Levodopa continues to be the most efficacious and widely used treatment for
Parkinson's disease.
Levodopa dosing is understood to be critical for the optimal control of symptoms, and increasing the
levodopa dose is a common method to treat advancing disease. Escalating
levodopa dosages coupled with
disease progression is associated with increasing likelihood of developing
levodopa-induced
dyskinesia. Moreover, frequent and complicated dosing schemes, combined with limited dose availability, leads to increasing pill burden and its associated impairment of patient adherence issues.
Levodopa/
carbidopa/
entacapone has been shown to improve the pharmacokinetic profile of
levodopa and provide superior symptomatic control compared with conventional
levodopa/
dopa decarboxylase inhibitor
therapy. We report four case histories describing clinical experience of using
levodopa/
carbidopa/
entacapone 200/50/200 mg, one of the latest doses of this formulation, in a range of patients with
Parkinson's disease. These cases illustrate that
levodopa/
carbidopa/
entacapone 200/50/200 mg provides improvements in symptomatic control and convenience, and that switching to this dose was not associated with safety concerns.