Product Information:

DOPACONE 200+50+200mg Tablets is a high-strength fixed-dose triple-combination medication for the management of Parkinson’s disease, containing:

1. Levodopa 200mg: A dopamine precursor that crosses the blood-brain barrier to replenish depleted dopamine in the basal ganglia.
2. Carbidopa 50mg: A peripheral aromatic L-amino acid decarboxylase inhibitor that prevents levodopa breakdown outside the brain, reducing nausea and allowing more levodopa to reach the central nervous system.
3. Entacapone 200mg: A catechol-O-methyltransferase (COMT) inhibitor that blocks peripheral metabolism of levodopa, prolonging its plasma half-life and clinical effect.

This formulation is intended for patients with moderate to advanced Parkinson’s disease experiencing significant motor fluctuations ("wearing-off") on standard levodopa therapy.

Uses of (DOPACONE 200+50+200MG TABLETS):

1. Adjunctive treatment in Parkinson’s disease patients with pronounced end-of-dose "off" periods
2. Replacement for equivalent doses of levodopa 200mg + carbidopa 50mg plus entacapone 200mg
3. Reduction of daily "off" time and improvement in motor function consistency

Key Benefits of (DOPACONE 200+50+200MG TABLETS):

1. Extends levodopa effect by 1–2 hours per dose
2. Reduces total daily "off" time by up to 1–2 hours
3. Maintains therapeutic response without increasing total daily levodopa load
4. Simplifies complex regimens into a single tablet
5. Carbidopa-to-levodopa ratio (1:4) aligns with standard optimized formulations

How To Use (DOPACONE 200+50+200MG TABLETS):

Take exactly as prescribed by your neurologist—typically one tablet per dose, replacing a prior levodopa 200mg + carbidopa 50mg dose along with entacapone 200mg.

1. Administer with or without food, but avoid high-protein meals within 1–2 hours of dosing (protein competes with levodopa absorption).
2. Swallow whole—do not crush, chew, or split.
3. Typical dosing frequency: 3 to 6 times daily, based on individual motor response pattern.
4. Do not initiate or switch abruptly without specialist supervision.

When Not to Use (DOPACONE 200+50+200MG TABLETS):

Do not use if you have:

1. Hypersensitivity to levodopa, carbidopa, entacapone, or any excipients
2. Narrow-angle glaucoma
3. History of melanoma or undiagnosed skin lesions (levodopa may stimulate melanoma growth)
4. Concurrent use of non-selective MAO inhibitors (e.g., phenelzine, tranylcypromine)—discontinue MAOI at least 2 weeks prior
5. Severe hepatic impairment (entacapone is metabolized in the liver)

Side Effects of (DOPACONE 200+50+200MG TABLETS):

Common: Dyskinesia (involuntary movements), nausea, diarrhea, urine discoloration (orange/brown), dizziness, headache, dry mouth.

Serious (rare):

1. Worsening parkinsonism or hallucinations (especially in elderly patients)
2. Impulse control disorders (pathological gambling, hypersexuality, compulsive shopping/eating)
3. Rhabdomyolysis (muscle pain, weakness, dark urine)
4. Hepatotoxicity (jaundice, right upper quadrant pain—monitor LFTs if symptomatic)
5. Orthostatic hypotension, confusion, or sudden sleep episodes
6. Discontinue and seek immediate medical help if severe psychiatric, motor, or hepatic symptoms occur.

Dosage: (DOPACONE 200+50+200MG TABLETS):

1. Replaces one dose of levodopa 200mg + carbidopa 50mg + entacapone 200mg
2. Usual regimen: 3–6 doses per day, tailored to motor fluctuation pattern
3. Maximum entacapone: 1,600mg/day (i.e., ≤8 tablets)
4. Adjust only under the guidance of a movement disorder specialist

Who It’s For (DOPACONE 200+50+200MG TABLETS):

Adults with advanced Parkinson’s disease already stabilized on high-dose levodopa/carbidopa who experience frequent "off" periods. Not for early-stage disease or levodopa-naïve patients.

Warnings & Precautions:

1. May cause sudden onset of sleep—avoid driving or operating machinery
2. Monitor closely for impulse control disorders and psychotic symptoms
3. Entacapone may cause chronic or severe diarrhea—discontinue if persistent
4. Urine may turn orange, red, or brown—harmless but may stain clothing
5. Avoid iron supplements within 2 hours of dosing (reduces levodopa absorption)

Drug Interactions:

1. Non-selective MAO inhibitors: Risk of hypertensive crisis—contraindicated
2. Antipsychotics (e.g., haloperidol, risperidone): May reverse anti-Parkinson effects
3. Iron salts: Decrease levodopa absorption—administer ≥2 hours apart
4. Dopamine-depleting agents (reserpine, tetrabenazine): Reduce efficacy
5. Always inform your neurologist about all medications and supplements.

Additional Information:

Store below 25°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not use after the expiration date printed on the blister pack. Available by prescription only in Pakistan.