The term LED (levodopa-equivalent doses) is a way of estimating the combined effect of different classes of anti-Parkinson’s medicines such as levodopa (Madopark /levodopa/benserazide; Duodopa, Flexilev, Sinemet/levodopa/carbidopa), and part of Stalevo/Sastravi/Lecigon/levodopa/carbidopa/entacapone), enzyme inhibitors that enhance and prolong the effect of levodopa (rasagiline/Xadago/safinamide/Comtess/entacapone/Ogentys/opicapone) and dopamine agonists/antagonists (Sifrol/Mirapex/pramipexole; ReQuip/ropinirole; Neupro/rotigotine; Apomorphine/Apo-Go/Dacepton).
Calculating the LED is important when switching treatments, for example from tablet-based medication to pump-delivered liquid medication, or when adjusting treatment for DBS (deep brain stimulation).
6 tablets of Pramipexole 0.18 mg = 1.08 mg, but depending on how these 6 tablets are taken, the effect may vary. If taken all at once, the effect lasts for about 6 hours and is equivalent to 150 mg of levodopa over 6 hours, which corresponds to approximately 2 x 150 Madopark taken at 3-hour intervals, as the duration of action is shorter for Madopark. If the 6 tablets are taken spread over 3 doses, 2+2+2 at approximately 6-hour intervals, the effect is equivalent to 50 mg of levodopa over 18 hours, which corresponds to approximately 100 mg of Madopark every 6 hours. If the dose is taken as a sustained-release tablet – e.g. 1.05 Sifrol Depot/Pramipexol Depot – this provides an effect over a 24-hour period that can be replaced by 150 mg of levodopa taken four times.
The conversion factor is 143 × mg of pramipexole = equivalent levodopa dose, but the conversion factor does not take into account the duration of action.
/Håkan Widner