Levodopa (L-Dopa) is an amino acid precursor of dopamine and is the most effective and commonly used drug in the treatment of Parkinson disease. Levodopa is usually combined with carbidopa, which is an inhibitor of L-amino acid decarboxylase, the plasma enzyme that metabolizes levodopa peripherally. Treatment with the combination of levodopa and carbidopa has been associated with mild and transient increases in serum enzymes in a proportion of patients and with very rare instances of clinically apparent acute liver injury.