How do you manage and adjust Parkinson’s medication if a patient has worsening orthostatic hypotension while being treated with carbidopa/levodopa?

Levodopa is such an important pillar of Parkinson's therapy that it is often necessary to continue this drug despite the worsening of orthostatic intolerance.

This is a step-wise approach (i.e., don't go to step 4 if you haven't addressed step 2):

1. Ensure that the patient is getting symptomatic benefits from carbidopa/levodopa as it could contribute to orthostasis.
2. Review concomitant medications to minimize those drugs that can contribute to BP drops. I'll often discuss with the patient's cardiolo...