A new formulation of carbidopa/levodopa 25/100, called DhivyTM, is now available. Manufactured by Avion Pharmaceuticals, its innovation is that it is scored into four sections allowing the pill to be easily cut into four equal parts. Each part contains 6.25 mg of carbidopa and 25 mg of levodopa. The medication was approved by the US Food and Drug Administration (FDA) in November 2021 and became available for prescribers in February 2022.
For some people with Parkinson’s disease (PD), carbidopa/levodopa use is associated with a clinical phenomenon called motor fluctuations. When this occurs, Parkinson’s symptoms can come and go throughout the day, with the biggest benefit of medication felt soon after taking a dose and with symptoms of PD returning prior to taking the next dose. Another complication of carbidopa/levodopa therapy are dyskinesias which are involuntary movements that tend to occur at the peak benefit of a dose or as the effect of a dose of medication is increasing or decreasing. One strategy used to smooth out the effects of carbidopa/levodopa throughout the day and minimize motor fluctuations and dyskinesias, is to prescribe smaller doses of carbidopa/levodopa more times during the day. In some cases, very small adjustments of the medication are required, and for this, Dhivy will come in handy.
It can also be used if only very small doses of carbidopa/levodopa are required or as part of a slow titration to an increased dose.
As always, please consult your neurologist about any new medications and to determine if Dhivy is a reasonable medication for you to try.
APDA welcomes this new addition to the collection of medications available to treat the symptoms of PD. Each new medication and formulation provides more ways to tailor treatment to each specific person.