Some studies have even shown that the pulsatile administration of levodopa can cause more motor complications than the continuous administration of the drug. Recent studies of such infusion have been shown to decrease the adverse effects of motor complications. Research has shown that levodopa infusion is associated with low plasma trough levels seen with oral drug administration. Infusion: another form of administration is a 16-hour infusion through a nasojejunal tube. Inhaled levodopa bypasses the intestinal absorption and hepatic metabolism of oral levodopa, and it is available in the form of dry powder. Food and Drug Administration in 2018 to treat Parkinson disease as adjunctive therapy to levodopa/carbidopa. Oral Inhalation: Inhaled formulation of levodopa was approved by the U.S. Patients who have trouble swallowing can open up the capsule, sprinkle the contents over food, and consume it immediately. The extended-release capsule of levodopa can be administered with or without food. The orally disintegrating tablets need to be dissolved entirely on the tongue before swallowing.

Also, high protein diets can decrease the amount of levodopa absorbed due to competition with amino acid transporters.

Patients should avoid high-fat, high-calorie meals when taking levodopa as it can delay absorption by 2 hours. The recommended titration schedule is to increase the dose by 100 mg every 3 or 4 days. Patients should take the oral form of levodopa with meals to decrease gastrointestinal (GI) upset. To improve absorption, patients should take levodopa 1 hour before or 2 hours after meals containing protein. Treatment should begin with small doses, and the recommended dose is 300 to 1200 mg (higher if tolerated) per day, divided into 3 to 12 doses.

A common off-label use for levodopa is restless leg syndrome and periodic limb movement in sleep (PLMS). Levodopa has been suggested as a reasonable treatment option for intermittent restless leg syndrome patients who do not need regular daily therapy. Recent data have suggested that levodopa can either slow down the progression of Parkinson disease and/or have increased benefits even after drug administration has stopped. The drug is also useful for post-encephalitic parkinsonism and symptomatic parkinsonism due to carbon monoxide intoxication. It is most effectively used to control bradykinetic symptoms that are apparent in Parkinson disease, and it is the most effective medication to improve the quality of life in patients with idiopathic Parkinson disease. Levodopa is typically prescribed to a patient with Parkinson disease once symptoms become more difficult to control with other antiparkinsonian drugs. Most commonly, clinicians use levodopa as a dopamine replacement agent for the treatment of Parkinson disease.

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