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Although metoclopramide may increase the bioavailability of levodopa by increasing gastric emptyingmetoclopramide may also adversely affect disease control by its dopamine receptor antagonistic properties.
When levodopa is administered orallyit is rapidly decarboxylated to dopamine in extracerebral tissues so that only a small portion of a given dose is transported unchanged to the central nervous systemFor this reasonlarge doses of levodopa are required for adequate therapeutic effectand these may often be accompanied by nausea and other adverse reactionssome of which are attributable to dopamine formed in extracerebral tissues.
The most common adverse reactions reported with SINEMET have included dyskinesiassuch as choreiformdystonicand other involuntary movementsand nausea.
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