Sample2_PDF.pdf

Parkinson’s Disease Quick Reference Guide for Initiating Therapy

The movement disorder experts from the 6 PADRECCs developed the following algorithm to be used as a general guideline, and is not intended to interfere with clinical judgment or replace existing practice parameters.

* Assess for history of Impulse Control Disorder—type behaviors (pathological gambling, eating, spending, sexual, etc) and consider using other agents if significant history and/or concerns exist; monitor for ICD symptoms periodically during dopamine agonist therapy

Please contact one of the six Parkinson’s Disease Research, Education and Clinical Centers (PADRECCs) for additional information or to arrange a consult appointment.

PADRECC/Consortium Hotline: 1-800-949-1001 x5769 Houston PADRECC: 713-794-7841 Philadelphia PADRECC: 215-823-5934 or 888-959-2323 Portland / Seattle PADRECC: 503-721-1091 or 206-277-4560 Richmond PADRECC: 804-675-5931 or 800-784-8381 x5931 San Francisco PADRECC: 415-379-5530 West Los Angeles PADRECC: 310-478-3711 x48001 www.parkinsons.va.gov

Employee Education System Updated May 2019 https://www.parkinsons.va.gov/

Medications Used to Treat Parkinson’s Disease

Medication Name®

(generic name) Start Dose Typical Daily

Dose Common SEs

Sinemet (carbidopa/levodopa)

25/100 1/2 tab TID

25/100 1 tab TID

Sinemet CR (carbidopa/levodopa controlled– release)

25/100 1 tab TID

25/100 or 50/200 1-2 tabs TID

Parcopa (carbidopa/ levodopa orally disin-tegrating tablets)

25/100 1/2 tab TID

25/100 1 tab TID

Comtan (entacapone)

1 (200mg) tab per Sinemet dose

1 (200mg) tab per Sinemet dose

1, urinary discoloration, diarrhea

Stalevo (carbidopa/levodopa/ entacapone)

12.5/50/200 mg TID — or — 25/100/200 mg

TID

25/100/200 mg

TID

Requip (ropinirole HCL)

0.25 mg TID 2.0-5.0 mg TID 1, impulse control disorder (ICD), edema, sedation Mirapex

(pramipexole)

0.125 mg TID 0.5-1.5 mg TID

Neupro (Rotigotine)

2 mg TID 2mg/24 hours 4mg/24 hour

1,2, Application site reaction

Azilect (rasagiline)

0.5 mg daily 1 mg daily 1, 2

Eldepryl (selegiline)

5 mg 5 mg BID 1, 2, psychosis, insomnia

Symmetrel (amantadine)

100 mg daily 100 mg TID pedal edema, psychosis, levido reticularis

Artane (trihexyphenidyl HCL)

1 mg BID 1 mg BID– 2 mg TID

Psychosis, cognitive decline, constipation, urinary retention, dry mouth blurre d vision

Cogentin (benztropine mes ylate)

0.5 mg BID 1-2 mg BID

Side Effect Key 1: Nausea, orthostatic hypotension, dyskinesias, hallucinations, sedation 2: Potential drug interactions with SSRIs (selective serotonin reuptake inhibitors) ICD: Impulse Control Disorder (pathological/impulsive behaviors: gambling, spending, eating, sexual)