Carbidopa / Levodopa Dosages for Adults: Your GoodRx Guide
Carbidopa / levodopa is a medication that treats Parkinson’s disease. Learn about the typical starting dosage, different formulations, and more.
Dhivy
Used for Parkinson's Disease
Used for Parkinson's Disease
Dhivy (carbidopa / levodopa) is FDA approved to treat adults with Parkinson's disease (PD). It can also treat conditions that cause PD symptoms. This medication raises the dopamine levels in the brain to help with PD symptoms like tremors and slowed movement. It comes as a tablet and is taken by mouth multiple times per day. The tablet has grooves (score lines) that make it easy to break for dosing and for people with trouble swallowing. Side effects include movement problems, nausea, and hallucinations.
What is Dhivy (carbidopa / levodopa)?
What is Dhivy (carbidopa / levodopa) used for?
- Parkinson's disease (PD)
- Parkinsonism (conditions that cause people to have PD symptoms, like slowness, stiffness, and tremors)
How Dhivy (carbidopa / levodopa) works
Dhivy (carbidopa / levodopa) is a combination of two medications. Carbidopa and levodopa work together to raise dopamine levels in the brain. This helps relieve symptoms of Parkinson's disease (PD).
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Levodopa is a dopamine replacement. Levodopa travels to the brain, where it gets turned into dopamine. By restoring dopamine levels in the brain, levodopa helps relieve PD symptoms.
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Carbidopa is a dopa decarboxylase inhibitor. Dopa decarboxylase is a protein that breaks down levodopa before it can reach the brain. Blocking this protein lets more levodopa reach the brain and turn into dopamine. This means more levodopa and dopamine stay in the brain longer. This helps improve PD symptoms.
When does Dhivy (carbidopa / levodopa) start working?Time passed since treatment started:
Drug facts
| Common Brands | Dhivy |
|---|---|
| Drug Class | Dopa decarboxylase inhibitor / Dopamine replacement |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Dhivy (carbidopa / levodopa)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Involuntary movements (dyskinesia or dystonia)
- Nausea
Less Common Side Effects
- Vomiting
- Diarrhea
- Dry mouth
- Back or shoulder pain
- Confusion
- Headache
- Weakness
- Dizziness
- Hallucinations
- Unusual dreams
- Shortness of breath
- Dark-colored saliva, sweat, or urine
- Changes in blood pressure
Dhivy (carbidopa / levodopa) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Falling asleep suddenly or feeling very sleepy
- Hallucinations: seeing things that aren't there, hearing sounds that aren't real, feeling unreal sensations
- Abnormal thinking or behavior: confusion; trouble sleeping; paranoia; delusions; aggression; agitation; strong urges to gamble, shop, or eat
- Depression and thoughts of suicide
- Low vitamin B6: depression, confusion, swollen or sore tongue, cracked corners of your mouth, skin irritation, numbness or tingling in the hands or feet, seizure
- Withdrawal symptoms after stopping or lowering the dose suddenly: very high fevers, confusion, irregular pulse, sweating, muscle stiffness, changes in blood pressure
When do Dhivy (carbidopa / levodopa) possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Y
Nausea
Uncontrolled movements (dyskinesia)
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
The following Dhivy (carbidopa / levodopa) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Falling asleep during daily activities
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Low vitamin B6 level—swollen or sore tongue, cracks at the corners of the mouth, rash, pain, tingling, or numbness in the hands or feet, irritability, confusion, feelings of depression, unusual weakness or fatigue, seizures
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dark red or black saliva, sweat, or urine
- Dizziness
- Drowsiness
- Headache
- Nausea
Get your GoodRx coupon
$417.81
Manufacturer exclusive discount
$130.14
Pros and cons of Dhivy (carbidopa / levodopa)
Pros
- Tablets can be broken into smaller pieces if needed (for your specific dose or easier swallowing)
- First-choice option for treating PD symptoms
- Might work within 1 hour
Cons
- Often need to take several times per day to manage PD symptoms
- Can make you very sleepy and possibly sudden sleep episodes
- Can darken the color of your saliva, sweat, and urine
Pharmacist tips for Dhivy (carbidopa / levodopa)
- You can take Dhivy (carbidopa / levodopa) with or without food. Try to avoid taking it with high-protein foods, such as meat, milk, cheese, or nuts. These can slow how your body absorbs the medication. Also, the medication might not work as well.
- If you have trouble swallowing the Dhivy (carbidopa / levodopa) tablet, you can break it into smaller pieces on the score lines. Hold the tablet with one hand on each side and gently snap it at the groove (score line). Keep any unused pieces of the tablet in the original container and close it tightly.
- If needed, follow your prescriber's instructions carefully on where to break the tablet for your dose if needed. There are a total of 3 score lines on each Dhivy (carbidopa / levodopa) tablet. They can be helpful for dosing. Ask your prescriber or pharmacist if you're not sure how much to take.
- Dhivy (carbidopa / levodopa) can make you feel very tired or sleepy. Some people might even fall asleep suddenly without any warning at all. Because of this, don't drive or do anything that requires you to stay alert until you know how the medication makes you feel. If you feel extra sleepy or suddenly nod off during the day, tell your care team right away.
- You might find it harder to control how your body moves after you start taking Dhivy (carbidopa / levodopa). This is called dyskinesia, and it can often happen after taking the medication for a long time, like many years. If these extra movements start to bother you or make your day hard, let your prescriber know. They might be able to help by adjusting your dose.
- Dhivy (carbidopa / levodopa) might make your vitamin B6 levels drop. This can cause your tongue to get sore or very red or little cracks at the corners of your mouth. You also might feel any strange "pins and needles" or numbness in your body. If this happens, tell your care team so they can check your vitamin levels. If they're too low, your prescriber might suggest a vitamin B6 supplement to help.
- Taking Dhivy (carbidopa / levodopa) can change the color of your urine, sweat, and saliva. It might look darker, like a red, brown, or black color. While this might look scary, it's actually harmless. But be careful because these dark bodily fluids can stain your clothing.
- Don't take iron supplements or multivitamins with iron at the same time as Dhivy (carbidopa / levodopa). It's best to wait a few hours between them. It prevents iron from blocking your body from absorbing the medication well. This is important to help the medication work as best it can to manage your PD symptoms.
- Tell your care team if your PD symptoms start to get worse while taking Dhivy (carbidopa / levodopa). It's common for the medication to stop working as well as it used to after you've taken it for a while. It can lead to more "off" time (when your symptoms come back between doses). If this happens, your prescriber can adjust your dose. They can also find other options to help manage your PD better.
- Don't suddenly stop taking Dhivy (carbidopa / levodopa) or lower your dose without talking to your prescriber first. This is because it can cause a very high fever, confusion, and stiff muscles. If you want to stop or lower your dose, talk to your prescriber. They'll help you decide if it's the right choice and slowly lower your dose.
Risks and warnings for Dhivy (carbidopa / levodopa)
Dhivy (carbidopa / levodopa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Sleepiness or falling asleep during activities
- Risk factors: History of drowsiness | History of sleep problems | Taking sedatives or medications that make you drowsy
Dhivy (carbidopa / levodopa) can sometimes make you fall asleep suddenly, even if you didn't feel tired beforehand. This can happen while eating, talking, or even driving, which can be dangerous.
Because of this risk, avoid driving or doing anything that requires your focus until you know how Dhivy (carbidopa / levodopa) affects you. This is extra important if you often feel sleepy or have ever fallen asleep suddenly before. Also avoid taking medications that make you sleepy since they can make this worse.
Let your prescriber know if you feel very sleepy during the daytime while taking Dhivy (carbidopa / levodopa). Also tell them if you fall asleep in the middle of activities that need your full attention.
High fevers and confusion when lowering the dose or stopping too suddenly
Although rare, stopping Dhivy (carbidopa / levodopa) or lowering your dose too fast can cause side effects. These can look similar to symptoms of neuroleptic malignant syndrome (NMS). It can cause very high fever, confusion, an irregular pulse, sweating, muscle stiffness, and changes in blood pressure.
Don't stop taking Dhivy (carbidopa / levodopa) or lower your dose without talking to your prescriber first. They can make sure it's the right choice and lower your dose safely.
Hallucinations and changes in behavior and thoughts
- Risk factors: History of certain mental health conditions
Dhivy (carbidopa / levodopa) can raise the risk of hallucinations. They might come with confusion, trouble sleeping, or a lot of dreaming. These symptoms can happen shortly after starting the medication, and they might go away after your dose is lowered. Tell your care team if you or your loved ones notice you're hallucinating while taking Dhivy (carbidopa / levodopa).
Dhivy (carbidopa / levodopa) can also raise the risk of having abnormal thinking and behavior. This can include paranoia, delusions, aggression, agitation, and confusion. Call your care team if you notice these changes while taking this medication.
Because it can worsen psychosis, you shouldn't take Dhivy (carbidopa / levodopa) if you have certain mental health conditions. Also, some mental health medications, like haloperidol (Haldol) or perphenazine, can make PD symptoms worse. They could also make Dhivy (carbidopa / levodopa) work less well. Let your prescriber know about any mental health problems you have.
Difficulty controlling impulsive behavior
Dhivy (carbidopa / levodopa) can sometimes make people act more impulsively. Some examples include having strong sexual or gambling urges, having urges to spend a lot of money, and binge eating. These behaviors can be hard to control.
Tell your care team if you or someone close to you notices you start having these urges while you're taking Dhivy (carbidopa / levodopa). In particular, tell them if the urges start to have a negative impact on your life. Your prescriber will also ask you about these behaviors during follow-up visits, since you might not notice them yourself.
Risk of depression and thoughts of suicide
Tell your prescriber if you feel depressed or have suicidal thoughts while taking Dhivy (carbidopa / levodopa). If you start thinking about hurting yourself, call 988 for the National Suicide Prevention Lifeline or call 911 right away.
Low vitamin B6 levels and seizures
- Risk factors: Taking a high dose of Dhivy (carbidopa / levodopa)
Taking Dhivy (carbidopa / levodopa) might lower your vitamin B6 levels. The risk of vitamin B6 deficiency is greater if you're taking a higher dose of the medication.
Low vitamin B6 can cause skin rash, swollen tongue, and numbness and tingling in the hands and feet. More seriously, it can lead to depression, confusion, and even seizures. These seizures might not get better with usual anti-seizure medications. And they might only improve when given extra vitamin B6.
Your care team will check your vitamin levels with blood tests before you start Dhivy (carbidopa / levodopa). They'll likely check again every so often during treatment. If you notice new symptoms like a sore tongue, cracked corners of your mouth, or numbness and tingling, tell your care team right away. They might suggest taking a vitamin B6 supplement to keep your levels in a safe range.
Caution use in people with a history of heart attack and arrhythmia
Before starting Dhivy (carbidopa / levodopa), tell your prescriber if you've had a heart attack and have a history of irregular heartbeats (arrhythmias). This medication can affect your heart rhythm. So your care team might want to keep an eye on your heart function as your dose gets adjusted.
Caution use in people with a history of stomach ulcers
If you've had stomach ulcers before, Dhivy (carbidopa / levodopa) might raise your risk of bleeding in your stomach or gut. Tell your prescriber if you have a history of ulcers or frequent stomach pain before starting this medication. They’ll check your digestive health more closely. They can make sure the medication isn't causing gut irritation or bleeding.
Higher eye pressure in people with glaucoma
If you have glaucoma, taking Dhivy (carbidopa / levodopa) might cause the pressure inside your eye to rise. High eye pressure can be dangerous if it isn't managed.
Tell your prescriber and care team if you have glaucoma. They'll want you to see your eye specialist periodically for eye exams while you're taking Dhivy (carbidopa / levodopa). They'll check your eye pressure to make sure it's within a safe range during treatment.
Dhivy (carbidopa / levodopa) dosage
The average cost for 90 tablets of 25mg/100mg of Dhivy (carbidopa / levodopa) is $130.14 with a free GoodRx coupon. This is 68.85% off the average retail price of $417.81. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg/100mg | 90 tablets | $130.14 | $1.45 |
Typical dosage for Dhivy (carbidopa / levodopa)
The typical starting dose is 25 mg/100 mg (carbidopa/levodopa) by mouth 3 times per day. Your prescriber will slowly raise your dose until your symptoms of PD are controlled. The maximum daily dose is 200 mg/800 mg (carbidopa/levodopa).
How much does Dhivy (carbidopa / levodopa) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Dhivy (brand)
$130.14
Dhivy (carbidopa / levodopa) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Dhivy (carbidopa / levodopa) will not be safe for you to take.
- Currently take or have taken a nonselective monoamine oxidase inhibitor (MAOI) within 2 weeks
What are alternatives to Dhivy (carbidopa / levodopa)?
There are a number of medications that your doctor can prescribe in place of Dhivy (carbidopa / levodopa). Compare a few possible alternatives below.
News about Dhivy (carbidopa / levodopa)
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