The carbidopa-levodopa dosing guidelines your healthcare provider will follow depend on factors such as how you respond to the drug and other medications you are taking. A dosage of 25-100 mg three times daily is often recommended when beginning the medication; your healthcare provider may then slowly increase your dose. Do not adjust your carbidopa-levodopa dosage unless your healthcare provider specifically instructs you to do so.
The dose of carbidopa-levodopa (Sinemet®) your healthcare provider recommends will vary, depending on a number of factors, including:
- How you respond to carbidopa-levodopa (especially if you develop bothersome side effects)
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
There is no standard carbidopa-levodopa dosage that will work for all people. Instead, the dose must be individualized. Typically, people start with a dose of carbidopa-levodopa 25-100 mg (25 mg of carbidopa and 100 mg of levodopa) three times daily. Your healthcare provider will probably recommend a gradual increase of the dose (usually by one tablet every day or every other day) until a dose of eight carbidopa-levodopa 25-100 mg tablets are taken per day (often as two tablets four times a day). However, you may require more or less carbidopa-levodopa, and you may need more or less of the individual components of the drug.
Carbidopa-levodopa comes in three different strengths that are designed to allow flexibility in dosing the individual components of carbidopa-levodopa. These strengths include:
- Carbidopa-levodopa 10-100 mg (10 mg of carbidopa and 100 mg of levodopa)
- Carbidopa-levodopa 25-100 mg (25 mg of carbidopa and 100 mg of levodopa)
- Carbidopa-levodopa 25-250 mg (25 mg of carbidopa and 250 mg of levodopa).
Most people need at least 70 mg to 100 mg of carbidopa a day in order to avoid severe nausea and vomiting due to the levodopa component. Doses that provide less than 70 mg of carbidopa per day are likely to cause severe nausea and vomiting.
Do not suddenly stop taking carbidopa-levodopa, as a serious group of side effects, known as neuroleptic malignant syndrome (NMS), may occur. Symptoms of NMS include:
- A high fever
- Stiff muscles
- Irregular pulse or blood pressure
- A fast heart rate (tachycardia)
- Irregular heart rhythms (arrhythmias).