It is necessary with precautions to combine Nakom with the following medicines:
Antihypertensives - in people taking such drugs, adding to the combination of Nakoma became the cause of postural hypotension (symptomatic). Because of this, at an early stage of Nakoma's use, correction of the dosage of antihypertensive drugs may be necessary.
Antidepressants - a combination of levodopa and MAO inhibitors (except for drugs such as MAO B) can lead to a disorder of the circulatory system, and therefore it is required to complete the use of inhibitors 2 weeks before the onset of Nakoma. This disorder arises from the cumulation of dopamine with norepinephrine under the influence of levodopa - their inactivation is slowed by MAO inhibitors. As a consequence, the risk of tachycardia and feelings of excitement increases, and in addition to dizziness, redness of the face and increased blood pressure.
There is some information about the development of side effects, including dyskinesia and an increase in blood pressure, when combining drugs with tricyclics.
Iron medications - the level of bioavailability of levodopa or carbidopa decreases in the case of combined use with gluconate / ferrous sulphate.
Other medications - when levodopa is combined with dithilin, β-adrenostimulants, and in addition with drugs used in inhalation anesthesia, the likelihood of heart rhythm disturbances may increase.
Antagonists of dopamine D2 receptors (among them risperidone with phenothiazines, as well as butyrophenones), and besides isoniazid - are able to weaken the medicinal action of levodopa.
There is evidence of a blocking of the positive drug effect of levodopa in the case of a tremor paralysis due to a combination with papaverine and phenytoin. It is necessary to closely monitor the condition of persons who use these drugs in combination - in time to detect a weakening of the medicinal effect.
Lithium drugs increase the likelihood of hallucinations or dyskinesias. Enhancement of adverse reactions is observed when combined with methyldopa, and a combination with tubocurarine increases the possibility of lowering blood pressure.
There may be a violation of absorption of levodopa in people who use a high-protein diet, since levodopa is a competitor to individual amino acids.
The effect of pyridoxine (the acceleration of the metabolism of levodopa in dopamine inside the peripheral tissues) may be impaired by carbidopa.