Parkinson Disease nts
therapy or adjunct to levodopa therapy aindicated with concomitant use of dextromethorphan, MAOIs, meperidine and other opioids, methadone, xyphene, tramadol dietary sympathomimetic amines, tyramine, SNRI and SSRI antidepressants, TCAs w tyramine diet ssociated with increased melanoma risk specifically, but patients should undergo periodic dermatological ing
aindicated with concomitant use of meperidine and other opioids amitriptyline, protriptyline, MAOIs, SSRIs,TCAs
ct to carbidopa/levodopa therapy; if levodopa associated side effects exacerbated, consider reducing dose of opa/levodopa by 10–30%
ssociated with increased melanoma risk specifically, but patients should undergo periodic dermatological ing
rs more active drug at a lower dose through bypassing the gut and first pass hepatic metabolism
ct to levodopa and other medication therapy for "wearing off" episodes; ause dyskinesia or exacerbate pre-existing dyskinesia aindicated in concomitant use of 5HT2 antagonists on with drugs prolonging QT/QTc interval, mild–moderate hepatic or mpairment
ct to carbidopa/levodopa therapy if deteriorating response to therapy aindicated with concomitant use of dextromethorphan, MAO inhibitors, and selective MAO-B inhibitors, idine, and other analgesics including tramadol, methadone and propoxyphene SSRIs, TCAs
olence/sudden sleep onset, orthostatic hypotension, hallucinations at nausea/vomiting with antiemetic trimethobenzamide (antiemetics with anti-dopaminergic actions can worsen l state of Parkinson disease)
ct to carbidopa/levodopa therapy; efficacy > 2 yr not established aindicated in uncontrolled hypertension, pregnancy, postpartum cardiovascular disease, concomitant use with alkaloids
olence/sudden sleep onset, orthostatic hypotension used in clinical practice
ct to carbidopa/levodopa therapy olence/sudden sleep onset, orthostatic hypotension, hallucinations or with echocardiogram due to concerns of cardiac valvular fibrosis
therapy or adjunct to levodopa therapy e dosage to achieve max therapeutic effect against side effects of dyskinesia, hallucinations, somnolence/sudden onset, dry mouth ssociated with increased melanoma risk specifically, but patients should undergo periodic dermatological ing
ntinue gradually over 1 wk
therapy or adjunct to levodopa olence/sudden sleep onset, orthostatic hypotension, hallucinations ssociated with increased melanoma risk specifically, but patients should undergo periodic dermatological ing
ntinue by reducing dosage from tid to bid for 4 d, then once daily for 3 d before withdrawal
