4.9.1 Dopaminergic drugs used in Parkinsonism |
Levodopa with a dopa-decarboxylase inhibitor is the treatment of choice for patients disabled by idiopathic Parkinson's disease. |
Therapy should be initiated with low doses, gradually increased. Final dose may be a compromise between mobility and side- |
effects. |
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GREEN Co-beneldopa (benserazide/levodopa) |
dispersible tablets 25/100 (Madopar 125®) |
capsules m/r 25/100 (Madopar CR 125®) |
GREEN Co-careldopa (carbidopa/levodopa) |
tablets 10/100 (Sinemet-110®), 25/250 (Sinemet-275®) |
tablets 25/100 (Sinemet-Plus®) |
tablets m/r 25/100 (Sinemet Half CR®), 50/200 (Sinemet CR®) |
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Other dopaminergic drugs |
In Parkinson’s disease pramipexole is seen as the dopamine agonist of choice in the movement disorders clinic, with cabergoline |
and ropinirole also seen as useful. Dose titration by GPs should be carried out in line with specialist nurse or clinician |
recommendations after the initial prescription. |
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AMBER Amantadine capsules 100mg & syrup 50mg/5mL |
AMBER Apomorphine injection (APO-go®) Click here for shared care agreement |
AMBER Cabergoline tablets 1mg, 2mg, 4mg |
AMBER Pramipexole (generic only) tablets 88mcg, 180mcg, 350mcg, 700mcg |
AMBER Pramipexole MR preparations (generic only) |
260mcg, 520mcg, 1.05mg, 1.57mg, 2.1mg, 2.62mg, 3.15mg |
(MR preparations are only for use only when there are compliance issues) |
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AMBER Rasagiline tablets 1mg |
AMBER Selegiline tablets 5mg, 10mg |
AMBER Ropinirole tablets 250micrograms, 1mg, 2mg, 5mg |
Starter pack (42 x 0·25 mg, 42 x 0·5 mg, 21 x 1 mg). |
Follow-on pack (42 x 0·5 mg, 42 x 1 mg, 63 x 2 mg) |
AMBER Ropinirole prolonged release, once daily tablets |
2mg, 4mg, 8mg. |
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AMBER Levodopa /carbidopa/ entacapone |
Stalevo®, Stanek® tablets 50/12.5/200 |
Stalevo®, Stanek® tablets 100/25/200 |
Stalevo®, Stanek® tablets 150/37.5/200 |
AMBER *Sastravi® tablets - NB: secondary care use only, who will prescribe and label generically. |
*Primary Care Prescribers to issue as Stanek® or Stalevo®; |
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AMBER Entacapone tablets 200mg |
RED Tolcapone tablets – Requires intensive LFT monitoring. |
AMBER Opicapone (Ongentys®) 50mg hard capsules |
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Note: Opicapone is recommended as a second line catechol-o-methyltransferase inhibitor in adult patients with Parkinson's disease with |
'end of dose' motor fluctuations who cannot be stabilised on levodopa/DDCI inhibitors and who fail to respond to or are intolerant |
of entacapone, where tolcapone is being considered. |
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BLACK Safinamide (Xadago®) 50mg and 100mg film-coated tablets |
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NICE TA934 Foslevodopa–foscarbidopa for treating advanced Parkinson's with motor symptoms |
Foslevodopa–foscarbidopa is recommended as an option for treating advanced levodopa-responsive Parkinson's in adults whose |
symptoms include severe motor fluctuations and hyperkinesia or dyskinesia, when available medicines are not working well |
enough, only if: |
> they cannot have apomorphine or deep brain stimulation, or these treatments no longer control symptoms, and |
> the company provides foslevodopa–foscarbidopa according to the commercial arrangement. |
RED Foslevodopa–foscarbidopa (Produodopa) 240 mg/12 mg per ml solution for infusion |
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