Today's Date:
Your patient's current medication list
Dosage of all levodopa-containing medications and COMT inhibitors your patient takes while awake
Number of hours your patient is awake per day
1ASelect the formulation(s) of levodopa-containing medications that the patient currently takes during awake time (typically 16 hours).
Select all that apply.
Current daily dose
mg/day
Morning dose
mL
Continuous dose
mL/hr
Carbidopa and levodopa enteral suspension 4.63 mg/20 mg per mL. Please see the Full Prescribing Information for CD/LD enteral suspension dosing guidance. This calculation assumes enteral suspension patients are on a 16-hour regimen.
1B Is your patient taking a COMT inhibitor?
COMT (catechol-O-methyltransferase) inhibitors are a class of Parkinson's medications that can be used in combination with levodopa.1,7
1CEnter patient’s hours of awake time per day.
hours
Based on the inputs you provided, the resulting flow rate is outside of operational parameters for the CDp/LDp Pump. Please review the patient’s levodopa-containing medications and COMT inhibitors for accuracy and consider starting a new CDp/LDp dose calculation.
Awake time is the average number of hours per day that the patient is awake during a 24-hour period. This is typically 16 hours but may vary based on the individual patient’s sleep patterns.1
mL/hr Base rate
1DGive your patients flexibility throughout their day by allowing them to toggle between high and low continuous hourly infusion rates.
Rate value type:
High hourly infusion rate:
% higher than the base rate
The CDp/LDp Pump is not able to deliver this high infusion rate. Available rates range from 0.15 mL/hr to 1.25 mL/hr, and the high rate must be greater than the base continuous rate.
Low hourly infusion rate:
% lower than the base rate
The CDp/LDp Pump is not able to deliver this low infusion rate. Available rates range from 0.15 mL/hr to 1.25 mL/hr, and the low rate must be less than the base continuous rate.
The maximum recommended daily dosage of CDp/LDp is 3525 mg of the foslevodopa component (equivalent to approximately 2500 mg levodopa).1
mL/hr Base Rate
mL/hr High Rate
mL/hr Low Rate
2 Select the amount of levodopa equivalents (mg) you would like to administer as an extra dose based on your clinical judgment. If you do not want to program an extra dose, select "None."
If 2 or more extra doses are used within 24 hours, consider revising the base continuous hourly infusion rate.1
Extra dose of levodopa (mg):
mg
Lockout time:
Lockout times are used to prevent patients from administering another extra dose until a set time has passed. The extra dose feature is limited to no more than 1 extra dose per hour.1,8
hr(s)
min
3Enter the amount of levodopa (mg) you would like to administer as a loading dose based on your clinical judgment. If you do not want to program a loading dose, select "None."
If CDp/LDp therapy is being initiated in an “Off” state or the patient has not been receiving their base continuous infusion for more than 3 hours, a loading dose can be administered immediately prior to starting or restarting the base continuous hourly infusion. The loading dose should be calculated from the first morning dose of oral immediate-release carbidopa/levodopa the patient took before starting treatment with CDp/LDp.1 The table below shows the conversion factors that were used in the clinical trial to convert current medications to oral immediate-release tablets. See the Prescribing Information of the respective drugs for conversions or adjustments. Morning dose of LD formulation taken by patient x Dose Multiplication Factor (determined by type of LD formulation in table below). Do not include COMT inhibitors when calculating the loading dose.
Amount of levodopa (mg):
Lockout times are used to prevent patients from administering another loading dose until a set time has passed. The loading dose feature is limited to no more than 1 loading dose every 3 hours.1,8
hrs
Base rate: mL/hr
This corresponds to mg of levodopa per hour ( mg levodopa per day)
High rate: mL/hr
Low rate: mL/hr
Extra dose: mL
This corresponds to mg of levodopa
Lockout time: hours minutes
Loading dose: mL
Lockout time: hours
The maximum recommended daily dosage of CDp/LDp is 3525 mg of the foslevodopa component (equivalent to approximately 2500 mg levodopa). Prescribing a backup oral carbidopa and levodopa product is recommended in the event that delivery of CDp/LDp is interrupted, which may result in underdosing.1
The CDp/LDp starting hourly infusion rates calculated by the CDp/LDp Dosing Calculator are suggested rates based on the Full Prescribing Information and do not replace the healthcare professional's judgment. Only a healthcare professional exercising independent clinical judgment can make decisions regarding appropriate patient care and treatment options considering the unique characteristics of each patient. The calculator and this site are intended only for access and use by licensed US healthcare professionals.
Calculating the total levodopa dosage (TLD)1,6
The amount of levodopa from all levodopa-containing medications taken during awake hours (typically 16-hour/day) should be converted to TLD. Below are the multiplication factors used in the clinical trial program for various levodopa formulations.
*The levodopa contained in combined CD/LD/COMT inhibitor formulations counts as immediate release and needs to be added to the TLD from all other sources of levodopa before the sum is multiplied for the COMT inhibitor correction factor. Do not apply COMT inhibitor correction factor until all TLD are summed.
Calculating the CDp/LDp hourly infusion rate1,6
CDp/LDp hourly infusion rate (mL/hr)=[(TLD x 1.3)/240]/hours patient is awake per day
†VYALEV may be administered over the patient’s waking hours or may be administered for 24 hours.
CD=carbidopa; COMT=catechol-O-methyltransferase; LD=levodopa.
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