Most common side effects of levodopa
What are the most common peripheral side effects of levodopa therapy, and how are they managed?
Nausea and vomiting are common side effects in the beginning of the use of levodopa.
Most of the patients overcome this difficulty by taking the medication after meals.
In some patients, extra amounts of carbidopa (typically, one 25-mg tablet with each dose of carbidopa/levodopa) may be necessary.
A small proportion of patients have nausea and vomiting despite these measures.
Treatment of the gastrointestinal (GI) side effects should not include dopamine blockers, such as metoclopramide, because they may cause worsening of PD. Hydroxyzine, trimethobenzamide, diphenidol, cyclizine, or domperidone are useful alternatives.
The most common cardiovascular side effect is orthostatic hypotension.
The management of this complication involves adding salt to the diet, wearing elastic stockings, and using medications such as fludrocortisone, midodrine, or droxidopa.
