Formulary
Co-beneldopa: Indications, Dosing, Side Effects and Interactions
Co-beneldopa clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Co-beneldopa: Indications, Dosing, Side Effects and Interactions
Co-beneldopa clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Parkinson's disease**
- **Adult** (By Mouth Using Immediate-Release Medicines): Initially 50 mg 3-4 times a day, then increased in steps of 100 mg daily, dose to be increased once or twice weekly according to response; maintenance 400-800 mg daily in divided doses.
- **Elderly** (By Mouth Using Immediate-Release Medicines): Initially 50 mg 1-2 times a day, then increased in steps of 50 mg daily, dose to be increased every 3-4 days according to response.
**Parkinson's disease (in advanced disease)**
- **Adult** (By Mouth Using Immediate-Release Medicines): Initially 100 mg 3 times a day, then increased in steps of 100 mg daily, dose to be increased once or twice weekly according to response; maintenance 400-800 mg daily in divided doses.
**Parkinson's disease (patients not taking levodopa/dopa-decarboxylase inhibitor therapy)**
- **Adult** (By Mouth Using Modified-Release Medicines): Initially 1 capsule 3 times a day; maximum 6 capsules per day.
**Parkinson's disease (patients transferring from immediate-release levodopa/dopa-decarboxylase inhibitor preparations)**
- **Adult** (By Mouth Using Modified-Release Medicines): Initially 1 capsule substituted for every 100 mg of levodopa and given at same dosage frequency, increased every 2-3 days according to response; average increase of 50% needed over previous levodopa dose and titration may take up to 4 weeks, supplementary dose of immediate-release Madopar may be needed with first morning dose; if response still poor to total daily dose of Madopar CR plus Madopar corresponding to 1.2 g levodopa-consider alternative therapy.
Cautions
For co-beneldopa Cushing's syndrome; diabetes mellitus; endocrine disorders; history of convulsions; history of myocardial infarction with residual arrhythmia; history of peptic ulcer; hyperthyroidism; open-angle glaucoma (monitor intra-ocular pressure); osteomalacia; phaeochromocytoma; psychiatric illness (avoid if severe and discontinue if deterioration); severe cardiovascular disease; severe pulmonary disease
Contraindications
For co-beneldopa Angle-closure glaucoma; suspicious undiagnosed skin lesions or history of skin melanoma (risk of activation)
Side effects
For co-beneldopa Common or very common Anxiety; appetite decreased; arrhythmia; depression; diarrhoea; hallucination; movement disorders; nausea; parkinsonism; postural hypotension; sleep disorder; taste altered; vomiting Rare or very rare Leucopenia Frequency not known Aggression; agranulocytosis; compulsions; confusion; delusions; dopamine dysregulation syndrome; drowsiness; eating disorders; euphoric mood; flushing; gastrointestinal haemorrhage; haemolytic anaemia; hyperhidrosis; oral disorders; pancytopenia; pathological gambling; psychosis; sexual dysfunction; skin reactions; sudden onset of sleep (can occur without warning); thrombocytopenia; tongue discolouration; tooth discolouration; urine discolouration
Pregnancy
For co-beneldopa Caution in pregnancy-toxicity has occurred in animal studies.
Breast feeding
For co-beneldopa May suppress lactation; present in milk-avoid.
Hepatic impairment
For co-beneldopa Manufacturer advises caution in mild to moderate impairment; avoid in decompensated hepatic function.
Renal impairment
For co-beneldopa Use with caution.
Medicinal forms
Solution,Tablet,Capsule,Capsule
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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