Ask The Doctor – Q & A
Q. What is the maximum dose of Carbidopa/Levodopa that can be used for PD?
A. Carbidopa/levodopa doses vary significantly. The range can be from 300 mg/day to up to as much as 3,000 mg/day. To determine the right dose for you, you and your physician should discuss:
- What (if any) positive effects that Carbidopa/Levodopa has on your symptoms
- How long a dose takes to work
- How long the effects of a dose lasts
- The side effects of the medication (which could include low blood pressure, hallucinations, fatigue, Sinemet-induced dyskinesias, among others)
Your dose can be determined (and adjusted) based on your answers to these questions. Visit www.apdaparkinson.org for more information on PD meds.
Q. When undergoing anesthesia for a procedure such as a colonoscopy, do I take my meds as usual or not take them that day?
A. Different medications have different issues. For Carbidopa/Levodopa, ask your neurologist and gastroenterologist (GI) when you should take your last dose prior to the procedure. You’ll likely be instructed not to take anything by mouth after a certain point prior to the procedure, but your GI may allow you to take a dose of Sinemet with a sip of water closer to the procedure, especially if you are dependent on the medication to move. Monoamine oxidase inhibitors (MAOIs) such as rasagiline (Azilect), safinamide (Xadago), or selegiline on the other hand, have a number of drug interactions, so some doctors advise patients to stop taking Azilect up to 1-2 weeks prior to any procedure and to restart it 1 week afterwards. It is important to check with your doctors on their specific policy.