Co-beneldopa

How it works

Levodopa is converted to dopamine in the brain to replenish deficient striatal dopamine, while benserazide is a peripheral dopa-decarboxylase inhibitor that reduces peripheral conversion, increasing central availability and limiting peripheral side effects.

Prescribing in practice

• Do not stop treatment abruptly, as sudden withdrawal can precipitate a neuroleptic malignant syndrome-like reaction.
• Long-term use is associated with motor fluctuations and dyskinesias, which may require regimen adjustment.
• Impulse-control disorders and excessive daytime sleepiness can occur with dopaminergic therapy.

Monitoring

Monitor motor response, the emergence of dyskinesias or 'wearing-off', and behavioural changes such as impulse-control disorders and daytime somnolence.

Counselling the patient

• Never stop this medicine suddenly; speak to the team if doses are missed or changes are needed.
• Report new gambling, hypersexuality, compulsive shopping or eating, which can be caused by the medicine.
• Be aware of possible sudden sleepiness, which may affect driving.

Evidence & guidelines

Levodopa-based therapy is the most effective treatment for the motor symptoms of Parkinson's disease and is endorsed by NICE.