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

Research letters

Pedig Protocol

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

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__/__/____.



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This letter is protected by the laws of Copyright and must not be reprinted, copied or otherwise disclosed in whole or in part to any person without the written consent of Dr. Lionel Kowal.