natgillin/translations-raw huggingface dataset:
Tasmar is not recommended for use in children below the age of 18 due to insufficient data on safety or efficacy.
Zdravilo Tasmar ni priporočeno jemati pri otrocih do 18. leta starosti zaradi nezadostnih podatkov o varnosti ali učinkovitosti zdravila.
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, even those not prescribed (non-prescription medicines and herbals).
Prosimo, da svojemu zdravniku ali farmacevtu poveste, če jemljete ali ste pred kratkim jemali katero koli zdravilo, tudi če ste ga dobili brez recepta (zdravila brez recepta in zelišča).
Tasmar may cause rare but potentially fatal liver injury.
Zdravilo Tasmar lahko povzroči redko, a potencialno usodno poškodbo jeter.
Tasmar is administered orally three times daily.
Zdravilo Tasmar se jemlje peroralno trikrat na dan.
The frequency of possible side effects listed below is defined using the following convention:
Pogostnost možnih neželenih učinkov zdravila navedenih spodaj, je določena v skladu z naslednjimi kriteriji:
Your doctor will discuss the risks and benefits of taking Tasmar during pregnancy.
Zdravnik bo proučil tveganja in koristi zdravljenja z zdravilom Tasmar med nosečnostjo.
Furthermore a reduction of levodopa dose or termination of therapy may be considered.
Nadalje je potrebno razmisliti o zmanjšanju odmerka levodope ali prekinitvi zdravljenja.
Patients must be informed of this and advised to exercise caution while driving or operating machines during treatment with levodopa.
Bolnike moramo o tem obvestiti in jim svetovati naj bodo pazljivi pri vožnji ali upravljanju strojev med zdravljenjem z levodopo.
Tasmar has an effect on the symptoms of your Parkinson's disease.
Zdravilo Tasmar ima učinek na simptome vaše Parkinsonove bolezni.
High levels of plasma 3-OMD have been associated with poor response to levodopa in Parkinson's disease patients.
Visoke vrednosti plazemskega 3-OMD povezujejo s slabim odzivom na levodopo pri bolnikih s Parkinsonovo boleznijo.
In vitro experiments have shown that tolcapone binds mainly to serum albumin.
In vitro poskusi so pokazali, da se tolkapon veže pretežno na serumske albumine.
Your doctor should always begin your treatment with the standard dose of 3 times daily 1 tablet (100 mg (1 tablet)).
Vaš zdravnik bo vedno začel zdravljenje s standardnim odmerkom (100 mg (1 tableta) trikrat na dan).
In addition, your doctor will stop Tasmar treatment if after 3 weeks you do not improve enough to justify the risks of continuing treatment.
Poleg tega bo vaš zdravnik zdravljenje z zdravilom Tasmar prekinil, če se vaše stanje po 3 tednih ne bo dovolj izboljšalo, da bi nadaljnje zdravljenje upravičevalo tveganja.
Food delays and decreases the absorption of tolcapone, but the relative bioavailability of a dose of tolcapone taken with a meal is still 80 % to 90 %.
Hrana upočasni in zmanjša absorpcijo tolkapona, relativna biološka uporabnost odmerka tolkapona, če ga jemljemo s hrano, pa je še vedno 80- do 90-%.
With 200 mg tolcapone, maximum inhibition of erythrocyte COMT activity is, on average, greater than 80 %.
Z 200 mg tolkapona je maksimalno zaviranje eritrocitne COMT aktivnosti v povprečju večje od 80 %.
Tell your doctor if you or your family/ carer notices you are developing urges or cravings to behave in ways that are unusual for you or you cannot resist the impulse, drive or temptation to carry out certain activities that could harm yourself or others.
Zdravniku povejte, če vi ali vaša družina/negovalec opazite, da so se pri vas razvile neobvladljive potrebe in želje, da bi se vedli na za vas nenavaden način, ali da se ne morete upreti impulzu, vzgibu ali skušnjavi, da bi izvedli določene dejavnosti, ki bi škodile vam ali drugim.
You can also report side effects directly via the national reporting system listed in Appendix V*.
O neželenih učinkih lahko poročate tudi neposredno na nacionalni center za poročanje, ki je naveden v Prilogi V.
Liver injury has occurred most often after 1 month and before 6 months.
Poškodba jeter se je najpogosteje pojavila po 1 mesecu in pred 6 meseci zdravljenja.
Biotransformation/Elimination: Tolcapone is almost completely metabolised prior to excretion, with only a very small amount (0.5 % of dose) found unchanged in urine.
Biotransformacija/izločanje: tolkapon se pred izločanjem skoraj popolnoma presnovi, zelo majhne količine nespremenjenega (0,5 % odmerka) pa najdemo v urinu.
Therefore, Tasmar should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.
Zato se zdravilo Tasmar lahko v nosečnosti uporablja le kadar pričakovana korist upravičuje morebitno tveganje za plod.
It should also be noted that female patients may have a higher risk of liver injury.
Prav tako je treba omeniti, da utegne biti tveganje za poškodbe jeter večje pri ženskah.
An interaction was observed with benserazide, which may lead to increased levels of benserazide and its active metabolite.
Medsebojno delovanje je bilo opaženo z benserazidom, kar lahko vodi v povišanje koncentracij benserazida in njegovega aktivnega presnovka.
Inform your doctor about all prescription and non-prescription medications as the risk of NMS may be increased if you are taking some specific medications.
Povejte zdravniku za vsa zdravila, ki ste jih prejeli na recept ali brez recepta, saj se lahko tveganje za MNS poveča, če jemljete določena zdravila.
Mutagenesis: Tolcapone was shown not to be genotoxic in a complete series of mutagenicity studies.
Mutageneza: tolkapon se ni izkazal za genotoksičnega v vseh serijah študij mutagenosti.
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
Če vam je vaš zdravnik povedal, da ne prenašate nekaterih sladkorjev, se z njim posvetujte preden začnete jemati to zdravilo.
The reduction to a putative amine, as well as the subsequent N-acetylation, occurs to a minor extent.
Redukcija v domnevni amin se tako kot posledična Nacetilacija pojavi v manjšem obsegu.
Increase of alanine aminotransferase (ALT)
Povišanje alanin-aminotransferaze (ALT)
Based on the physicochemical properties of the compound, hemodialysis is unlikely to be of benefit.
Glede na fizikalno-kemijske lastnosti učinkovine hemodializa verjetno ne bo koristila.
In general, the average peak levodopa plasma concentration (Cmax) and the time of its occurrence (tmax) were unaffected.
Povprečna najvišja plazemska koncentracija levodope (Cmax) in čas nastopa (tmax) na splošno nista bila spremenjena.
Urine discolouration: Tolcapone and its metabolites are yellow and can cause a harmless intensification in the colour of the patient's urine.
Obarvanje urina: tolkapon in njegovi presnovki so rumeni in lahko povzročijo neškodljivo ojačitev barve bolnikovega urina.
During dosing with Tasmar 200 mg three times daily, erythrocyte COMT inhibition at trough is 30 % to 45 %, with no development of tolerance.
Med odmerjanjem zdravila Tasmar 200 mg trikrat na dan je zaviranje eritrocitne COMT tik pred naslednjim odmerkom 30 % do 45 % brez razvoja tolerance.
If Tasmar is to be prescribed, the patient should be informed about the signs and symptoms which may indicate liver injury, and to contact the physician immediately.
Če zdravilo Tasmar nameravamo predpisati, mora biti bolnik obveščen o znakih in simptomih, ki lahko kažejo na poškodbo jeter in o tem, da nemudoma obvesti zdravnika.
This could be explained by the fact that only a negligible amount of unchanged tolcapone is excreted in the urine, and the main metabolite, tolcapone-glucuronide, is excreted both in urine and in bile (faeces).
To lahko razložimo z dejstvom, da se samo zanemarljiva količina nespremenjenega tolkapona izloča v urin in da se glavni presnovek, tolkapon-glukuronid izloča v urin in z žolčem (blatom).
In addition, the compound is methylated by COMT to 3-O-methyl-tolcapone and metabolised by cytochromes P450 3A4 and P450 2A6 to a primary alcohol (hydroxylation of the methyl group), which is subsequently oxidised to the carboxylic acid.
Dodatno se spojina metilira s COMT v 3-O-metil tolkapon in presnavlja s citokromi P450 3A4 in P450 2A6 v primarni alkohol (hidroksilacija metilne skupine), ki se nato oksidira v karboksilno kislino.
Isolated cases of either accidental or intentional overdose with tolcapone tablets have been reported.
Znani so posamezni primeri bodisi slučajnega bodisi namernega prevelikega odmerjanja tablet tolkapona.
Do not break or crush the tablets.
Ne lomite ali drobite tablet.
However, if taking the next dose should be directly ahead, do not make up for the forgotten dose.
Če je naslednji odmerek potrebno vzeti takoj zatem, ne jemljite pozabljenega odmerka.
Only in exceptional circumstances, when the anticipated incremental clinical benefit justifies the increased risk of hepatic reactions, should the dose be increased to 200 mg three times daily (see sections 4.4 and 4.8).
Samo v izjemnih primerih, ko pričakovane zvečane klinične koristi upravičujejo povečano tveganje za poškodbe jeter, naj se odmerek poveča na 200 mg trikrat na dan (glejte poglavje 4.4 in 4.8).
Pharmaco-therapeutic group: Anti-Parkinson drugs, other dopaminergic agents, ATC code: NO4BX01
Farmakoterapevtska skupina: antiparkinsoniki, druga dopaminergična zdravila, Oznaka ATC: N04BX01
However, in patients with moderate cirrhotic liver disease, clearance of unbound tolcapone was reduced by almost 50 %.
V nasprotju s tem se je pri bolnikih z zmerno cirotično boleznijo jeter očistek nevezanega tolkapona zmanjšal za skoraj 50 %.
The treatment with Tasmar may sometimes lead to disturbances in the way the liver works.
Zdravljenje z zdravilom Tasmar lahko včasih vodi v motnje delovanja jeter.
Other Medicines and Tasmar
Druga zdravila in zdravilo Tasmar
Studies in healthy volunteers have shown that tolcapone reversibly inhibits human erythrocyte COMT activity after oral administration.
Študije na zdravih prostovoljcih so pokazale, da tolkapon reverzibilno zavira humano eritrocitno aktivnost COMT po peroralnem dajanju.
Under such a diagnosis Tasmar should be immediately discontinued and the patient should be followed up closely.
Z vzpostavitvijo te diagnoze moramo zdravljenje z zdravilom Tasmar nemudoma prekiniti in skrbno spremljati bolnika.
However patients should be advised that their ability to drive and operate machines may be compromised due to their Parkinson's disease symptoms.
Vseeno je treba bolnikom pojasniti, da je lahko njihova sposobnost vožnje in upravljanja s stroji zaradi simptomov Parkinsonove bolezni zmanjšana.
Therefore, if symptoms occur after discontinuing Tasmar, physicians should consider increasing the patient's levodopa dose (see section 4.2).
Če se simptomi pojavijo po prekinitvi zdravljenja z zdravilom Tasmar, naj zdravniki razmislijo o zvečanju bolnikovega odmerka levodope (glejte poglavje 4.2).
Isolated cases consistent with NMS have been associated with Tasmar treatment.
Posamezni primeri skladni z MNS so bili povezani z zdravljenjem z zdravilom Tasmar.
13 (17 %) 24 (32 %) NA NA
13 (17 %) 24 (32 %) ni na voljo ni na voljo
Tasmar may be taken with or without food (see section 5.2).
Zdravilo Tasmar se lahko jemlje s hrano ali brez nje (glejte poglavje 5.2).
There is no evidence from clinical studies that Tasmar adversely influences a patient's ability to drive and use machines.
Iz kliničnih študij ni dokazov, da bi zdravilo Tasmar negativno vplivalo na bolnikovo sposobnost vožnje in upravljanja s stroji.
Elderly patients No dose adjustment of Tasmar is recommended for elderly patients.
Starejši bolniki Prilagajanje odmerkov zdravila Tasmar pri starejših bolnikih ni priporočljivo.
When Tasmar was given together with levodopa/carbidopa and desipramine, there was no significant change in blood pressure, pulse rate and plasma concentrations of desipramine.
Ko so zdravilo Tasmar dajali skupaj z levodopo/karbidopo in dezipraminom, ni bilo pomembnih sprememb v krvnem tlaku, srčni frekvenci in plazemskih koncentracijah dezipramina.
The data of more than 400 patients have confirmed that over a wide range of creatinine clearance values (30-130 mL/min) the pharmacokinetics of tolcapone are unaffected by renal function.
Podatki več kot 400 bolnikov so potrdili, da je v velikem razponu vrednosti očistka kreatinina (30 do 130 ml/min) farmakokinetika tolkapona neodvisna od ledvične funkcije.
Tolcapone markedly reduces the formation of 3-OMD.
Tolkapon občutno zmanjša nastajanje 3-OMD.
The primary outcome was the proportion of patients with a 1 or more hour increase in ON time (see Table 1).
Primarni izid je bilo razmerje bolnikov z eno- ali večurnim povečanjema obdobja »vklopa« (ON) (glejte preglednico 1).
Lactose intolerance: Tasmar contains lactose.
Intoleranca za laktozo: Zdravilo Tasmar vsebuje laktozo.
Swallow Tasmar with 1 glass of water.
Pogoltnite zdravilo Tasmar z 1 kozarcem vode.
The main metabolic pathway of tolcapone is conjugation to its inactive glucuronide.
Glavna presnovna pot tolkapona je konjugacija v neaktivni glukuronid.
In clinical trials, more than 70 % of patients required a decrease in their daily levodopa dose if their daily dose of levodopa was >600 mg or if patients had moderate or severe dyskinesias before beginning treatment.
V kliničnih preskušanjih je več kot 70 % bolnikov potrebovalo zmanjšanje dnevnega odmerka levodope, če so jemali več kot 600 mg levodope na dan ali pa so pred začetkom zdravljenja imeli zmerno ali hudo diskinezijo.
Summary of potentially Tasmar-related adverse reactions, with crude incidence rates for the phase III placebo-controlled studies:
Povzetek neželenih učinkov, potencialno povezanih z zdravilom Tasmar, z grobimi deleži pojavnosti za fazo III s placebom kontroliranih študij:
For the treatment of your Parkinson´s disease you already take levodopa.
Za zdravljenje vaše Parkinsonove bolezni že jemljete zdravilo, ki vsebuje levodopo.
Tasmar tablets are film-coated and should be swallowed whole because tolcapone has a bitter taste.
Tablete Tasmar so filmsko obložene in jih je treba pogoltniti cele, ker ima tolkapon grenak okus.
However, a study in Parkinson's patients confirmed that after treatment discontinuation there was no significant change in levodopa pharmacokinetics or in patient response to levodopa compared to pretreatment levels.
Toda študija pri Parkinsonovih bolnikih je potrdila, da v primerjavi z vrednostmi pred zdravljenjem, po prekinitvi zdravljenja ni bilo pomembnih sprememb v farmakokinetiki levodope ali v odzivu bolnika na levodopo.
You should only receive Tasmar if your Parkinson's disease is not adequately controlled by the use of other therapies.
Zdravilo Tasmar naj bi prejemali le, če vaša Parkinsonova bolezen ni bila zadostno urejena z uporabo ostalih zdravil.
Patients who have experienced somnolence and/or an episode of sudden sleep onset must refrain from driving or operating machines (see section 4.7).
Bolniki, ki so občutili zaspanost in/ali doživeli obdobje nenadnega uspavanja morajo opustiti vožnjo ali upravljanje s stroji (glejte poglavje 4.7).
Diarrhoea associated with Tasmar usually began 2 to 4 months after initiation of therapy.
Diareja, povezana z zdravilom Tasmar, se je pojavila 2 do 4 mesece po začetku zdravljenja.
Before starting treatment: If liver function tests are abnormal or there are signs of impaired liver function, Tasmar should not be prescribed.
Pred začetkom zdravljenja: če jetrni testi niso normalni ali obstajajo znaki okvare jeter, se zdravila Tasmar ne sme predpisati.
Rarely, after abruptly reducing or stopping Tasmar or other antiparkinsonian drugs, you may experience severe symptoms of muscle stiffening, fever or mental confusion.
Redko, potem ko vam nenadoma zelo zmanjšajo odmerek ali prekinejo zdravljenje z zdravilom Tasmar ali drugimi antiparkinsoniki, lahko izkusite hude simptome togosti mišic, visoko vročino ali duševno zmedenost.
The treatment will be stopped, if these blood tests become abnormal.
Zdravljenje bo prekinjeno, če izvidi ne bodo normalni.
This means when it is taken together with levodopa (as levodopa/benserazide or levodopa/carbidopa) you should have an improvement in the symptoms of your Parkinson's disease.
To pomeni, da ko ga jemljete skupaj z levodopo (kot levodopa/benserazid ali levodopa/karbidopa), se morajo vaši simptomi Parkinsonove bolezni izboljšati.
Neuroleptic Malignant Syndrome (NMS):
Maligni nevroleptični sindrom (MNS):
Do not stop Tasmar or any other Parkinson's medications without telling your doctor as this may increase the risk of NMS.
Ne prekinite jemanja zdravila Tasmar ali katerega drugega zdravila za zdravljenje Parkinsonove bolezni, ne da bi se posvetovali z zdravnikom, saj to lahko poveča tveganje za MNS.
The effect of tolcapone on the pharmacokinetics of other drugs metabolised by COMT such as -methyldopa, dobutamine, apomorphine, adrenaline and isoprenaline have not been evaluated.
Učinek tolkapona na farmakokinetiko drugih zdravil, ki se presnavljajo s COMT, kot je -metildopa, dobutamid, apomorfin, adrenalin in izoprenalin, ni bil ocenjen.
Time of day Dose
Del dneva Odmerek
If another person accidentally takes your medicine, contact a doctor or hospital immediately as he or she may need urgent medical attention.
Če druga oseba po pomoti zaužije vaše zdravilo, mora nemudoma obiskati zdravnika ali bolnišnico, saj bo verjetno potrebovala takojšnjo medicinsko pomoč.
When Tasmar is administered together with levodopa, it increases the relative bioavailability (AUC) of levodopa approximately twofold.
Kadar se zdravilo Tasmar daje skupaj z levodopo, poveča relativno biološko uporabnost (AUC) levodope približno dvakratno.
Number (proportion) improved on both primary and secondary outcome
število (delež) bolnikov s primarnim in sekundarnim izidom
If you feel unwell, you should contact your doctor because you may need to take less levodopa.
Če se ne počutite dobro, obvestite svojega zdravnika, ker lahko potrebujete manjši odmerek levodope.
Symptoms of overdose may include nausea, vomiting, dizziness and breathing difficulties.
Simptomi čezmernega odmerjanja lahko vključujejo slabost, bruhanje, omotico in težave z dihanjem.
Selective MAO-B inhibitors should not be used at higher than recommended doses (e.g. selegiline 10 mg/day) when coadministered with Tasmar.
Selektivnih zaviralcev MAO-B se ne sme uporabljati v odmerkih, večjih od priporočenih (npr. selegilin 10 mg/dan), kadar se jemljejo skupaj z zdravilom Tasmar.
To reduce the risk of NMS you should not use Tasmar if your doctor says you have severe involuntary movement (dyskinesia) or a previous illness that may have been NMS.
Da bi zmanjšali tveganje za MNS, ne smete jemati zdravila Tasmar, če vaš zdravnik pravi, da imate resno nehoteno gibanje (diskinezija), ali ste v preteklosti imeli bolezen, ki bi lahko bila MNS.
The following doses of Tasmar should be taken 6 and 12 hours later.
Ostala odmerka zdravila Tasmar vzemite 6 in 12 ur pozneje.
Do not use after the expiry date stated on the pack.
Zdravila ne smete uporabljati po datumu izteka roka uporabnosti, ki je naveden na ovojnini.
However, the relationship of renal function and tolcapone pharmacokinetics has been investigated using population pharmacokinetics during clinical trials.
Razmerje med ledvično funkcijo in farmakokinetiko tolkapona so v nasprotju s tem raziskovali z uporabo populacijske farmakokinetike med kliničnimi preskušanji.
Tasmar should be discontinued if substantial clinical benefits are not seen within 3 weeks of the initiation of the treatment regardless of dose.
Zdravljenje z zdravilom Tasmar je treba prekiniti, če bistvene klinične koristi niso opažene v prvih 3 tednih zdravljenja ne glede na odmerek.
The inhibition is closely related to plasma tolcapone concentration.
Zaviranje je tesno povezano s plazemsko koncentracijo tolkapona.
If you have been already treated with Tasmar and developed acute liver injury during treatment, Tasmar should not be re-introduced again.
Če ste že jemali zdravilo Tasmar in med zdravljenjem dobili akutno poškodbo jeter, zdravila Tasmar ne bi smeli ponovno jemati.
These behaviours are called impulse control disorders and can include addictive gambling, excessive eating or spending, an abnormally high sex drive or a preoccupation with an increase in sexual thoughts or feelings.
Taka vedenja se imenujejo motnje nadzora impulzov in lahko vključujejo patološko igranje iger na srečo, prenajedanje, prekomerno nakupovanje, nenormalno povečano spolno poželenje ali nenormalno pogosto razmišljanje o spolnosti in občutkih, povezanih z njo.
A study in patients with hepatic impairment has shown that moderate non-cirrhotic liver disease had no impact on the pharmacokinetics of tolcapone.
Študija pri bolnikih z okvaro jeter je pokazala, da zmerna necirotična bolezen jeter ni imela vpliva na farmakokinetiko tolkapona.
Double blind placebo controlled clinical studies have shown a significant reduction of approximately 20 % to 30 % in OFF time and a similar increase in ON time, accompanied by reduced severity of symptoms in fluctuating patients receiving Tasmar.
Dvojno slepe s placebom kontrolirane klinične študije so pokazale pomembno zmanjšanje obdobja »izklopa« (OFF) za približno 20 do 30 % in podobno povečanje obdobja »vklopa« (ON), skupaj z zmanjšano resnostjo simptomov bolnikov s fluktuacijami, ki prejemajo zdravilo Tasmar.
Soon after beginning and during your treatment with Tasmar, you may have symptoms caused by levodopa such as involuntary movement and nausea.
Kmalu po začetku in med zdravljenjem z zdravilom Tasmar lahko opazite simptome povzročene z levodopo kot so nehoteno gibanje in slabost.
Benserazide interaction: Due to the interaction between high dose benserazide and tolcapone (resulting in increased levels of benserazide), the prescriber should, until more experience has been gained, be observant of dose-related adverse reactions (see section 4.5).
Interakcija z benserazidom: zaradi medsebojnega delovanja med velikimi odmerki benserazida in tolkapona (ki se kažejo v povišanih vrednostih benserazida), mora biti predpisovalec, preden dobi več izkušenj, pozoren na od odmerka odvisne neželene učinke (glejte poglavje 4.5).
Experience with Tasmar obtained in parallel placebo-controlled randomised studies in patients with Parkinson's disease is shown in the following table, which lists adverse reactions with a potential relationship to Tasmar.
Izkušnje z zdravilom Tasmar, pridobljene v vzporednih, s placebom kontroliranih študijah pri bolnikih s Parkinsonovo boleznijo, so prikazane v spodnji tabeli, ki vsebuje seznam neželenih učinkov z možno povezavo z zdravilom Tasmar.
Catechols and other drugs metabolised by catechol-O-methyltransferase (COMT): Tolcapone may influence the pharmacokinetics of drugs metabolised by COMT.
Kateholi in druga zdravila, ki se presnavljajo s katehol-O-metiltransferazo (COMT): tolkapon lahko vpliva na farmakokinetiko učinkovin, ki se presnavljajo s COMT.
Rare cases of severe hepatocellular injury resulting in death have been reported during marketed use (see section 4.4).
Redki primeri hude hepatocelularne poškodbe s smrtnim izidom so bili opisani v času trženja zdravila (glejte poglavje 4.4).
What Tasmar is and what it is used for What do you need to know before you take Tasmar How to take Tasmar
Kaj je zdravilo Tasmar in za kaj ga uporabljamo Kaj morate vedeti, preden boste vzeli zdravilo Tasmar Kako jemati zdravilo Tasmar Možni neželeni učinki
Inform your doctor also: - if you have any illnesses other than Parkinson's disease, - if you are allergic to other medicines, food and dyes, - if soon after beginning and during treatment with Tasmar you have symptoms which may be caused by levodopa such as involuntary movement (dyskinesia) and nausea.
Prav tako obvestite svojega zdravnika: - če imate katero drugo bolezen poleg Parkinsonove bolezni, - če ste alergični na druga zdravila, hrano ali barvila, - če se vam kmalu po začetku zdravljenja z zdravilom Tasmar in med njim pojavijo znaki, ki so povezani z levodopo kot so nehoteno gibanje (diskinezija) in slabost.