Dopamine antagonists Antihypertensives, anticoagulants drugs that affect protein binding

Adjunct therapy to levodopa in Parkinsons disease

Pain, abdominal pain, GI upset , dyskinesia, hallucinations, confusion, somlolence sometimes with sudden sleep onset, rhinitis, dyspnoea, diplopia, Insomnia, dizziness, syncope, abnormal liver function tests, Hypotension, prmature arterial contractions, Sinus tachycardia, Rash, fever, cardiac fibrosis, other fibrotic and serosalinflammatory conditions Peripheral vasosapasm, neuroleptic malignant syndrome Elevated creatinine phosphokinase, Pathological gambling and increased libido

History of fibrotic disorders Cardiac valvulopathy

Special precautions-

Cardiac disease, arrhythmias, psychosis Perform ECG and full cardiovascular assesssment before starting therapy

Do not treat if evidence of fibrotic valvular disease Monitor during treatment for fibrotic reactions including pleuropulmunary disease Retroperitoneal and cardiac fibrosis , discontinue if appear Withdraw gradually Pregnancy, Lactation

Adjunct therapy to levodopa in Parkinsons disease

Dosage-

Monotherapy Initially 50microgram daily taken as a single dose in evening on Day 1 twice daily then 50microgram twice daily on Day 2-4 then titarate gradually over the next 25 days to 1.5mg daily in 3 divided doses.

Then increase by 250 micrograms twice a week until optimal response is acheived Max 3mg daily in 3 divided doses Adjunct therapy- Initially 50 microgram daily for first 2 days increasing gradually by 100- 150 microgram daily every 3rd day over next 12 days

Then increase by 250micrgram daily every third day until optimal response is acheived Max 3mg daily in 3 divided doses Reduce leviodopa dose cautiously during titration

Children - not recommended

Contraindicated for use during pregnancy and lactation Observe caution if use is required