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Parkinson's Disease - Medications
amantadine (Symmetrel ®) |
| Increases dopaminergic activity. Dosing: 100 mg orally twice daily. |
benztropine (Cogentin ®) |
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Anticholinergic. Dosing (Adults) : Drug-induced extrapyramidal symptom: Oral, I.M., I.V.: 1 to 4 mg/dose 1-2 times/day. Acute dystonia: I.M., I.V.: 1 to 2 mg Parkinsonism: Oral: 0.5-6 mg/day in 1-2 divided doses; if one dose is greater, give at bedtime. Titrate dose in 0.5 mg increments at 5- to 6-day intervals. Supplied: Injection solution:: 1 mg/ml (2 ml). Tablet: 0.5 mg, 1 mg, 2 mg. |
bromocriptine (Parlodel ®) |
| Dopamine agonist. Initiate at 1.25 mg q hs. Titrate over 4-6 weeks. Usual dose 10-40 mg/day divided tid. |
entacapone (Comtan ®) |
| Inhibitor of catechol-O-methyltransferase (COMT). Dosing: 200-mg tablet administered concomitantly with each carbidopa/levodopa dose to a maximum of eight times daily, (1,600 mg/day) . Entacapone should always be administered in association with carbidopa /levodopa, since entacapone has no antiparkinsonian effect of its own.[200] |
pergolide (Permax ®) |
| A long-acting synthetic ergoline derivative with potent dopamine agonist activity at both D-1 and D-2 dopamine receptors. Initial: 0.05 mg orally once daily, then increase to 1 mg orally three times daily. Max: 5 mg/day. |
pramipexole (Mirapex ®) |
| Dopamine receptor agonist (D3>>D2). Initial: 0.125 mg orally three times daily, then increase to 0.5-1.5 mg orally three times daily. |
ropinirole (Requip ®) |
| Dopamine-2 (D2)-receptor agonist. Primary indication is early Parkinson's disease, where it may delay the need for levodopa therapy. Initial: 0.25 mg orally three times daily, then increase to 1 mg orally three times daily. Maximum: 24 mg/day. |
selegiline (Eldepryl ®) |
|
Monoamine oxidase (MAO) inhibitor that is specific for the MAO-B isozyme.
Dosing: 5 mg orally every morning and at noon daily. |
Sinemet ® (carbidopa/levodopa): |
| Initially: 1 tab (10/100 to 25/100) orally three times daily, may increase every 1 to 4 days as needed to max 200mg carbidopa/day. |
tolcapone (Tasmar ®) |
| First of new class of COMT inhibitors. Increases the elimination half-life of levodopa. Start 100 mg orally three times daily. Only as adjunct to Sinemet. Maximum: 600 mg/day. |
trihexyphenidyl (Artane ®) |
| Anticholinergic. Initial: 1 mg/day, then increase slowly to 6-10mg/day in 3 divided doses. Max: 15 mg/day. |
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