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Carbidopa, entacapone, and levodopa and Flintstones Toddler

Determining the interaction of Carbidopa, entacapone, and levodopa and Flintstones Toddler and the possibility of their joint administration.

Check result:
Carbidopa, entacapone, and levodopa <> Flintstones Toddler
Relevance: 14.11.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Levodopa and multivitamin with iron should not be taken orally at the same time. Products that contain iron may interfere with the absorption of levodopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Contact your doctor if your Parkinson symptoms worsen. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSING INTERVAL: The oral bioavailability and pharmacologic effects of levodopa and carbidopa may be decreased during concurrent administration with iron-containing products. The proposed mechanism is chelation of levodopa and carbidopa by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In nine patients with Parkinson's disease, administration of levodopa-carbidopa 100 mg-25 mg with ferrous sulfate 325 mg decreased levodopa peak plasma concentration (Cmax) and systemic exposure (AUC) by 47% and 30%, respectively, and carbidopa Cmax and AUC by 77% and 82%, respectively, compared to administration with placebo. There was also evidence of reduced efficacy of levodopa in some patients. In another study consisting of eight healthy subjects, coadministration of levodopa 250 mg with ferrous sulfate 325 mg resulted in greater than 50% reductions in the Cmax and AUC of levodopa compared to administration of levodopa alone. The magnitude of the interaction was the greatest in patients whose plasma levels of levodopa were the highest following administration of levodopa alone.

MANAGEMENT: Until more information is available, patients receiving levodopa and/or carbidopa in combination with iron-containing products should be advised to separate the times of administration by as much as possible. Patients should be monitored for reduced efficacy of levodopa, and the dosage adjusted as necessary.

References
  • Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
  • Greene RJ, Hall AD, Hider RC "The interaction of orally administered iron with levodopa and methyldopa therapy." J Pharm Pharmacol 42 (1990): 502-4
  • Campbell NR, Hasinoff B "Ferrous sulfate reduces levodopa bioavailability: chelation as a possible mechanism." Clin Pharmacol Ther 45 (1989): 220-5
  • Campbell NR, Rankine D, Goodridge AE, Hasinoff BB, Kara M "Sinemet-ferrous sulphate interaction in patients with Parkinson's disease." Br J Clin Pharmacol 30 (1990): 599-605
Carbidopa, entacapone, and levodopa

Generic Name: carbidopa / entacapone / levodopa

Brand name: Stalevo 100, Stalevo 125, Stalevo 150, Stalevo 200, Stalevo 50, Stalevo 75, Stalevo

Synonyms: Levodopa, Carbidopa, and Entacapone

Flintstones Toddler

Generic Name: multivitamin with iron

Brand name: Fero-Folic 500, Theragran Hematinic, Ultra Enerforce

Synonyms: Multivitamin with iron, Polysaccharide-Iron Complex, Vitamin B12, and Folic Acid

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.