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In 2021, the U.S. Food and Drug Administration (FDA) approved Dhivy, an easy-to-break carbidopa/levodopa tablet. Dhivy can be taken whole or easily snapped in half or quarters for smaller, more precise dosing.

Levodopa is one of the best medications available to treat Parkinson’s disease (PD) motor symptoms, including tremor, slowness and stiffness. As with any medication, doctors prescribe the lowest dose of levodopa possible to control symptoms and avoid side effects. Because everyone’s Parkinson’s is different, some people need more medication and others, less.

A tablet of Dhivy includes 100 mg levodopa and 25 mg carbidopa. (These are the same amounts as in other immediate-release levodopa/carbidopa tablets, such as Sinemet.) A quarter tablet of Dhivy contains 25 mg levodopa and 6.25 mg carbidopa.

Pros

Dhivy may allow lower medication doses early in PD, when symptoms are mild. It also may help later on, if a person develops involuntary movement (dyskinesia) or medication benefit comes and goes throughout the day (motor fluctuations). Smaller, more frequent doses, for example, may limit extra movement while also easing motor symptoms.

Advantages of Dhivy may include smaller, more specific levodopa doses to control movement symptoms while, at the same time, limiting risk of or easing motor complications. The easy-to-break tablets may also be beneficial for those in whom tremor, slowness or stiffness make pill cutting a difficult task.

Cons and Complications

Like all levodopa formulations, Dhivy can cause side effects of nausea or vomiting, low blood pressure with lightheadedness or dizziness, or seeing things that aren’t there (hallucinations). After living with Parkinson’s for many years, higher levodopa doses also could lead to dyskinesia or motor fluctuations.

The medical information contained in this article is for general information purposes only. The Michael J. Fox Foundation for Parkinson's Research has a policy of refraining from advocating, endorsing or promoting any drug therapy, course of treatment, or specific company or institution. It is crucial that care and treatment decisions related to Parkinson's disease and any other medical condition be made in consultation with a physician or other qualified medical professional.