Our last full discussion of Parkinson’s disease recommended using the minimum effective dose of levodopa in combination with a peripheral dopa decarboxylase inhibitor1 - carbidopa in Sinemet (co-careldopa) and benserazide in Madopar (co-beneldopa). Combined formulations offer levodopa in various doses together with an inhibitor: Madopar 62.5 contains levodopa 50mg + benserazide 12.5mg base; low strength Sinemet, Sinemet-LS, contains levodopa 50mg + carbidopa 12.5mg. Both these preparations offer a relatively low dose but the Sinemet-LS tablet is scored and the 62.5mg tablet of Madopar Dispersible can be broken so that even lower doses can be used. This article examines when these small doses are useful.
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