Nacom (levodopa, carbidopa) tablets 250 mg/25 mg. №100

Description

Nacom composition
The drug contains the main active ingredients: levodopa, carbidopa.
This drug also contains as auxiliary substances: corn starch, pregelatinized starch, magnesium stearate, microcrystalline cellulose, etc.

Release form
Produced in tablet form. Available in a dosage of 250 mg levodopa / 25 mg carbidopa.

Pharmacological properties
Nacom belongs to the group of antiparkinsonian dopaminergic drugs.
Combined drug, the main active ingredients of which are levodopa (which is a metabolic precursor of dopamine) and carbidopa (which is an inhibitor of peripheral dopa decarboxylase).
Levodopa is able to arrest the manifestations of Parkinson’s disease after decarboxylation to dopamine in the brain. Carbidopa is able to suppress extracerebral decarboxylation, allowing levodopa to enter the brain in large quantities, converting to dopamine.
The absence of carbidopa will not bring the desired effect quickly and will require significantly more levodopa to achieve it.
Taking the drug leads to a decrease in motor function disorders, dyskinesia and hyperkinesia. Moreover, the effect can often be observed already on the first day of drug therapy.

Indications
Nacom is indicated for the treatment of Parkinson’s syndrome, Parkinson’s disease and its symptoms.
The effect of taking the drug can be observed already on the first day of administration, maximum – during the first week of administration.

Contraindications
Not applicable if the patient has hypersensitivity (allergy) to one of the components that make up the drug.
Also contraindicated for:

• glaucoma;
• severe hepatic and renal failure;
• severe heart failure, arrhythmias;
• severe psychosis;
• ban on taking sympathomimetics.
• concomitant use of non-selective MAO inhibitors;
• selective MAO inhibitors type A (use should be discontinued at least 2 weeks before prescribing this drug.

Before use, it is necessary to make sure that the patient does not have suspicious lesions on the skin. The suspicion of malignant melanoma is excluded, since the use of the drug is contraindicated if the patient has ever had melanoma in the past.

Children
Use in pediatrics is contraindicated.

Application during pregnancy and lactation
Treatment of pregnant women is not recommended, since there is no guarantee of complete safety of its use for both the woman and the fetus. At the same time, the final decision is made by the attending physician based on the benefit / harm ratio.
During treatment, lactation (breastfeeding) should be suspended.

Method of administration and dosage
The exact dosage of Nacom is determined by the attending physician on an individual basis. The tablet can be halved if necessary. The duration of treatment is up to six months. The specific duration of therapy with this drug will depend on the body’s response to treatment. It is determined by the attending physician.
Recommended dosages:

• patients receiving the drug for the first time – 0.5 tablets 1 or 2 times a day (if necessary, increase the dosage – increase by no more than 0.5 tablets per day);
• patients undergoing levodopa therapy – the drug is taken after a minimum pause of 12 hours, the dose is 20% of the previous daily dose of levodopa.
• initial dose – 75-100 mg of carbidopa and 300-400 mg of levodopa for 3-4 doses per day (if the dose was less than 1500 mg of levodopa per day), and 1 tablet of the drug 3-4 times a day (if the dose was more than 1500 mg levodopa per day).
• maintenance dose – usually 1 tablet 3-4 times a day, the maximum dose per day is 8 tablets).

Overdose
In case of an overdose, symptoms such as:

• dystonia;
• dyskinesia;
• blepharospasm;
• arrhythmia;
• confusion of consciousness;
• anxiety, anxiety.

Dialysis has not been proven to be effective.
Treatment is symptomatic. It is necessary to rinse the stomach as soon as possible, take sorbents.

Side effects
Side effects are usually caused by the neuropharmacological effects of dopamine and are reduced by decreasing the dose of levodopa.
In particular, the patient may experience:

• leukopenia, hemolytic and non-hemolytic anemia, thrombocytopenia, agranulocytosis;
• anorexia, weight gain;
• hallucinations, confusion, nightmares, drowsiness, fatigue, insomnia, depression, euphoria, dementia;
• dyskinesias, dystonia, on-off episodes, dizziness, bradykinesia (on-off episodes), drowsiness, ataxia, increased hand tremors;
• paresthesia, headache, convulsions;
• blepharospasm, dilated pupils;
• palpitations, arrhythmias, fainting; infrequently – arterial hypertension;
• phlebitis;
• nausea, vomiting, dry mouth, bitter taste, gastrointestinal pain, dark saliva, duodenal ulcers.
• angioedema, allergic urticaria, itching, facial redness, dark sweat, malignant melanoma;
• dark urine, anuria, priapism.

Storage conditions and periods
The shelf life of the drug is no more than 3 years from the production date indicated on the package. Storage temperature – 25 ° С.