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Dhivy
Dhivy is a prescription medication primarily used in the treatment of Parkinson’s disease and Parkinsonism. It contains carbidopa and levodopa, two medications that work together to manage the symptoms of Parkinson's disease, such as tremors, rigidity, and bradykinesia (slowness of movement). Levodopa is converted into dopamine in the brain, which is deficient in patients with Parkinson’s, while carbidopa helps prevent the breakdown of levodopa before it reaches the brain, enhancing its effectiveness.
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Frequently Asked Questions
How long does it take for Dhivy to start working?
Most patients begin to notice improvements in symptoms within 1 to 2 weeks of starting the medication, but full benefits may take longer.
Can I stop taking Dhivy if I feel better?
Do not stop taking Dhivy suddenly without consulting your healthcare provider. Stopping abruptly can lead to severe symptoms, including neuroleptic malignant syndrome.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at once.
Does Dhivy affect sleep?
Yes, Dhivy can cause sleep disturbances, such as insomnia or, in rare cases, excessive daytime sleepiness. Inform your healthcare provider if you experience significant changes in your sleep patterns.
Is Dhivy safe for long-term use?
Yes, Dhivy is generally safe for long-term use in managing Parkinson’s disease when taken as prescribed. Regular monitoring by your healthcare provider is important to ensure the medication remains effective and to manage any side effects.
Comprehensive Drug Guide
How Does Dhivy Work?
Dhivy works by combining levodopa, which is converted into dopamine in the brain to replenish the deficient neurotransmitter, and carbidopa, which prevents levodopa from being prematurely broken down before reaching the brain. Together, these actions improve movement control and reduce symptoms of Parkinson’s disease.
What is Dhivy Used For?
- Treatment of Parkinson’s disease
- Management of Parkinsonism resulting from encephalitis or injury to the nervous system
Common Dosages
Dhivy is available in the following strengths:
- Carbidopa 25 mg / Levodopa 100 mg tablets
- Carbidopa 50 mg / Levodopa 200 mg tablets
Typical Dosing
FDA Approved Indications
For patients with Parkinson’s disease, the typical starting dose is 1 tablet three times daily, with adjustments made based on patient response and tolerance. The dose may be increased as needed, but the patient’s response is monitored closely to avoid excessive side effects.
Who Shouldn't Take Dhivy?
Dhivy should not be used in individuals with:
- Narrow-angle glaucoma
- History of malignant melanoma
- Concurrent use of nonselective monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOIs
Advice From The Pharmacist
- Take Dhivy with food to reduce stomach upset. However, avoid high-protein meals, as protein can interfere with the absorption of levodopa.
- Do not stop taking Dhivy suddenly, as abrupt discontinuation may lead to a severe worsening of symptoms or a potentially dangerous condition called neuroleptic malignant syndrome (NMS).
- Store the medication in a cool, dry place and keep it out of reach of children.
- Monitor your response to the medication and report any new or worsening side effects, such as abnormal involuntary movements (dyskinesia).
Side Effects of Dhivy
Common Side Effects
- Nausea
- Dizziness
- Dry mouth
- Drowsiness
- Insomnia
Uncommon/Severe Side Effects
- Involuntary movements (dyskinesia)
- Hallucinations or delusions
- Severe hypotension
- Neuroleptic malignant syndrome (NMS) if discontinued abruptly
Risks and Warnings of Dhivy
Dyskinesia: Patients may develop involuntary movements, especially at higher doses. Monitoring and dose adjustments may be necessary.
Cardiovascular Effects: Dhivy can cause low blood pressure (orthostatic hypotension), especially when standing up quickly. Be cautious when changing positions.
Neuroleptic Malignant Syndrome (NMS): Abrupt discontinuation of Dhivy can lead to NMS, a potentially life-threatening condition characterized by fever, muscle rigidity, and altered mental status.
Interactions with Dhivy
Common Drug Interactions
- Nonselective MAOIs: Combining Dhivy with MAOIs can lead to dangerous interactions, including hypertensive crisis.
- Antihypertensive medications: Dhivy may enhance the effects of blood pressure-lowering medications, leading to hypotension.
- Iron supplements: Iron can reduce the absorption of levodopa. If needed, take iron supplements at least two hours before or after Dhivy.
Alternatives to Dhivy
- Sinemet: Another combination of carbidopa and levodopa used for Parkinson’s disease management.
- Ropinirole (Requip): A dopamine agonist that mimics the action of dopamine in the brain and is used to treat Parkinson’s disease.
- Pramipexole (Mirapex): Another dopamine agonist used for Parkinson’s disease and restless leg syndrome.
- Selegiline (Eldepryl): A selective MAOI that is sometimes added to Parkinson’s treatment to boost the effects of levodopa.