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| Interactions: | Amitriptyline Adverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued anti-parkinsonian effects. Discontinue the Amitriptyline if a hypertensive episode occurs.
AmoxapineAdverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued antiparkinsonian effects. Discontinue Amoxapine if a hypertensive episode occurs.
Bupropion hcl Adverse Effect Concomitant administration results in higher incidence of adverse effects # Clinical Management: Administer Bupropion HCL with caution to patients receiving Levodopa concurrently. Drug has to be administered in small doses and gradually increasing as initial large doses often precipitate a series of adverse reactions.
Chlordiazepoxide Adverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued anti-parkinsonian effects. Discontinue the tricyclic antidepressant if a hypertensive episode occurs.
Cisapride Adverse Effect An increased risk of levodopa adverse effects (abnormal involuntary movements, tremor, nausea and vomiting, cardiovascular stimulation)Clinical Management Monitor patients for excessive levodopa adverse effects (abnormal involuntary movements, tremor, nausea and vomiting, cardiovascular stimulation) if cisapride is being concurrently administered.
ClomipraminAdverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued antiparkinsonian effects. Discontinue Clomipramine if a hypertensive episode occurs.
DothiepinAdverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued antiparkinsonian effects. Discontinue Dothiepin if a hypertensive episode occurs.
Doxepin Adverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued anti-parkinsonian effects. Discontinue the Doxepin if a hypertensive episode occurs.
Erithrityl TetranitrateIncreased risk of postural hypotension
Fluphenazine Adverse Effect Decreased levodopa effectivenessClinical Management Monitor therapeutic efficacy of levodopa; larger doses may be needed with concomitant Fluphenazine therapy.
Furazolidone Adverse Effect Efficacy and adverse effects of Levodopa is increased # Clinical Management: Monitor the patients for evidence of adverse effects and adjust the dose accordingly.
Glyceryl Trinitrate Increased risk of postural hypotension
HalothaneAdverse Effect Enhanced halothane cardiac sensitivityClinical Management If general anesthesia is required, levodopa may be continued as long as the patient is able to consume fluids and oral medication. If therapy is temporarily discontinued, the usual daily dosage may be reinstituted as soon as the patient is able to take oral medications. If levodopa therapy is interrupted for a longer period, the dosage should be adjusted gradually; however, in many cases the patient can be rapidly titrated to the previous dose.
INH Adverse Effect symptomatic deterioration of Parkinsons diseaseClinical Management Upward titration of antiparkinson drugs may restore response. Monitor patient for clinical response to dosage adjustment and for adverse effects associated with the antiparkinson therapy.
ImipramineAdverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued anti-parkinsonian effects. Discontinue the Imipramine if a hypertensive episode occurs.
Isosorbide 5 MononitrateIncreased risk of postural hypotension
Isosorbide DinitrateIncreased risk of postural hypotension
Methyldopa Adverse Effect Altered response to levodopa and/or enhanced hypotensive effectClinical Management Monitor the patient for continuing beneficial or even enhanced parkinsonian response to levodopa; some dosage reduction may be possible. Generally mild additive hypotensive effects may manifest which might require adjustment of methyldopa dosage.
Metoclopramide - AntispasAdverse Effect Increased levodopa bioavailability and an increased incidence of extrapyramidal symptomsClinical Management While metoclopramide can increase the bioavailability of levodopa, these two drugs should generally not be given concurrently since metoclopramide may cause parkinsonian-like symptoms.
MoclobemideAdverse Effect Concomitant administration leads to hypertensive crisis # Clinical Management: Avoid the concomitant use of these drugs if possible.
NortriptylineAdverse Effect Reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued anti-parkinsonian effects. Discontinue the Nortriptyline if a hypertensive episode occurs.
OrphenadrineIt has a synergistic effect
Pentaerythritol Tetranitrate Increased risk of postural hypotension
PhenytoinAdverse Effect decreased levodopa effectivenessClinical Management Monitor therapeutic efficacy of levodopa; larger doses may be needed with concomitant phenytoin therapy.
RisperidoneAdverse Effect loss of levodopa efficacy .Clinical Management: Concurrent use of risperidone in patients with parkinsonism should be avoided. If concurrent use cannot be avoided, monitor the patient for signs of increasing extrapyramidal effects. .
SelegilineAdverse Effect hypertension or increased mortalityClinical Management The concurrent administration of levodopa and a Selegiline is contraindicated. Allow two weeks to elapse between the discontinuation of the Selegiline and the initiation of levodopa therapy.
SpiramycinAdverse Effect reduced levodopa plasma concentrations and potential loss of antiparkinsonian effectsClinical Management Observe patients for reduced antiparkinsonian effects and adjust doses of levodopa accordingly.
ThioridazineAdverse Effect Loss of levodopa efficacyClinical Management Concurrent use of thioridazine and levodopa should be avoided. If concomitant use is necessary, monitor the patient for loss of levodopa therapeutic efficacy.
Trifluoperazine Adverse Effect Loss of levodopa efficacyClinical Management Concurrent use of trifluoperazine and levodopa should be avoided. If concomitant use is necessary, monitor the patient for loss of levodopa therapeutic efficacy.
TrimipramineAdverse Effect A reduced levodopa response; hypertensive episodes; postural hypotensionClinical Management Monitor blood pressure and watch the patient for continued antiparkinsonian effects. Discontinue Trimipramine if a hypertensive episode occurs. |
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