CARBIDOPA + LEVODAPA

COMMON BRAND NAME(S): Sinemet

GENERIC NAME(S): CARBIDOPA/LEVODOPA

Description: Levodopa, a precursor of dopamine, crosses the blood-brain barrier and gets converted to dopamine in the basal ganglia while carbidopa is a dopa-decarboxylase inhibitor. The latter prevents conversion of L-dopa to dopamine outside the brain and minimises side effects.

Uses

This combination medication is used to treat symptoms of Parkinson’s disease or Parkinson-like symptoms (such as shakiness, stiffness, difficulty moving). Levodopa changes into dopamine in the brain, helping to control movement. Carbidopa prevents the breakdown of levodopa in the bloodstream so more levodopa can enter the brain. Carbidopa can also reduce some of levodopa’s side effects such as nausea and vomiting.

How to use carbidopa-levodopa

Take this medication by mouth with or without food as directed by your doctor, usually 3 to 4 times a day.

Taking this medication with food may help to decrease nausea. It is best to avoid a high-protein diet (it decreases the amount of levodopa that your body takes in) during treatment, unless directed otherwise by your doctor.

Separate your dose of this medication by as many hours as possible from any iron supplements or products containing iron (such as multivitamins with minerals) you may take. Iron can reduce the amount of this medication absorbed by the body. Consult your doctor or pharmacist for more details.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. This combination medication comes in different strengths with different amounts of carbidopa and levodopa in each tablet. Be sure you have the correct strength of both drugs. Your doctor may also prescribe carbidopa alone to be taken with this combination.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Some patients may experience a “wearing-off” (worsening of symptoms) before the next dose is due. An “on-off” effect might also occur, in which sudden short periods of stiffness occur. If these effects occur, contact your doctor for possible dose adjustments that may help to lessen this effect.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is quickly reduced or suddenly stopped. Your dose may need to be gradually reduced. (See also Side Effects section.)

Tell your doctor if your condition does not improve or if it worsens.

Warnings

Side Effects

Tell your doctor or pharmacist promptly if any of these effects persist or worsen:

dizziness
lightheadedness
nausea
vomiting
loss of appetite
trouble sleeping
unusual dreams
headache

This medication may cause saliva, urine, or sweat to turn a dark color. This effect is harmless, but your clothes may be stained.

Some people taking this medication have fallen asleep suddenly during their usual daily activities (such as talking on the phone, driving).

Tell your doctor right away if you have any serious side effects, including:

new/worsening movements you can’t control/spasms
greatly increased eye blinking/twitching
fainting
vision changes (such as blurred vision, double vision)
eye pain
severe stomach/abdominal pain
black/tarry stools
vomit that looks like coffee grounds
mental/mood changes (such as agitation, hallucinations,depression, thoughts of suicide)
signs of infection (such assore throat that doesn’t go away)
easy bleeding/bruising
unusual tiredness
tingling of the hands/feet
unusual strong urges (such as increased gambling, increased sexual urges)

Get medical help right away if you have chest pain.

Abruptly stopping or reducing the dose of this medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS).

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Precautions

Allergic reaction to this medication.
Patients with medical history of:
- liver disease
- glaucoma
- breathing problems (such as asthma)
- heart disease(such as heart attack, irregular heartbeat)
- kidney disease
- stomach/intestinal ulcer
- mental/mood disorders(such as depression, schizophrenia)
- blood disorders
- seizures
- sleep disorders

Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
Tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before having surgery.
Used only when clearly needed during pregnancy.
Consult your doctor before breast-feeding.

Consult your doctor regarding the precautions mentioned above.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.

Some products that may interact with this drug include:

antipsychotic drugs (such as chlorpromazine, haloperidol, thioridazine)
certain drugs used to treat high blood pressure (such as methyldopa, reserpine)
tetrabenazine

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, tranylcypromine) during treatment with this medication.

This medication may interfere with certain laboratory tests (including urine catecholamine/glucose/ketone tests), possibly causing false test results.

Overdose & Brands

Overdose

If overdose is suspected, contact a poison control center or emergency room right away.

Notes: Do not share this medication with others.

Laboratory and/or medical tests (such as heart/kidney/liver function, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

People with Parkinson’s disease may have an increased risk for developing skin cancer (melanoma). Tell your doctor promptly if you have a mole that gets bigger or looks different, or if you have other unusual skin changes. Ask your doctor if you should have regular skin exams.

Missed Dose: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Brands

Available Brands

Pardopa [ Brown & Burk Phils ]
Parkimet 275/Parkimet CR [ Sun Pharma ]
Sinedin [ MedChoice Pharma ]
Sinemet 25/100/Sinemet 25/250/Sinemet CR [ Merck Sharp & Dohme ]
Tidomet/Tidomet CR [ Torrent ]