L-DOPA AND AMBLYOPIA
The medicine 'L-dopa' or 'Levodopa' has been used to treat Parkinson's disease
for decades. In much lower doses it has been used to treat amblyopia since
the early 1990's. In Europe, the similar 'citicholine' has also been used.
The earlier studies on L-Dopa in amblyopia were done in Ohio, at the Children's
hospital in Columbus. They used the medicine plus glasses plus patching in
'all comers', and compared this with dummy-pill plus glasses plus patching.
L-Dopa medicine gave better and faster results than dummy pills.
I have tended to use L-Dopa in 'difficult' patients, typically older patients
where glasses plus patching is more likely to be difficult and less successful.
There were many cases of no effect, some cases of slight effect, some cases
of larger effect.
Recently there has been an American study showing that in 8-17 year olds with
'stubborn' amblyopia, glasses [if relevant] plus patching plus L-Dopa results
in a 2 line improvement in 1/3 patients over 9 weeks. . This has been recommended
for your consideration for your child. We will adhere to the American protocol
as closely as possible.
This folder also contains information provided to the American researchers
and parents who used this medicine, the results of the study, and information
on where to obtain the medicine.
If you wish to proceed, you will need to:
1. read all this data
2. spend at least 30 minutes with Kim Salter and / or Dr Kowal discussing
the material to your satisfaction
3. commit to attend [ and pay] for all the examinations used in the American
protocol [at our '105 S extended' rate'].
4. sign a form acknowledging that this is not standard treatment
in Australia, but you wish to try it for your child. (see bottom of page)
Dosage Matrix
Based on the requirement for a capsule that delivers 0.76mg/kg levodopa and
0.17mg/kg carbidopa, three times daily for up to 9 weeks, I can give you the
following pricing matrix.
Total quantity: 190 capsules (3 capsules daily x 7 days per week x 9 weeks
of treatment = 190 capsules)
| Patient Weight(Kg) | Levodopa Dose per Cap (mg) | Caridopa Dose per Cap (mg) | Total Cost |
| 40 | 30.4 | 6.8 | $230. |
| 45 | 34.2 | 7.7 | $250 |
| 50 | 38.0 | 8.5 | $260 |
| 55 | 41.8 | 9.4 | $270 |
| 60 | 45.6 | 10.2 | $280 |
| 65 | 49.4 | 11.1 | $290 |
| 70 | 53.2 | 11.9 | $310 |
| 75 | 57.0 | 12.8 | $320 |
| 80 | 60.8 | 13.6 | $330 |
Capsules would take up to 2 working days to produce, although the initial
order may take a day or two longer as we would have to order in the raw materials
from Sydney.
If you need any further info feel free to give me a call or email
Thanks
Andrew Inchley
Pharmacist-in-Charge, Compounding________________________________________
Slade Compounding
Suite 2.1, 32 Erin St, Richmond 3121
t: (03) 9421 1055 | f: (03) 9421 6273 | m: 0488 318 777
e: andrew.inchley@slade.net.au | w: www.slade.net.au
Request For Treatment
My name is ______________and I am the parent of _______________
who has resistant amblyopia.
I have read the PEDIG material including the Research Letters supplied to
me by Dr Kowal, and find the idea of treatment using this protocol to be attractive
and desirable for my child. I have had unrestricted opportunity to discuss
all details with Dr Kowal or his staff. I have been encouraged to make my
own further enquiries from other doctors, optometrists and from the Internet.
I understand that L-Dopa treatment for amblyopia has rarely been used in Australia,
and only infrequently used in America over the last 18 -20 years. If there
are any rare or late side effects or complications from this treamtent they
may not be known at this time.
___________________________ is aged __ and weighs ___Kg.
Signed ________________________ Date__/__/____.