Pyridoxine reverses effect of levodopa. Type B MAOIs have synergistic effect. Effects reduced by phenothiazines, haloperidol, reserpine, puridoxine, diazepam, oxazepam, Chlordiazepoxide , phenobarbitone.

Effects of levodopa enhanced by carbidopa, amantadine, anticholinergics, amphetamine Effects of sympathemimetic agents enhanced. Enhances effects of bethanidine, bretylium, guanithidine, Hypertensive crises with furazoidones or MAOI nhibitors

Parkinsons disease

Nausea, vomiting, Anorexia, increased risk of GI bleeding in peptic ulcer patients. Orthostatic hypotension, cardiac arrhthmias, Pschiatric symptoms ( depression with or without suicidal tendecy ) Abnormal involuntary movements or dyskinesias, Delirium, hallucinations ( elderly ) Slight elevation in liver enzymes, Leucopenia, thrombocytopenia. Severe hypotension in elderly

Contraindication:

Hypersens, concomittant therapy with MAO inhibitors, narrow angle glaucoma, suspicious undiagnosed skin lesions, history of melanoma, lactation.

Special Precaution:

In patients receiving levodopa drug must be discontinued atleast 8 hr prior to starting combination. History of depression, suicidal tendencies, severe CVS or pulmonary disease, bronchial asthma, renal hepatic or endocrine disease, myocardial infarction, arrhythmias, peptic ulcers, withdraw drug gradually, pregnancy. Regular monitoring of renal and hepatic function is recommended

Parkinsons disease

Adult- initially - 1 tab tid, increase by 1 tablet a day every 1-2 days up to a max of 8 tablet of day If the patient has been taking L-dopa alone, the combination should be started after a gap of at least 8 hr after stopping L-dopa

Observe caution if required to be used pregnancy and lactation