Деякі поширені пероральні протипаркінсонічні препарати
Medication | Major Adverse Effects |
|---|---|
Dopamine precursors | |
Carbidopa/levodopa 10/100, 25/100, or 25/250 mg (immediate-release or dissolvable) | Central: Drowsiness, confusion, orthostatic hypotension, psychotic disturbances, nightmares, dyskinesia Peripheral: Nausea, anorexia, flushing abdominal cramping, constipation, palpitations With sudden discontinuation: Neuroleptic malignant syndrome |
Carbidopa/levodopa 25/100 or 50/200 mg (controlled-release; recommended only for nighttime [not daytime] symptoms) | |
Antiviral medication | |
Amantadine | Confusion, urinary retention, leg edema, elevated intraocular pressure, livedo reticularis Rarely, with discontinuation or a decrease in dose: Neuroleptic malignant syndrome |
Dopamine agonists | |
Apomorphine | Nausea, vomiting, light-headedness (due to orthostatic hypotension), hallucinations, impulse control disorder (gambling, buying, excessive eating, collecting) With the rotigotine patch only, redness, itching, and swelling in the legs and at the application site |
Pramipexole | |
Ropinirole | |
Rotigotine (transdermal) | |
Monoamine oxidase type B (MAO-B) inhibitors | |
Rasagiline | Nausea, insomnia, somnolence, edema |
Selegiline* | Possible potentiation of nausea, insomnia, confusion, and dyskinesias when given with levodopa |
Anticholinergic medications† | |
Benztropine | Drowsiness, dry mouth, urinary retention, constipation, blurred vision Particularly in older adults: Confusion, delirium, impaired thermoregulation due to decreased sweating |
Trihexyphenidyl | |
Catechol O-methyltransferase (COMT) inhibitors | |
Entacapone‡ | Due to increased bioavailability of levodopa: Dyskinesias, nausea, confusion, hallucinations Unrelated to levodopa: Back pain, diarrhea, changes in color of urine With tolcapone, risk of liver toxicity (rare) |
Opicapone | |
Tolcapone | |
* Selegiline is also available in a formulation designed for buccal absorption. | |
† Anticholinergic medications should preferably not be used in older adults. Because these medications have adverse effects and because recent findings suggest that these medications may increase tau pathology and neurodegeneration, their use should be limited. | |
‡ Entacapone is also available in a triple combination tablet (carbidopa, levodopa, and entacapone). | |
