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To Tidomet Forta
The description is actual on 25.04.2014
- Latin name: Tidomet Forte
- ATH code: N04BA02
- Active ingredient: Levodopa (Levodopa) + Karbidopa (Carbidopa)
- Producer: Torrent Farmasyyutikalz, India
1 tablet contains a levodopa of 250 mg and a karbidopa of 25 mg.
Tablets in planimetric packagings; on 4, 10 and 100 pieces in a box.
Levodopa — amino acid of which the dopamine with the participation of a decarboxylase of amino acids is formed. The levodopa can turn already in peripheral fabrics into a dopamine which will not be able to get through a blood-brain barrier (GEB).
Karbidopa is decarboxylase inhibitor, interferes with transformation of a levodopa into a dopamine as a part of peripheral fabrics; does not pass through GEB and does not influence synthesis of a dopamine from a levodopa in TsNS. Therefore the combination of a karbidopa and a levodopa increases quantity of the levodopa coming to a brain. Karbidopa increases bioavailability of a levodopa twice.
Pharmacodynamics and pharmacokinetics
Meal slows down absorption of a levodopa. The greatest possible level of concentration in blood is defined after reception, in 1 - 2 hour. About 75% of the accepted levodopa are metabolized in intestines.
Time of semi-removal of a levodopa in combination with karbidopy — 3 h. It is removed with urine.
Karbidopa does not pass through GEB. The maximum concentration in blood — approximately in 2-4 h. About 50% of a karbidopa are removed through intestines and kidneys.
Indications to use
- parkinsonism syndrome (postencephalitic parkinsonism, after intoxication manganese or carbon monoxide);
- Parkinson's illness.
- closed-angle form of glaucoma;
- mental disorders;
- skin diseases of the obscure genesis;
- chorea of Gentington;
- essential tremor;
- reception of non-selective inhibitors of a monoaminooxidase;
- the secondary parkinsonism caused by use of anti-psychotics (neuroleptics);
- to children till 18 flyings in connection with a lack of data on safety and efficiency;
- individual intolerance.
With care appoint at stomach ulcer and a duodenum, epilepsy, heart failure, a myocardial infarction and disturbances of a heart rhythm, severe damages of a liver and kidneys, diseases of endocrine system, disturbances of mentality, bronchial asthma.
Often: nausea, dyskinesia. At emergence of muscular twitchings and a nictitating spasm drug should be cancelled.
Nervous system: nonsense, hallucinations, malignant antipsychotic syndrome, bradykinesia, excitement, paresthesias, headache, dizziness, dreadful dreams, sleeplessness; confusion of consciousness, depression, dementia, increase of sexual desire.
Cardiovascular system: heartbeat, arrhythmias, orthostatic hypotension.
System of a hemopoiesis: hemolitic anemia, thrombocytopenia, leukopenia, agranulocytosis.
Respiratory system: respiratory infections, asthma.
Integuments: perspiration, skin rash, baldness.
Urinary system: frequent urinations, infections of urinary tract.
Laboratory indicators: increase of activity of ALT (alaninaminotranspherase) and nuclear heating plant (aspartate aminotransferase), alkaline phosphatase, lactate dehydrogenase, increase of level of urea, bilirubin, hyperglycemia, hamaturia, leukocyturia, bacteriuria.
Application instruction of Tidomet (Way and dosage)
Accept inside, during food or later. The tablet is not chewed, wash down with water. During treatment reception of a large amount of protein is not recommended. The daily dose of a levodopa — 2000 mg, karbidopa – 100 mg is maximum.
Treatment is begun with an initial dose — 1/2 tab. twice a day. Then, if necessary, the dose is increased on 0,5 tab. 2 times a day. At the beginning of therapy a daily dose — no more than 3 tablets divided into 3 receptions. The daily dose of drug can be increased, but no more than 8 tablets divided into 8 receptions. At purpose of the dose exceeding 6 tablets a day strict control of the doctor is necessary.
The instruction on Tidomet Forta recommends to stop prior to therapy in 12 hours reception of a levodopa, and at treatment by the prolonged forms — for 24 h. A maintenance dose is the dose to 6 tablets a day.
In case of overdose carry out a gastric lavage, ECG control and supervision for diagnosis of arrhythmia; in case of developing of arrhythmias — antiarrhytmic therapy.
At simultaneous use to be careful with anti-hypertensive drugs in connection with danger of orthostatic hypotension.
Use with inhibitors of a monoaminooxidase (MAO) can cause blood circulation disturbances — increase of the ABP, tachycardia, face reddening. Therefore reception of MAO inhibitors is stopped in 14 days prior to therapy.
Reception along with tricyclic antidepressants can cause arterial hypertension, dyskinesia, reduction of bioavailability of a levodopa.
Drug can strengthen action of adrenomimetik therefore their dose needs to be lowered. Use of a levodopa with beta-adrenergic agonists can increase risk of development of cardiac arrhythmias.
Amantadin with a levodopa cause mutual exponential effect.
Levodopa in combination with metildopy increase risk of side effects of each other.
Co-administration with diazepam, Phenytoinum, derivatives of a fenotiazin, phenyl propyl ketone, thioxanthene, a clonidine, a papaverine, a pyridoxine, Reserpinum, M-holinoblokatorami can reduce protivoparkinsonichesky effect of drug.
Use with drugs of lithium increases probability of development of hallucinations and diskineziya.
Iron preparations reduce bioavailability of drug.
Terms of sale
According to the recipe.
To store far from children, the dry and closed from light place, temperature is not above 30 °C.
Period of validity
Not to apply at parkinsonism caused by use of neuroleptics.
It is necessary to stop treatment by drug gradually, for avoidance of development of a symptom complex, similar to a malignant antipsychotic syndrome (muscular rigidity, increase of activity of a kreatinfosfokinaza in blood, fervescence).
At Tidomet Forte's reception the constant control of the mental status and action of the heart is necessary.
To patients with an open angle glaucoma to appoint drug with care; the constant control of intraocular pressure is necessary.
In the course of treatment driving of the car and performance of work, requiring special attention is not recommended.
It is necessary to remember that at elderly patients absorbability of a levodopa is better, than at young people.
Coincidence on the ATH code of the 4th level:
The main analogs are Madoparum, stalevo.
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Section: For a nervous system
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