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Madopar medicine 250mg is made in the form of tablets, with the main ingredients including levodopa and benserazide. Madopar is used to treat Parkinson's disease.
1. Uses of Madopar 250mg
Madopar 250mg contains 200mg of levodopa and 50mg of benserazide. Madopar is indicated for use in: Treatment of idiopathic Parkinson's disease. On the other hand, this drug is contraindicated for use in the following cases:
Patients with hypersensitivity to levodopa, benserazide or other ingredients in the drug; Do not combine Madopar with MAO inhibitors (non-selective monoamine oxidase inhibitors); Patients with endocrine disease, decompensated liver or kidney disease (except dialysis patients), psychiatric patients with psychotic manifestations, cardiovascular disorders or closed-angle glaucoma; Patients under 25 years old; Pregnant women, women of childbearing potential but not using birth control methods. The drug should be discontinued if pregnant while using Madopar; People with a history of or at risk of melanoma; Madopar should not be used concurrently with neuroleptics with antiemetic effects.
2. How to take Madopar 250mg
Drugs for oral use. When taking the capsule or Madopar HBS, the patient should swallow the capsule whole without the capsule. With regular Madopar tablets, the tablets can be broken to swallow.
Madopar tablets dissolve in about 25 - 50ml, tablets completely disintegrate, forming a milky solution in a few minutes. Because the solution has the ability to settle quickly, users need to stir well before drinking. Madopar soluble tablets should be taken within 30 minutes of preparing the solution.
With Parkinson's disease:
Madopar should be taken at least 30 minutes before eating or 1 hour after eating; Gastrointestinal side effects, which often occur early in the course of treatment, can be controlled by taking Madopar with light food (such as biscuits), liquid form, or by increasing the dose. wait a minute.
3. Dosage of Madopar 250mg
Treatment with Madopar 250mg should be gradually increased. Dosage should be individually assessed and adjusted to achieve the most effective dose. The dosing instructions below are for general guidance only.
3.1 Initial dose In the early stages of Parkinson's disease, patients should start treatment with 1 Madopar 62.5" capsule or 1/2 Madopar 125° tablet, administered 3-4 times/day. day; As soon as good tolerability is observed with the initial regimen, the dose should be gradually increased according to the patient's response; Optimal effect is usually achieved when the daily dose of Madopar is equivalent to 300 - 800 mg levodopa + 75 - 200 mg benserazide, divided into 3 times/day or more; It takes about 4-6 weeks of taking the drug to achieve optimal effect. If it is deemed necessary to further increase the daily dose, it should be increased monthly. 3.2 Maintenance treatment dose The average maintenance dose is 1 capsule or 1 tablet of Madopar 125mg, used with a frequency of 3 - 6 times/day; The number of times of drug administration for each patient should not be less than 3 times/day, the dosing interval should be adjusted for optimal effectiveness; Madopar HBS or soluble Madopar can be used to replace conventional Madopar for optimal effectiveness. 3.3 Special Dosing Notes The dose of Madopar should be carefully adjusted in all patients; Patients who are taking other Parkinson's drugs can still take Madopar. However, when treatment with Madopar is ongoing and the therapeutic effect becomes evident, the dose of other drugs can be gradually reduced or gradually discontinued; Madopar soluble tablets are suitable for patients with dysphagia or where a rapid onset of action is required; For patients known to have large fluctuations in the effect of the drug during the day, Madopar should be taken in divided doses with smaller doses or Madopar HBS form should be used; When switching from regular Madopar to Madopar HBS, it should be done from day to day with the dose starting in the morning. The dose and frequency of administration should be started at the same dose as that of regular Madopar. After 2-3 days, the dose should be gradually increased by approximately 50%. Patients should be informed by their doctor that their condition may be affected for a period of time. Due to the pharmacological properties of Madopar HBS, the duration of action is often delayed; A faster clinical effect may be obtained if Madopar HBS is co-administered with either soluble Madopar or conventional Madopar. This really helps with the first dose in the morning (it is recommended to take a slightly higher dose than subsequent doses of the day); Dosage determinations for patients receiving Madopar HBS should be done slowly and carefully, with at least 2-3 days intervals between each dose change; In patients immobilized at night, a positive effect was observed when the final evening dose was gradually increased to 250 mg of Madopar HBS administered at bedtime; Over-response to Madopar HBS (dyskinesia) can be controlled by increasing the dosing interval; In case of poor response to Madopar HBS, treatment with standard Madopar or dispersible Madopar should be reintroduced; Patients treated with Madopar should be carefully monitored for psychiatric adverse events. 3.4 Treatment of overdose and missed dose Overdose: Symptoms of overdose are similar to the side effects of Madopar at therapeutic doses but more severe. Overdose may lead to: Arrhythmia, confusion, insomnia, nausea, vomiting, abnormal movements,... Treatment includes: Monitor vital signs, establish supportive measures, symptomatic treatment,...
Missed dose: When a dose of Madopar is forgotten, the patient should take it as soon as possible. If it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time.
4. Side effects of Madopar 250mg
Some side effects that patients may encounter when using Madopar 250mg include:
Blood and lymphatic system disorders: Hemolytic anemia, leukopenia, thrombocytopenia; Psychiatric disorders: Dopamine disorder, depression, agitation, anxiety, insomnia, hallucinations, delusions, disorientation, pathological gambling, increased libido, hysteria; Nervous system disorders: Loss of taste, dysgeusia, dyskinesias (chorea and choreography), fluctuations in response to therapy, refractory phenomena, on-off phenomena, somnolence, somnolence sudden onset; Cardiovascular disorders: Arrhythmia; Vascular disorders: Postural hypotension; Gastrointestinal disorders: Nausea, vomiting, diarrhea, discolored saliva, discolored teeth, discolored oral mucosa, gastrointestinal bleeding, loss or change of taste; Hepatobiliary disorders: Increased transaminases, increased alkaline phosphatase, increased Gamma - glutamyltransferase; Skin and subcutaneous tissue disorders: Skin itching, rash; Musculoskeletal and connective tissue disorders: Restless leg syndrome; Renal and urinary tract disorders: Blood urea increased.
5. Be careful when taking Madopar 250mg
Some notes users need to remember before and while taking Madopar:
When using Madopar with other drugs, patients should be carefully monitored for unusual side effects or increased effects of Madopar. medicine; Madopar may cause hypersensitivity reactions in susceptible patients; It is important to regularly measure intraocular pressure in patients with open-angle glaucoma because levodopa (the main ingredient of Madopar) can increase intraocular pressure; Madopar should be used with caution in patients with a history of coronary artery disease, heart failure or arrhythmia; It is necessary to monitor and take special care of heart function in patients receiving Madopar in the early stages of treatment and periodically throughout the course of drug use; Closely monitor the health status in patients taking Madopar and at risk such as advanced age, concomitant use of antihypertensive drugs or drugs that can cause orthostatic hypotension, who have a history of hypotension. orthostatic blood pressure (especially during the initial phase of drug administration or when increasing the dose); Madopar may cause a decrease in the number of blood cells (thrombocytopenia, leukopenia, hemolytic anemia). Some cases of agranulocytosis and pancytopenia. Therefore, it is necessary to periodically check the blood count during treatment with the drug; Patients treated with Madopar may experience depression, restless legs syndrome. Patients should be carefully monitored for mental changes and depression; If a patient taking Madopar requires general anesthesia, it should be continued as close to the day of surgery as possible (except in the case of halothane anesthesia). If you have general anesthesia with halothane, you should stop taking Madopar about 12 - 48 hours before surgery because it can cause fluctuations in blood pressure, arrhythmia. Madopar can be continued after surgery, the dose should be increased gradually until the dose applied before surgery; Madopar should not be stopped abruptly because it may cause high fever, muscle spasticity, mental changes, increase in serum creatinine and phosphokinase, myoglobinuria, acute renal failure, rhabdomyolysis,... If the above symptoms appear, the patient should be closely monitored, if necessary for hospitalization, rapid symptomatic treatment. This includes re-treatment with Madopar after a full evaluation; The levodopa component in the drug has been linked to drowsiness or irregular sleep patterns. Patients should be informed of this, and should be careful when driving or operating machinery while being treated with levodopa. Patients who have experienced somnolence or sudden sleep disturbances should refrain from driving or operating machinery while taking this medication. Furthermore, the patient may consider reducing the dose or discontinuing treatment; Patients need periodic health monitoring to detect impulse control disorders. Patients and caregivers need to be aware of symptoms such as: Pathological gambling, hypersexuality, increased libido, uncontrolled shopping, binge eating and drinking, etc. Should be reconsidered treatment if these symptoms appear; Patients with Parkinson's disease have a higher than normal risk of developing melanoma. Therefore, patients using Madopar should monitor their health regularly (periodic skin examination) to detect melanoma; Dopaminergic drugs: Patients using Madopar may have a pathological state of playing cards, increased libido and excessive sexual activity; Madopar is contraindicated in pregnant women and women of childbearing potential but not using contraceptive methods. Breastfeeding mothers should not use the drug to avoid the risk of bone deformities in the baby; No dose reduction is required when administering Madopar in patients with mild and moderate renal impairment; There are no data on the use of Madopar in patients with liver failure, patients need to be cautious, follow all instructions of the doctor.
6. Madopar 250mg . drug interactions
6.1 Pharmacokinetic Interactions Co-administration of regular Madopar with the anticholinergic trihexyphenidyl reduces the rate of absorption of levodopa, not the extent of absorption. Co-administration of trihexyphenidyl with Madopar HBS did not affect the pharmacokinetics of levodopa; Concomitant use of Madopar HBS with antacids reduces the extent of absorption of levodopa. Iron sulphate may reduce the maximum plasma concentration and AUC of levodopa; Metoclopramide may increase the rate of absorption of levodopa. 6.2 Pharmacodynamic interactions Opioids, sedatives and reserpine-containing antihypertensives all inhibit the effect of Madopar; If Madopar is to be used in patients receiving irreversible and non-selective MAO inhibitors, the MAO inhibitors should be discontinued at least 2 weeks prior to treatment with Madopar. Otherwise, side effects such as high blood pressure may occur; Selective MAO-B inhibitors (including selegiline and rasagiline) and selective MAO-A inhibitors (such as moclobemide) may be indicated for patients taking Madopar. The dose of levodopa should be adjusted individually for each patient based on efficacy and tolerability; The combination of MAO-A and MAO-B inhibitors is equivalent to non-selective MAO inhibitors, so this combination should not be used with Madopar; Do not take Madopar with epinephrine, norepinephrine, isoproterenol or amphetamine (sympathomimetic stimulants) because levodopa can increase the effects of these drugs. If necessary, the cardiovascular system should be closely monitored, the dose of sympathomimetic drugs should be reduced; Concomitant use of antipsychotics with dopamine receptor blocking properties may antagonize the antiparkinsonian effects of Madopar. Levodopa may reduce the antipsychotic effects of these drugs, so caution should be exercised when combining them. 6.3 Other drug interactions Madopar 250mg can be combined with other drugs such as: anticholinergics, selegiline, amantadine, bromocriptine and dopamine agonists but may increase desired effects and side effects. Therefore, it is necessary to reduce the dose of Madopar or the above drugs. When starting treatment with COMT inhibitors, the dose of Madopar should be reduced; Anticholinergics should not be stopped suddenly when starting Madopar because levodopa takes time to work; Levodopa can also affect the results of some tests for catecholamines, creatinine, uric acid, and glucose. Urine test results may give false positives for ketone bodies. The coombs test may give false positive results if performed in patients receiving Madopar; The effectiveness of Madopar is reduced when it is taken with a high-protein meal; Madopar should be discontinued 12 to 48 hours before surgery requiring general anesthesia with halothane to avoid the risk of blood pressure fluctuations and cardiac arrhythmias. Madopar 250mg is a brand name medicine used to treat Parkinson's disease. When taking medication, the patient must strictly follow the doctor's instructions. If you experience adverse side effects, the patient should also notify the doctor immediately.
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