Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Dopamine Precursor / Decarboxylase Inhibitor

Levodopa-Carbidopa (Co-Careldopa)

Brand names: Sinemet, Caramet, Duodopa (enteral)

Co-careldopa (levodopa with carbidopa) is the mainstay treatment of Parkinson's disease, replacing dopamine; carbidopa reduces peripheral side effects.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Levodopa is converted to dopamine in the brain; carbidopa, a peripheral dopa-decarboxylase inhibitor that does not cross the blood-brain barrier, reduces peripheral conversion (and so nausea) and allows lower levodopa doses.

Prescribing in practice

  • It is the most effective symptomatic therapy, but long-term use is limited by motor fluctuations ('wearing off') and dyskinesias.
  • Do not stop it abruptly — sudden withdrawal can cause a neuroleptic-malignant-like syndrome; timing relative to protein-rich meals affects absorption.
  • Nausea, postural hypotension, hallucinations and impulse-control disorders can occur.

Monitoring

Review motor response and fluctuations, blood pressure, and neuropsychiatric effects (hallucinations, impulse control).

Counselling the patient

  • Take it at regular times as directed; do not stop it suddenly.
  • Separating doses from high-protein meals can help if it seems less effective.
  • Report new compulsive behaviours (gambling, shopping) or hallucinations.

Evidence & guidelines

The most effective symptomatic treatment for Parkinson's disease (NICE NG71), with long-term motor complications to manage.

Reference: NICE NG71 Parkinson's Disease; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways