Optimizing extended-release carbidopa/levodopa in Parkinson disease Review Article (Web of Science)


  • AbstractPurpose of review:To help clinicians optimize the conversion of a patient's Parkinson disease pharmacotherapy from immediate-release carbidopa/levodopa (IR CD/LD) to an extended-release formulation (ER CD/LD).Recent findings:Eleven movement disorders specialists achieved consensus positions on the modification of trial-based conversion guidelines to suit individual patients in clinical practice.Summary:Because the pharmacokinetics of ER CD/LD differ from those of IR CD/LD, modification of dosage and dosing frequency are to be expected. Initial regimens may be based on doubling the patient's preconversion levodopa daily dosage and choosing a division of doses to address the patient's motor complications, e.g., wearing-off (warranting a relatively high ER CD/LD dose, possibly at a lower frequency than for IR CD/LD) or dyskinesia (warranting a relatively low dose, perhaps at an unchanged frequency). Patients should know that the main goal of conversion is a steadier levodopa clinical response, even if dosing frequency is unchanged.


  • Espay, Alberto J.
  • Pagan, Fernando L.
  • Walter, Benjamin L.
  • Morgan, John C.
  • Elmer, Lawrence
  • Waters, Cheryl H.
  • Agarwal, Pinky
  • Dhall, Rohit
  • Ondo, William G.
  • Klos, Kevin J.
  • Silver, Dee E.

publication date

  • 2017

published in

number of pages

  • 7

start page

  • 86

end page

  • 93


  • 7


  • 1