Levodopa Oral Inhalation

Levodopa inhalation is used along with the combination of levodopa and carbidopa (Duopa, Rytary, Sinemet) to treat ”off” episodes (times of difficulty moving, walking, and speaking that may happen when other medication(s) wear off) in people with Parkinson’s disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance). Levodopa inhalation will not work to prevent ”off” episodes but will help to control symptoms when an ”off” episode has already begun. Levodopa is in a class of medications called dopamine agonists. Levodopa works by mimicking the action of dopamine, a natural substance in the brain that is lacking in patients with PD.

🔔 How should this medicine be used?

Levodopa inhalation comes as a capsule to use with a specially designed oral inhaler. You will use the inhaler to breathe in the dry powder contained in the capsules. It is usually inhaled when needed. You will need to orally inhale the contents of two capsules for a full dose. Do not inhale more than one dose (2 capsules) per “off” period. Do not inhale more than 5 doses in one day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use levodopa inhalation exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not swallow levodopa capsules for inhalation.

Do not open the blister package surrounding a capsule or remove the capsule until just before you are ready to use it. If you accidentally open the package of a capsule that you cannot use immediately, discard that capsule. Do not store the capsules inside the inhaler. Dispose of the inhaler when all of the capsules in the carton have been used. Use the new inhaler that comes with your prescription refill each time.

Only use the inhaler it comes with to inhale the powder in the capsules. Never try to inhale them using any other inhaler. Never use your levodopa inhaler to inhale any other medication.

Before you use levodopa inhalation for the first time, read the written instructions that come with the inhaler. Look at the diagrams carefully and be sure that you recognize all the parts of the inhaler. Ask your doctor, pharmacist, or other healthcare professionals to show you how to use it. Practice using the inhaler while they watch you.

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Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

🔔 Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

🔔 What special precautions should I follow?

Before using levodopa inhalation,

• tell your doctor and pharmacist if you are allergic to levodopa, any other medications, or any of the ingredients in levodopa inhalation. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking certain monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) or if you have stopped taking them within the past 2 weeks. Your doctor will probably tell you not to use levodopa inhalation if you are taking one or more of these medications.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: haloperidol (Haldol); iron pills and vitamins containing iron; isoniazid (Laniazid); linezolid (Zyvox); methylene blue medications for mental illness, motion sickness or nausea; metoclopramide (Reglan); other medications for Parkinson’s disease; rasagiline (Azilect); risperidone (Risperdal); safinamide (Xadago); sedatives; selegiline (Eldepryl, Emsam, Zelapar); sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with levodopa, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had any disease that affects your breathing such as asthma or chronic obstructive pulmonary disease (COPD); glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision); a sleep disorder; or a mental health problem.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using levodopa inhalation, call your doctor.
• you should know that levodopa inhalation may make you drowsy or may cause you to suddenly fall asleep during your regular daily activities while you are using levodopa inhalation and for up to 1 year after treatment. You might not feel drowsy or have any other warning signs before you suddenly fall asleep. Do not drive a car or operate machinery, work at heights, or participate in potentially dangerous activities until you know how this medication affects you. If you suddenly fall asleep while you are doing something such as eating, talking, or watching television, or riding in a car, or if you become very drowsy, especially during the daytime, call your doctor.
• you should know that some people who used medications such as levodopa inhalation developed gambling problems or other intense urges or behaviors that were compulsive or unusual for them, such as increased sexual urges or behaviors. There is not enough information to tell whether the people developed these problems because they took the medication or for other reasons. Call your doctor if you have an urge to gamble that is difficult to control, you have intense urges, or you are unable to control your behavior. Tell your family members about this risk so that they can call the doctor even if you do not realize that your gambling or any other intense urges or unusual behaviors have become a problem.
• you should know that levodopa inhalation may cause dizziness, lightheadedness, nausea, sweating, and fainting when you get up too quickly from a lying or sitting position. To avoid this problem, get out of bed or get up from a seated position slowly, resting your feet on the floor for a few minutes before standing up.