Twindopa Dosage/Direction for Use

Levodopa + Carbidopa (Twindopa) is used in adults orally. The optimal daily dose of the drug should be carefully selected for each patient.
Patients not receiving levodopa: For patients starting treatment with Levodopa + Carbidopa (Twindopa), the initial dose is 1/2 tablets once or twice daily after a meal. If necessary, increase the dose by gradual addition of 1/2 tablets daily or alternate day till optimal therapeutic effect is obtained.
Response has been observed in one day, and sometimes after one dose. Fully effective doses usually are reached within seven days as compared to weeks or months with levodopa alone.
Patients receiving levodopa: Levodopa should be stopped for at least 12 hours (24 hours for slow release) before starting treatment with Levodopa + Carbidopa (Twindopa). The easiest way is to take the drug in the morning, and at the same time do not use levodopa. The dose of the drug should contain approximately 20% of the previous daily dose of levodopa.
Initial dose: Patients who receive more than 1500 mg levodopa per day should start with a dose of 1 tablet 3-4 times a day.
Supportive therapy: Levodopa + Carbidopa (Twindopa) therapy should be individualized and adjusted gradually according to the therapeutic effect.
If necessary, the dose of the drug can be increased to 1 tablet 3-4 times a day. If necessary, the dose of the drug can be increased by 1 tablet per day or on alternate day. The maximum daily dose of Levodopa + Carbidopa (Twindopa) is 8 tablets (200 mg carbidopa and 2 g levodopa).
Patients receiving other decarboxylase inhibitors: When a patient is switched from a combination of levodopa to other decarboxylase inhibitors, the use of these drugs should be stopped 12 hours prior to the start of the drug Levodopa + Carbidopa (Twindopa). It is necessary to begin with the dosage of the drug Levodopa + Carbidopa (Twindopa), which will provide the same amount of levodopa as in the combination of levodopa/other inhibitors of decarboxylase.
Patients receiving other anti-parkinsonian drugs: Other anti-parkinsonian agents may be continued when Levodopa + Carbidopa (Twindopa) is introduced, although their dose should be adjusted by a physician in accordance with instructions for medical use.
Use in children: The safety of Levodopa + Carbidopa (Twindopa) in patients under 18 years of age has not been established and its use in patients below the age of 18 is not recommended.
Elderly patients: This drug is used in elderly patients.
Mode of administration: Oral.