<p>Patients currently treated with conventional levodopa/decarboxylase inhibitor combinations: Dosage with Levodopa-Carbidopa prolonged-release tablet should be substituted initially at an amount that provides no more than approximately 10% more levodopa per day when higher dosages are given (more than 900 mg per day). The dosing interval between doses should be prolonged by 30 to 50% at intervals ranging from 4 to 12 hours. It is recommended to give the smaller dose, if divided doses are not equal, at the end of the day. The dose needs to be titrated further depending on clinical response, as indicated below under &#39;Titration&#39;. Dosages that provide up to 30% more levodopa per day may be necessary. A guide for substitution of Levodopa Carbidopa prolonged-release tablet treatment for conventional levodopa/decarboxylase inhibitor combinations is shown in the table below:<br />
<br />
<strong>Guideline for conversion from conventional Levodopa/Carbidopa tablet to Levodopa-Carbidopa prolonged-release tablet:</strong><br />
<br />
Conventional tablet: Daily Dosage of Levodopa 300-400 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 400 mg. Dosage Regimen: 1 tablet 2x daily.</li>
</ul>

<p>Conventional tablet: Daily Dosage of Levodopa 500-600 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 600 mg. Dosage Regimen: 1 tablet 3x daily.</li>
</ul>

<p>Conventional tablet: Daily Dosage of Levodopa 700-800 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 800 mg. Dosage Regimen: 4 tablets in 3 or 4 divided doses.</li>
</ul>

<p>Conventional tablet: Daily Dosage of Levodopa 900-1000 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 1000 mg. Dosage Regimen: 5 tablets in 3 or more divided doses.</li>
</ul>

<p>Conventional tablet: Daily Dosage of Levodopa 1100-1200 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 1200 mg. Dosage Regimen: 6 tablets in 3 or more divided doses.</li>
</ul>

<p>Conventional tablet: Daily Dosage of Levodopa 1300-1400 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 1400 mg. Dosage Regimen: 7 tablets in 3 or more divided doses.</li>
</ul>

<p>Conventional tablet: Daily Dosage of Levodopa 1500-1600 mg</p>

<ul>
	<li>Controlled Release tablet: Daily Dosage of Levodopa 1600 mg. Dosage Regimen: 8 tablets in 3 or more divided doses.</li>
</ul>

<p>&nbsp;</p>

<p><strong>Administration</strong></p>

<p><strong>Patients currently treated with levodopa alone</strong>: Levodopa must be discontinued at least eight hours before therapy with this CR tablet is started. In patients with mild to moderate disease, the initial recommended dose is one tablet of this CR tablet twice daily.<br />
<br />
<strong>Patients not receiving levodopa</strong>: In patients with mild to moderate disease, the initial recommended dose is one tablet of this CR tablet twice daily. Initial dosages should not exceed 600 mg per day of levodopa, nor be given at intervals of less than six hours.<br />
<br />
<strong>Titration</strong>: Following initiation of therapy, doses and dosing intervals may be increased or decreased, depending upon therapeutic response. Most patients have been adequately treated with two to eight tablets per day of this CR tablet administered as divided doses at intervals ranging from four to twelve hours during the waking day. Higher doses (up to 12 tablets) and shorter intervals (less than four hours) have been used, but are not usually recommended. When doses of this CR tablet are given at intervals of less than four hours, or if the divided doses are not equal, it is recommended that the smaller doses be given at the end of the day. In some patients the onset of effect of the first morning dose may be delayed for up to one hour compared with the response usually obtained from the first morning dose of conventional levodopa-carbidopa tablet. An interval of at least three days between dosage adjustments is recommended.<br />
<br />
<strong>Maintenance</strong>: Because Parkinson&rsquo;s disease is progressive, periodic clinical evaluations are recommended and adjustment of the dosage regimen of this CR tablet may be required.<br />
<br />
<strong>Addition of other antiparkinson medication</strong>: Anticholinergic agents, dopamine agonists and amantadine can be given with this CR tablet. Dosage adjustment of this CR tablet may be necessary when these agents are added to an existing treatment regimen for this CR tablet.<br />
<br />
<strong>Interruption of therapy</strong>: Patients should be observed carefully if abrupt reduction or discontinuation of this CR tablet is required, especially if the patient is receiving antipsychotics.</p>