carbidopa + levodopa + entacapone Tablets 12,5mg+50mg+200mg, 25mg+100mg+200mg, 37,5mg+150mg+200mg

Dossier type
EU CTD
Dossier status
Ready to file
Country of origin
European Union
Manufacturer #554

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Carbidopa

Carbidopa is a drug used in the treatment of Parkinson's disease in order to inhibit peripheral metabolism of levodopa. This property is significant because allows a greater proportion of peripheral levodopa to cross the blood–brain barrier for central nervous system effect, thus paving way for the best possible absorption. Parkinson’s disease damages the neurons that produce dopamine, the motor symptoms of PD appear, including tremor, rigidity, impaired balance, and includes loss of spontaneous movement. These are motor symptoms of PD related to depletion of the neurotransmitter (chemical messenger) dopamine in the brain. Carbidopa prevents the conversion of L-DOPA to dopamine peripherally, thus reducing the side effects caused by dopamine on the periphery, and finally increasing the concentration of L-DOPA and dopamine in the brain.
Many combinations of Carbidopa/levodopa carry the brand names of Kinson, Sinemet, Pharmacopa and Atamet.
Amerigens Pharmaceuticals Ltd, first approved product by the FDA containing only carbidopa in 2014. Initially, The combination treatment of carbidopa/levodopa was originally developed by Watson Labs, However, the historical information by the FDA brings back to the approval of this combination therapy by Mayne Pharma in 1992.

Forms and dosage

The combination of levodopa/carbidopa is sold as a regular tablet, an orally disintegrating tablet, an extended-release, long-acting tablet, and an extended-release, long-acting capsule to take by mouth. It is also sold as a suspension to be given into your stomach through a PEG-J tube or sometimes through a naso-jejunal tube using a special infusion pump.
The regular and orally disintegrating tablets are given three or four times a day and extended-
release capsule is usually taken three to five times a day. The suspension is usually given as a morning dose by infusion over 10 to 30 minutes and then as a continuous dose given by infusion over 16 hours.

The cost of Carbidopa

In the USA, the consumers have to pay an average retail price of $44.23 and in the UK a supply of 100 tablets of 25mg strength cost 35 pounds. In India, the same supply costs less than dollar for a generic brand.

How does it work?

Carbidopa works by inhibiting aromatic-L-amino-acid decarboxylase, an enzyme important in the biosynthesis of L-tryptophan to serotonin and in the biosynthesis of L-DOPA to dopamine (DA). Increased dopamine availability increases the effectiveness of the remaining neurons thus providing alleviation from symptoms for a time. However, exogenously provided, L-DOPA gets metabolized peripherally before reaching the blood–brain barrier. But, Carbidopa decreases peripheral DDC conversion of L-DOPA before it crosses the blood–brain barrier. Carbidopa acts as a peripheral DDC inhibitor, it has no effect on brain DDC conversion of L-DOPA to dopamine. As result of these actions, a greater proportion of the exogenously provided levodopa/L-DOPA reaches the brain

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