Tidomet Forte tabs 25mg/250mg #100

Tidomet Forte instruction

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Composition

1 tablet contains levodopa 250 mg and carbidopa 25 mg.

Form of issue

Tablets in contoured packages; on 4, 10 and 100 pieces. in the box.

pharmachologic effect

Antiparkinsonian action.
Levodopa is an amino acid from which dopamine is formed with the participation of amino acid decarboxylase. Levodopa can be converted already in peripheral tissues to dopamine, which can not penetrate the blood-brain barrier (GEB).
Carbidopa is an inhibitor of decarboxylase, prevents the conversion of levodopa into dopamine in the peripheral tissues; through the BBB does not pass and does not affect the synthesis of dopamine from levodopa in the central nervous system. Therefore, the combination of carbidopa and levodopa increases the amount of levodopa entering the brain. Carbidopa doubles the bioavailability of levodopa.

Pharmacodynamics and pharmacokinetics

Eating slows the absorption of levodopa. The maximum possible level of concentration in the blood is determined after taking, after 1 -2 hours. About 75% of the levodopa taken is metabolized in the intestine.
The half-life of levodopa in combination with carbidopa is 3 hours. It is excreted in the urine.
Carbidopa does not pass through the BBB. The maximum concentration in the blood is approximately 2-4 hours. About 50% of carbidopa is excreted through the intestine and kidneys.

Indications for use

    Parkinsonism syndrome (postencephalitic parkinsonism, after intoxication with manganese or carbon monoxide);
    Parkinson's disease.

Contraindications

    closed-angle form of glaucoma;

    mental disorders;
    melanoma;
    skin diseases of unexplained genesis;
    Huntington's chorea;
    essential tremor;
    The use of nonselective monoamine oxidase inhibitors;
    secondary parkinsonism, caused by the use of antipsychotics (neuroleptics);
    Children under 18 years of age due to a lack of safety and efficacy data;
    individual intolerance.
With caution appoint with gastric ulcer and duodenal ulcer, epilepsy, heart failure, myocardial infarction and heart rhythm disturbances, severe liver and kidney damage, endocrine system diseases, mental disorders, bronchial asthma.

Side effects

Often: nausea, dyskinesia. When there is muscle twitching and blepharospasm, the drug should be discarded.
Nervous system: delirium, hallucinations, malignant neuroleptic syndrome, bradykinesia, agitation, paresthesia, headache, dizziness, nightmares, insomnia; confusion, depression, dementia, increased sexual desire.
Digestive system: vomiting, eating disorders, dyspepsia, taste change, dry mouth, diarrhea, constipation, bleeding from the digestive tract, duodenal ulcer.
Cardiovascular system: palpitation, arrhythmias, orthostatic hypotension.
The hemopoietic system: hemolytic anemia, thrombocytopenia, leukopenia, agranulocytosis.
Allergic reactions: urticaria, hemorrhagic vasculitis, skin itching, reactions similar to pemphigus, angioedema.
Respiratory system: respiratory tract infections, dyspnea.
Skin: sweating, skin rash, baldness.
Urinary system: frequent urination, urinary tract infections.
Laboratory indicators: increased activity of ALT (alanine aminotransferase) and AST (aspartate aminotransferase), alkaline phosphatase, lactate dehydrogenase, increased urea levels, bilirubin, hyperglycemia, hematuria, leukocyturia, bacteriuria.

Instructions for use Tidomet (Method and dosage)

Is taken orally, during meals or after. Tablets are not chewed, washed down with water. During the treatment period it is not recommended to take large amounts of protein. The maximum daily dose of levodopa is 2000 mg, carbidopa is 100 mg.
Treatment begins with the initial dose - 1/2 tab. twice a day. Then, if necessary, increase the dose by 0.5 tablets. 2 times a day. At the beginning of therapy, the daily dose is no more than 3 tablets divided into 3 doses. The daily dose of the drug can be increased, but not more than 8 tablets, divided into 8 receptions. When appointing a dose exceeding 6 tablets per day, strict medical supervision is necessary.
Instruction on Tidomet Forte recommends before the beginning of therapy to stop taking 12 hours of Levodopa, and when treating with prolonged forms - for 24 hours. The maintenance dose is a dose of up to 6 tablets per day.

Overdose

In case of an overdose, gastric lavage, ECG monitoring and monitoring are performed for the diagnosis of arrhythmia; in the case of arrhythmias - antiarrhythmic therapy.

Interaction

With simultaneous use with antihypertensive drugs, exercise caution in connection with the risk of orthostatic hypotension.
Use with monoamine oxidase (MAO) inhibitors can cause circulatory disorders - increased blood pressure, tachycardia, reddening of the face. Therefore, the administration of MAO inhibitors is stopped 14 days before the start of therapy.
Admission simultaneously with tricyclic antidepressants can cause arterial hypertension, dyskinesia, a decrease in the bioavailability of levodopa.
The drug may increase the effect of adrenomimetics, so their dose should be reduced. The use of levodopa with beta-adrenomimetics may increase the risk of developing cardiac arrhythmias.
Amantadine with levodopa causes a mutual potentiating effect.
Levodopa in combination with methyldopa increases the risk of side effects of each other.
Simultaneous administration with diazepam, phenytoin, phenothiazine derivatives, butyrophenone, thioxanthene, clonidine, papaverine, pyridoxine, reserpine, M-holinoblokatorami can reduce the antiparkinsonian effect of the drug.
Use with lithium drugs increases the likelihood of developing hallucinations and dyskinesias.
Preparations of iron reduce the bioavailability of the drug.

Storage conditions

Keep away from children, dry and protected from light, the temperature does not exceed 30 ° C.
Shelf life - 3 years.

special instructions

Do not use in Parkinsonism caused by the use of neuroleptics.
Stop treatment with the drug should be gradual, to avoid the development of a symptom complex similar to malignant neuroleptic syndrome (muscle rigidity, increased activity of creatine phosphokinase in the blood, increased body temperature).
When taking Tidomet Forte, constant monitoring of the mental status and activity of the heart is necessary.
Patients with open-angle glaucoma should be administered with caution; constant monitoring of intraocular pressure is necessary.
In the process of treatment, it is not recommended to drive a car and perform work that requires special attention.
It should be remembered that in elderly patients the absorption of levodopa is better than in young patients.

Children

Data on the safety of use in children under 18 years is not enough.

In pregnancy and lactation

Use in case the expected benefit of therapy for the mother exceeds the risk to the fetus. When using the drug during lactation, breastfeeding is discontinued.

Tidomet Forte Reviews

Patients and their relatives note the side effects of the drug in the form of jumps of blood pressure, nausea and insomnia. There is a review of the progression of the disease on the background of taking the drug. In any case, the choice of therapy for Parkinsonism should be carried out by a specialist.