Madopar

Madopar belongs to the antiparkinsonian drugs based on levodopa.

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Indications Madopar

Madopar may be indicated for the treatment of any variation of Parkinson's disease. The exception is drug-induced parkinsonism.

In addition, Madopar can be used for the specific therapy of idiopathic and symptomatic restless legs syndrome.

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Release form

Madopar is available in capsule form (size #1), with a dense bluish-green capsule and a deep green cap, with small powder granules inside. The capsule clearly has the word "Roche" on it.

The active component is represented by two substances: levodopa and benserazide.

The standard package contains 100 pcs. of the encapsulated preparation in a brown bottle with a screw cap. The cap has a control strip to guarantee the "first opening" of the bottle.

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Pharmacodynamics

One of the main ingredients of Madopar, levodopa, is a link in the production of dopamine, a neurotransmitter in the brain. It is dopamine deficiency that is considered the main factor in the pathogenesis of Parkinson's disease.

Madopar is used primarily to increase dopamine levels, as this drug perfectly overcomes the blood-brain barrier. After entering the CNS structures, levodopa is transformed into dopamine through a complex bioreaction.

Dopamine plays one of the main roles in the development of restless legs syndrome, so the use of Madopar in this case is also completely justified.

Madopar is a combination of levodopa and benserazide - this combination is optimal, which is confirmed by clinical and therapeutic trials. This combination allows to correct the lack of dopamine in the brain structures.

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Pharmacokinetics

The components of Madopar are slowly absorbed in the digestive tract. The maximum plasma concentration is reached 3 hours after taking the medication.

Levodopa crosses the blood-brain barrier without binding to plasma proteins. The distribution volume is 57 l.

The second active ingredient, benserazide, is unable to pass through the blood-brain barrier. Its accumulation is recorded in the tissues of the liver, kidneys, lungs and small intestine.

The main products of drug metabolism are homovanillic and dihydroxyphenylacetic acid. The half-life of the main plasma metabolite is 15 to 17 hours, which means that when taking standard doses of the drug, the patient's body experiences an accumulation of active substances.

Benserazide is almost entirely excreted in the form of metabolites: more than 60% with urine, more than 20% with feces.

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Dosing and administration

The standard dosage at the beginning of treatment is 1 capsule of Madopar 125 mg three times a day for 7 days.

After this, the dosage is increased by one capsule weekly, monitoring the effect of the drug. Having achieved the optimal effect, the dosage increase is stopped. Usually, 4-8 capsules of 125 mg (sometimes up to 10 pcs.) daily, divided into three doses, are sufficient.

The standard maintenance dose of the drug is 250 mg Madopar three times a day.

The capsules are swallowed whole, without opening or chewing.

The exact dosage and frequency of administration are carefully determined for each individual patient.

Use Madopar during pregnancy

Madopar is strictly contraindicated for use not only by pregnant women, but also by women of childbearing age who are not using adequate contraception or are not using contraception at all.

If during the period of Madopar therapy the doctor diagnoses pregnancy in the patient, the drug is strictly discontinued.

Madopar negatively affects the amount of breast milk in a nursing woman, and can also affect the abnormal development of the baby's skeletal system. For these reasons, lactation and the simultaneous use of Madopar are incompatible.

Contraindications

• Diagnosed hypersensitivity to any ingredient of the drug.
• Concomitant use of MAO inhibitor drugs.
• Decompensated conditions associated with the functioning of the endocrine system, kidneys, liver, heart, as well as psychopathology with psychotic elements.
• Closed-angle glaucoma.
• The period of pregnancy and breastfeeding.

In addition, Madopar is not used to treat patients under 25 years of age (the period of completion of bone growth).

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Side effects Madopar

• Feelings of anxiety, sleep disturbances, delusional and hallucinatory states, spatial disorientation, depression, headaches, episodic uncontrolled movements, episodes of drowsiness, dizziness.
• Dyspepsia, taste disturbance, thirst.
• Heart rhythm disturbances, changes in blood pressure.
• Runny nose, bronchitis.
• Anemia, changes in the number of leukocytes and platelets.
• Rashes, itching.
• Emaciation.
• Infectious diseases.

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Overdose

An overdose is characterized by the appearance of the following symptoms:

• heart rhythm disturbances;
• disturbances of consciousness;
• sleep disorders;
• attacks of nausea and vomiting;
• uncontrolled motor activity.

Treatment in such situations consists of prescribing symptomatic medications: medications to support the respiratory system, antiarrhythmic drugs, neuroleptics. The main goal for the doctor is to control the vital functions of the body.

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Interactions with other drugs

The combination of Madopar with other medications can be controlled according to the following table:

Trihexyphenidyl	Reduces the rate of absorption of Madopar
Antacids	Reduces the absorption of Madopar
Ferrous sulfate	Reduces the maximum concentration of Madopar in plasma.
Metoclopramide	Accelerates the absorption of Madopar
Neuroleptics, reserpine-based drugs and opium preparations	Suppresses the properties of Madopar
Sympathomimetics	Their action is enhanced under the influence of Madopar.
Other antiparkinsonian drugs	They mutually enhance the effect and increase the likelihood of side effects.
COMT inhibitors	Requires a reduction in the dosage of Madopar
Protein rich food	Disrupts the absorption of Madopar from the digestive system

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Storage conditions

The antiparkinsonian drug Madopar is stored in places completely inaccessible to children's pranks. The optimal storage temperature is up to +30°C.

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Shelf life

Madopar is stored for up to 3 years in its original packaging.

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