Drug interactions
Carbidopa-entacapone-levodopa + Droxidopa
Severity: Moderate
Carbidopa-entacapone-levodopa and Droxidopa: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Droxidopa is converted to norepinephrine by dopa decarboxylase, and carbidopa inhibits this enzyme in the periphery. Carbidopa can therefore reduce the pressor effect of droxidopa, although it may also reduce peripheral dopamine formation from levodopa. Efficacy of droxidopa for neurogenic orthostatic hypotension may be diminished.
What this interaction means in plain words
Carbidopa-entacapone-levodopa and Droxidopa can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbidopa-entacapone-levodopa belongs to Central Nervous System; Droxidopa belongs to Cardiovascular.
Why it happens
Carbidopa inhibits peripheral dopa decarboxylase, reducing conversion of droxidopa to norepinephrine.
What to do
Monitor supine and standing blood pressure and symptoms, and titrate droxidopa upward if the response is inadequate. Watch for supine hypertension when doses are changed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Carbidopa-entacapone-levodopa
- Carbidopa-entacapone-levodopa + Isocarboxazid Contraindicated
- Carbidopa-entacapone-levodopa + Phenelzine Contraindicated
- Carbidopa-entacapone-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-entacapone-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-entacapone-levodopa Major
- Asenapine transdermal + Carbidopa-entacapone-levodopa Major
Other interactions of Droxidopa
- Droxidopa + Lisdexamfetamine Major
- Droxidopa + Methamphetamine Major
- Droxidopa + Pseudoephedrine Major
- Adrenaline-articaine + Droxidopa Moderate
- Almotriptan + Droxidopa Moderate
- Caffeine + Droxidopa Moderate
Frequently asked questions
Can I take Carbidopa-entacapone-levodopa with Droxidopa?
MediHelp rates the interaction as moderate. Carbidopa-entacapone-levodopa and Droxidopa can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Droxidopa is converted to norepinephrine by dopa decarboxylase, and carbidopa inhibits this enzyme in the periphery. Carbidopa can therefore reduce the pressor effect of droxidopa, although it may also reduce peripheral dopamine formation from levodopa. Efficacy of droxidopa for neurogenic orthostatic hypotension may be diminished.
How serious is the interaction between Carbidopa-entacapone-levodopa and Droxidopa?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor supine and standing blood pressure and symptoms, and titrate droxidopa upward if the response is inadequate. Watch for supine hypertension when doses are changed.
What other medicines interact with Carbidopa-entacapone-levodopa?
MediHelp also lists interactions of Carbidopa-entacapone-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-entacapone-levodopa page.
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