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What is Duopa?
DUOPA is a combination of carbidopa, an inhibitor of aromatic amino acid decarboxylation, and levodopa, an aromatic amino acid.
Carbidopa is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.2. It is designated chemically as (2S)-3-(3,4-dihydroxyphenyl)-2-hydrazino-2-methylpropanoic acid monohydrate. Its empirical formula is CHNO•HO, and its structural formula is:
The content of carbidopa in DUOPA is expressed in terms of anhydrous carbidopa which has a molecular weight of 226.3. The 4.63 mg/mL of anhydrous carbidopa is equivalent to 5.0 mg/mL of carbidopa.
Levodopa is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (2S)-2-Amino-3-(3,4-dihydroxyphenyl) propanoic acid. Its empirical formula is CHNO, and its structural formula is:
The inactive ingredients in DUOPA are carmellose sodium and purified water.
What does Duopa look like?
What are the available doses of Duopa?
Enteral Suspension: 4.63 mg carbidopa and
20 mg levodopa per mL
What should I talk to my health care provider before I take Duopa?
Pregnancy: Based on animal data,
may cause fetal harm
How should I use Duopa?
DUOPA is indicated for the treatment of motor
fluctuations in patients with advanced Parkinson’s disease.
DUOPA is administered over a 16-hour infusion period. The daily dose is determined by individualized patient titration and composed of:
The maximum recommended daily dose of DUOPA is 2000 mg of the levodopa component (i.e., one cassette per day) administered over 16 hours. At the end of the daily 16-hour infusion, patients will disconnect the pump from the PEG-J and take their night-time dose of oral immediate-release carbidopa-levodopa tablets.
Treatment with DUOPA is initiated in 3 steps :
DUOPA has an extra dose function that can be used to manage acute “Off” symptoms that are not controlled by the Morning Dose and the Continuous Dose administered over 16 hours. The extra dose function should be set at 1 mL (20 mg of levodopa) when starting DUOPA. If the amount of the extra dose needs to be adjusted, it is typically done in 0.2 mL increments. The extra dose frequency should be limited to one extra dose every 2 hours. Administration of frequent extra doses may cause or worsen dyskinesias.
Once no further adjustments are required to the DUOPA Morning Dose, Continuous Dose, or Extra Dose, this dosing regimen should be administered daily. Over time, additional changes may be necessary based on the patient’s clinical response and tolerability.
What interacts with Duopa?
Sorry No Records found
What are the warnings of Duopa?
Sorry No Records found
What are the precautions of Duopa?
Sorry No Records found
What are the side effects of Duopa?
Sorry No records found
What should I look out for while using Duopa?
is contraindicated in patients who are currently taking a nonselective
monoamine oxidase (MAO) inhibitor (e.g., phenelzine and tranylcypromine)
or have recently (within 2 weeks) taken a nonselective MAO inhibitor.
Hypertension can occur if these drugs are used concurrently .
What might happen if I take too much Duopa?
of acute overdosage with DUOPA is the same as management of acute
overdosage with levodopa. Pyridoxine is not effective in reversing
the actions of oral immediate-release carbidopa-levodopa.
In the event of an overdosage with DUOPA, the infusion should be stopped and the pump disconnected immediately. Administer intravenous fluids and maintain an adequate airway. Patients should receive electrocardiographic monitoring for arrhythmias and hypotension.
How should I store and handle Duopa?
Chemical StructureNo Image found
When levodopa is administered orally, it is rapidly decarboxylated to dopamine in extracerebral tissues so that only a small portion of a given dose is transported unchanged to the central nervous system. Carbidopa inhibits the decarboxylation of peripheral levodopa, making more levodopa available for delivery to the brain.
Levodopa is the metabolic precursor of dopamine, does cross the blood-brain barrier, and presumably is converted to dopamine in the brain. This is thought to be the mechanism whereby levodopa treats the symptoms of Parkinson's disease.
Non-Clinical ToxicologyDUOPA is contraindicated in patients who are currently taking a nonselective monoamine oxidase (MAO) inhibitor (e.g., phenelzine and tranylcypromine) or have recently (within 2 weeks) taken a nonselective MAO inhibitor. Hypertension can occur if these drugs are used concurrently .
Because DUOPA is administered using a PEG-J or naso-jejunal tube, gastrointestinal complications can occur.
These complications include bezoar, ileus, implant site erosion/ulcer, intestinal hemorrhage, intestinal ischemia, intestinal obstruction, intestinal perforation, , pancreatitis, peritonitis, pneumoperitoneum, and post-operative wound infection. These complications may result in serious outcomes, such as the need for surgery or death.
Instruct patients to notify their healthcare provider immediately if they experience abdominal pain, prolonged constipation, nausea, vomiting, fever, or melanotic stool .
The following serious adverse reactions are discussed below and elsewhere in labeling:
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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