L-Dopa

Question 1

Dose and administration frequency

Answer 1

• Initial dose: typically starts at a low dose to minimize side effects, usually 100-300mg per day, divided into several doses

• Maintenance dose: gradually increased on individual needs and tolerance, often between 300-800 mg daily, sometimes higher

• Frequency: Given in 3-6 doses per day to maintain stable blood levels
Extented-release formulations: administered 1-3 times daily for improved compliance

Question 2

Side effects

Answer 2

Classified as early averse effects and long-term complications

• early disease effects:
- digestive: nausea and vomiting due to peripheral dopamine stimulation of the chemoreceptor trigger zone, loss of appetite

• cardiovascular: orthostatic hypotension
• neurological/psychiatric: drowsiness, confusion, anxiety or agitation

• long term complications
- motor fluctuations:
*‘on-off phenomenon’ = alternating periods of normal mobility (on) and akinesia (off)
*dyskinesia: involuntary, abnormal movements during ‘on’ phases

• neuropsychiatric effects:
• impulses control disorders (shopping, hyper sexuality)
• depression or psychosis

Question 3

Practical tips

Answer 3

• Absorption can be influenced by food, particularly proteins, so timing with meals is crucial
- Take Levodopa away from protein-rich meals 30 minutes to 1 hour before a meal or 2 hours after if possible

Due to the competition for intestinal absorption and at the brain level

• Regular medical follow-up are essential to adjust doses and monitor for complications