A mixture of benserazide hydrochloride and levodopa in mass prop.ortions corresponding to 1 part of benserazide and 4 parts of levodopa.

Indications: treatment of all stages of Parkinson's disease (but not drug-induced extrapyramidal symptoms).

Cautions: pulmonary disease, peptic ulceration, cardiovascular disease, diabetes mellitus, osteomalacia, open-angle glaucoma, susceptibility to angle-closure glaucoma, history of skin melanoma (risk of activation), psychiatric illness (avoid if severe); excessive drowsiness; in prolonged therapy, psychiatric, hepatic, haematological, renal, and cardiovascular surveillance is advisable; warn patients to resume normal activities gradually; avoid abrupt withdrawal of levodopa preparations.

Contra-indications: narrow-angle glaucoma; severe psychoneuroses or psychoses; concomitant MAO I therapy; pregnancy; breast-feeding.

Side Effects: anorexia, nausea and vomiting, insomnia, agitation, postural hypotension (rarely labile hypertension), dizziness, tachycardia, arrhythmias, reddish discoloration of urine and other body fluids, rarely hypersensitivity; abnormal involuntary movements and psychiatric symptoms which include hypomania and psychosis may be dose-limiting; depression, drowsiness, headache, flushing, sweating, gastro-intestinal bleeding, peripheral neuropathy, taste disturbance, pathological gambling, increased libido, hypersexuality, pruritus, rash, and liver enzyme changes also reported; syndrome resembling neuroleptic malignant syndrome reported on withdrawal; very rarely angle-closure glaucoma.

Dose: expressed as levodopa, initially, 50 mg 3-4 times daily increased by 100 mg once or twice weekly according to response. Usual maintenance dose 400-800 mg daily in divided doses after meals.