Tridopa 100mg+25mg+200mg Tablet | 1 Strip

✔️ Pharmacology

Tridopa combines three active agents to improve dopaminergic stimulation in Parkinson’s disease:

Levodopa – a precursor of dopamine that crosses the blood-brain barrier and is converted into dopamine in the CNS.

Carbidopa – a peripheral dopa decarboxylase inhibitor that prevents premature breakdown of levodopa, ensuring more levodopa reaches the brain.

Entacapone – a selective catechol-O-methyltransferase (COMT) inhibitor that prolongs levodopa’s effect by sustaining plasma concentrations, providing more consistent symptom control.

✔️ Dosage & Administration

• Dose must be individualized and titrated according to patient response.
• One tablet per administration; maximum daily dose of entacapone is 2000 mg.
• May be taken with or without food, but should be swallowed whole.

Switching guidelines:

• Patients stabilized on levodopa/carbidopa + entacapone at equivalent strengths may be switched directly to corresponding Tridopa tablets.
• If patients are on levodopa/benserazide + entacapone, discontinue the previous regimen at night and start Tridopa the following morning.
• For patients not on entacapone, direct switching is not recommended in those with dyskinesias or levodopa >800 mg/day. Entacapone should be introduced separately first, then converted to Tridopa.

Dose adjustments may be needed after initiation, usually requiring a 10–30% reduction in levodopa dose to control dyskinesia.

Discontinuation:

If stopping Tridopa and returning to levodopa/DDC inhibitor without entacapone, other antiparkinsonian medication doses (especially levodopa) must be readjusted.

✔️ Side Effects

Common: Dyskinesia, nausea, hyperkinesia, abdominal pain, urine discoloration, diarrhea.
Others reported: Colitis, hallucinations, confusion, orthostatic hypotension, rhabdomyolysis, skin cancer, fibrosis, and severe diarrhea.

✔️ Contraindications

• Severe hepatic impairment.
• Narrow-angle glaucoma.
• Pheochromocytoma.
• Concurrent use with non-selective MAO inhibitors.
• History of neuroleptic malignant syndrome (NMS) or non-traumatic rhabdomyolysis.
• Hypersensitivity to active ingredients or excipients.

✔️ Precautions & Warnings

• May cause dizziness, drowsiness, or orthostatic hypotension – caution when driving or operating machinery.
• Regular monitoring of liver, kidney, cardiovascular, and hematopoietic function is advised in long-term use.
• Use cautiously in mild to moderate hepatic impairment and in patients with severe renal disease.
• Risk of hallucinations, psychiatric effects, and impulse control disorders.
• Sudden discontinuation may precipitate NMS-like syndrome.

✔️ Drug Interactions

Antihypertensives – may increase risk of postural hypotension.

Dopamine antagonists (antipsychotics, antiemetics), phenytoin, and papaverine – may reduce levodopa efficacy.

High-protein diet – reduces levodopa absorption.

Iron supplements – may lower bioavailability of levodopa.

✔️ Pregnancy & Lactation

Pregnancy Category C – use only if potential benefits outweigh risks.

Unknown if excreted in breast milk; breastfeeding is not recommended during therapy.

✔️

Store below 30°C, protected from light and moisture.

Keep out of the reach of children.