms of skin cancer
- have any unusual moles in the skin that has not yet been examined by the doctor
- have narrow-angle glaucoma (increased pressure in the eye)
- have a severe mental disorder (Ex. severe panic disorder, psychosis, severe depression, bipolar disorder)
Before taking LCD 125, inform your physician if you:
- have a history of fits (epilepsy)
- have had an ulcer in the stomach
- have vomited blood
- have any hormonal problems
- have had depression or any other similar mental problems
- have chronic wide-angle glaucoma (a painless eye condition that can affect your vision)
- feel sleepy or having sudden sleep attacks (Ex. Narcolepsy)
- are due to have a surgery
- are due to have a blood/urine test
Use in pediatrics:
- LCD 125 is generally not recommended for use in children and adolescents (below 18 years) due to lack of safety data. However, consult your doctor before taking.
Use in geriatrics:
- LCD 125 is considered safe for use in elderly patients (aged 65 years or above). However, proper dose adjustment and careful monitoring is required in such patients.
INTERACTIONS
A. Drug-Drug interactions:
Before taking LCD 125, inform your physician if you are taking any of the following:
- medicines used to treat depression (such as isocarboxazid, phenelzine, selegiline, tranylcypromine)
- medicines used to treat tuberculosis (Ex. rifaximin, isoniazid)
- medicines used to treat high blood pressure (Ex. atenolol, propranolol, captopril, enalapril, olmesartan, telmisartan)
- medicines used to treat epilepsy (Ex. carbamazepine, valproic acid, phenytoin)
- medicines used to treat involuntary movements (such as ataxia, dystonia, myoclonus, tardive dyskinesia) Ex. fluphenazine, haloperidol, chlorpromazine, or thioridazine
- medicines used to treat iron deficiency (Ex. ferrous fumarate, iron isomaltoside)
- medicines that can reduce muscle stiffness, strain, or spasms (such as trihexyphenidyl, orphenadrine, benzatropine and procyclidine)
- papaverine (a medicine used to treat impotence in men)
B. Drug-Food interaction:
Try to avoid eating a heavy meal that includes a lot of protein (such as beef, pork, fish, and eggs) while taking LCD 125, as it may interfere with its absorption.
Overdosage:
If you or anyone else accidentally take too much of LCD 125, contact your doctor immediately or go to a hospital straight away.
SYNOPSIS
| Drug | : | Carbidopa, Levodopa |
| Pharmacological Category | : | Anti-parkinsonian drugs |
| Therapeutic Indication | : | Parkinsonism |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep out of reach of children
- Store at room temperature
FAQs ABOUT LCD 125
What foods need to be avoided while taking LCD 125?
It is better to avoid protein rich foods like beef, chicken, pork, fish, and eggs while taking LCD 125, as it could interfere with its absorption.
Are there any medicines that needs to be avoided while taking LCD 125?
Before taking LCD 125, it is better to inform your doctor about all the medicines that you are taking, to avoid the risk of unwanted side effects. It is known that LCD 125 can interact with certain medicines used to treat depression (such as isocarboxazid, phenelzine, selegiline, tranylcypromine). These medicines should be stopped for at least two weeks before taking LCD 125. Also, consult your doctor for more information about the medicines that needs to be avoided.
How long does it take for LCD 125 to start working?
LCD 125 starts showing its effects after 24 hours. Although, it can have an effect after one day, it may take up to 7 days to show its complete effects, and so take this medicine at the same time each day as instructed by your doctor. Avoid eating a heavy meal rich in protein to enhance the antiparkinsonian effects.
Can I stop taking LCD 125 when the symptoms subside?
No. Do not stop taking LCD 125 unless your doctor tells you, because sudden withdrawal of LCD 125 can cause excessive muscle tightness, fever, and mental changes in patients. Therefore, continue to take LCD 125 as informed by your physician.
Can LCD 125 be make you feel sleepy?
Yes. LCD 125 can make you feel drowsy suddenly or can cause sudden sleep attacks (like narcolepsy) while doing your daily activities. You may not be experiencing any drowsiness or notice any warning signs before falling asleep suddenly. Avoid driving or operating any tools or heavy machines while taking LCD 125. If you experience any unusual episodes of sudden sleepiness or excessive sleepiness during the daytime, contact your doctor.
Can LCD 125 cause dark urine?
Yes. LCD 125 may alter the color of your urine and make it look darker. This is usually harmless. However, if you experience any blood in urine or other unusual symptoms consult your doctor immediately.
Can I take a higher dose of LCD 125 without consulting a doctor?
No. Consuming LCD 125 can make you feel addictive and tolerant for the existing dose. One must not consume a higher dose of [GBNKEYWORD without consulting their doctor.
REFERENCES
1. KD. Tripathi. Drugs acting on central nervous system. Antiparkinsonian drugs. Essentials of medical pharmacology. 8th Edition. 2019. Page – 452-457.
2. Gerald G. Briggs and Roger K. Freeman. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 657 & 2455.
3. Dr. Rebecca Gilbert. The many variations of carbidopa/levodopa – the mainstay of Parkinson’s disease treatment. American Parkinson Disease Association. March 2021. [Accessed 21st March 2022] https://www.apdaparkinson.org/article/carbidopa-levodopa-formulations-and-parkinsons-disease/
4. Masahiro Nomoto, Masahiro Nagai, Rina Ando, Yoshifumi Kagamiishi, Koji Yano, Shigeto Saito Atsushi Takeda. Pharmacokinetics and safety/efficacy of levodopa pro-drug ONO-2160/carbidopa for Parkinson's disease. Sciencedirect.com. December 2018. [Accessed 21st March 2022] https://www.sciencedirect.com/science/article/pii/S2405650218300315
5. Merck Sharp & Dohme B.V. Electronic Medicines Compendium (EMC). [Revised in February 2021] [Accessed 21st March 2022] https://www.medicines.org.uk/emc/files/pil.7805.pdf
6. Merck Sharp & Dohme B.V. Electronic Medicines Compendium (EMC). [Revised in February 2021] [Accessed 21st March 2022] https://www.medicines.org.uk/emc/files/pil.1655.pdf
7. Fair-Med Healthcare GmbH. Health Products Regulatory Authority (HPRA). [Revised in October 2018] [Accessed 21st March 2022] https://www.hpra.ie/img/uploaded/swedocuments/a48b3e79-0aae-4c3d-b727-a4272f22fc16.pdf
8. TORRENT PHARMACEUTICALS LTD. TIDOMET FORTE
(Carbidopa 25mg and Levodopa 250 mg tablets). [Revised in June 2018]. [Accessed 21st March 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/542.pdf
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