Levokom

Levokom is an anti-Parkinsonian drug from the group of dopaminergic medicines.

Indications of the levocoma

It is used for parkinsonism and Parkinson's disease.

Release form

Release of the medicine is carried out in tablets, 10 pieces inside the blister plate. In the box there are 3 or 10 such plates.

Pharmacodynamics

Levokom is a complex antiparkinsonian drug, the constituent of which is carbidopa (a component that slows down the decarboxylase of amino acids of an aromatic nature) with levodopa (a metabolic element preceding dopamine, which, unlike dopamine itself, can pass through the BBB).

As a result of the process of decarboxylation, the levodopa inside the cerebrospinal tissues is transformed into dopamine, replacing its deficiency and thus reducing the manifestations of Parkinsonism. Levodopa reduces the severity of many signs of the disease, especially rigidity, and in addition bradykinesia. Together with this, it weakens the dysphagia with tremor, ptialysis and orthostatic instability, which arise due to Parkinson's disease and parkinsonism.

But most of the levodopa used orally is transformed into dopamine in the extra-cerebral environment, without penetrating the BBB.

Carbidopa can not pass through the BBB. It prevents the process of extracerebral decarboxylation of the element of levodopa, thereby increasing the volumes of levodopa, which penetrates into the brain and is converted into dopamine inside it.

Among the benefits of a complex medicine is a stronger drug treatment and better patient sensitivity when compared with levodopa. In addition, there are fewer side effects, because lower portions of levodopa are used to obtain a medicinal effect.

Levokom helps to ensure a long-term maintenance of the drug concentration of levodopa within the blood plasma. Carbidopa prevents the activity of pyridoxine hydrochloride, which allows to increase the rate of peripheral metabolic processes of levodopa.

Pharmacokinetics

The existing elements that make up the LS pass through the inherent transformations. Levodopa is perfectly absorbed inside the gastrointestinal tract (most of it inside the small intestine).

The distribution of matter is carried out inside the tissues together with the organs. Levodopa passes through complex metabolic transformations (the main one is decarboxylation, in which it is transformed into noradrenaline, dopamine with adrenaline). Metabolism products are excreted with the help of kidneys.

About 80% of levodopa is excreted in urine, most in the form of homovaniline and 2-hydroxyphenylacetic acids. Unchanged excreted less than 1% of drugs. The half-life of the substance from the plasma is approximately 1 hour (with the participation of carbidopa this segment is prolonged to 2 hours).

Carbidopa (α-methyldophahydrazine), when administered orally, is fast, although not completely absorbed inside the digestive tract. It is distributed within the body, but does not pass through the BBB. About 50% of drugs in the form of an unchanged component and its decay products are excreted with the help of kidneys.

Dosing and administration

The medicine is used orally. Each individual patient needs to choose a suitable daily dose individually.

People who are just starting therapy should be given a dosage of 0.5 tablets with a 1-2-fold intake per day, after eating. If necessary, the dosage can be gradually increased - every day or every other day, 0.5 tablets, until the desired medication result is achieved.

For the day allowed to use no more than 8 tablets of Levocom (0.2 g carbidopa, as well as 2 g of levodopa).

[1]

Use of the levocoma during pregnancy

The medicine can not be administered to pregnant and breastfeeding mothers.

To prevent the development of negative symptoms in the infant, you either have to give up breastfeeding, or cancel the use of the medication - the choice is made based on the evaluation of the importance of taking drugs for the mother.

Contraindications

The main contraindications:

• the presence of hypersensitivity to any element of the drug;
• glaucoma.
• application in combination with MAOI;
• skin diseases that have not been diagnosed, or a history of melanoma.

Side effects of the levocoma

After using Levocome, there are often negative manifestations associated with central neuropharmacological effects of dopamine - such as dyskinesia (among them choreiform), muscle twitchings, dystonic and other involuntary movements, and also blepharospasm. Such side effects occur after a reduction in the portion of the drug.

Among other serious negative symptoms - dementia, a change in mental state (this includes paranoid signs and transient psychosis), and in addition depression, against which there are suicidal intentions.

Sometimes there are heart rhythm disturbances, increased heart rate, orthostatic collapse, signs of disinhibition or inhibition, and vomiting, drowsiness, dizziness or nausea, and anorexia.

Occasionally bleeding occurs in the gastrointestinal tract, development of intestinal ulcers, phlebitis, anemia (hemolytic or non-hemolytic), leukemia or thrombocytopenia, and agranulocytosis. In addition, there are convulsions, dyspnoea, pain after the sternum and paresthesia, as well as the blood pressure values increase.

During therapy with levodopa, as well as carbidopa, there may be deviations from normal indices of different laboratory tests - for example, alkaline phosphatase, liver, LDH, ALT and AST, as well as bilirubin, and in addition a positive response from the Coombs test. Hemoglobin with hematocrit may also decrease, blood glucose levels within the blood serum and the number of bacteria with leukocytes inside the urine increase.

Other negative manifestations:

• disrupting the work of the National Assembly: numbness, muscle twitching, ataxia affecting the hands of tremors, and besides trismus, blepharospasm, which has a tonic character, gait disorder and activation of Horner's latent syndrome;
• mental disorders: insomnia, a sense of anxiety, confusion, euphoria and arousal. There are also hallucinations, delusions and nightmares;
• problems with the digestive function: burning in the tongue, dryness of the oral mucosa and bitterness in the mouth, dysphagia and hypersalivation. In addition, there are pain in the peritoneum, attacks of hiccough, diarrhea, constipation and bloating;
• disorders of metabolic processes: the appearance of swelling, as well as increase or decrease in weight;
• lesions of the skin surface: hyperhidrosis, flushing of the blood to the skin on the face, alopecia and rashes. Also, sweat can be painted in a dark shade;
• disorders of the function of the urogenital system: urinary incontinence or delay, dark urine and priapism;
• disturbances in the work of the senses: mydriasis and diplopia, and also oculomotor crisis;
• other symptoms: a feeling of malaise and weakness, hot flashes, hoarse voice, dyspnea, headaches, dental scrape, malignant melanoma and ZNS.

Overdose

Signs of poisoning: among the early symptoms - muscle twitching and blepharospasm. Also, the values of heart rate increase, the index of blood pressure increases and appetite is weakened. There is a feeling of anxiety, anxiety and excitement, and at the same time confusion of consciousness, and besides insomnia.

To eliminate symptoms requires an emergency gastric lavage and induction of vomiting.

Symptomatic measures are also performed: the infusions are carefully performed, the level of patency of the respiratory ducts is monitored, when the arrhythmia develops, perform the appropriate procedures while monitoring the ECG. There is no evidence of the effect of dialysis on these disorders. The use of pyridoxine will not have an effect.

Interactions with other drugs

In people who use antihypertensive drugs, a drug can provoke the development of manifestations of orthostatic collapse. In this regard, it is necessary to correct portions of antihypertensive drugs at the initial stage of therapy with the use of Levocom.

When combined with tricyclics, negative symptoms can develop, including dyskinesia and increased blood pressure.

It is forbidden to combine the medicine with MAOI. These funds must be canceled within 14 days of the commencement of the use of Levocom.

Butyrophenones with phenothiazines can reduce the drug effect of the drug.

Phenytoin and papaverine are able to eliminate the antiparkinsonian effect of the drug.

Metoclopramide increases the levels of levodopa within the blood plasma.

Iron drugs can inhibit the absorption of levodopa.

The drug can be combined with other antiparkinsonian drugs, which do not contain levodopa.

In people who follow a diet with a large amount of protein consumed, there is a decrease in drug absorption.

[2], [3]

Storage conditions

The leftist is required to be kept in a place that is not accessible to young children. The temperature level is not more than 25 ° C.

[4]

Shelf life

Levokom can be used for 3 years since the manufacture of the drug.

Application for children

It is forbidden to appoint Levocom to children.

Analogues

The analogues of the medication are such drugs: Levocarbexal with Duodopa and Madopar, and in addition Carbidopa and levodopa, Nakom, Levok retard and Stalevo.