PHARM417 Lecture Notes - Lecture 30: Idiopathic Intracranial Hypertension, Aromatic L-Amino Acid Decarboxylase, Triptan
21 Mar 2016
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Doses of up to 200 mg daily have been studied. Some patients do receive doses higher than this, and we can observe that those patients may tolerate the medication quite well. It is recommended that once the patient approaches 200 mg/day of carbidopa, we use caution to start limiting the carbidopa intake, or switching some 25 mg doses to 10 mg doses. In some countries the products are separate, but in canada, we only have combination products on the market. Carbidopa partially saturates dopa decarboxylase (also known as aromatic l-amino acid decarboxylase). We have to keep in mind that enzymes that break down l-dopa, including dopa decarboxylase, and com-t, have physiologic functions beyond just breaking down l-dopa. To completely saturate the enzyme may be detrimental. Perhaps referring to the enzyme as aromatic l-amino acid decarboxylase better emphasizes this point, that the enzyme has a broader function in metabolism. Smoking is listed as a relative contraindication for use of triptans.
