CARBIDOPA & LEVODOPA

Brand & Generic Names

Sinemet
Sinemet CR

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antiparkinsonism

Uses

Controls Parkinson's disease symptoms such as rigidity, tremor and unsteady gait.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
At the same times each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Restores chemical balance necessary for normal nerve impulses.

Time lapse before drug works:
2 to 3 weeks to improve; 6 weeks or longer for maximum benefit.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Muscle twitch, spastic eyelid closure, nausea, vomiting, diarrhea, irregular and rapid pulse, weakness, fainting, confusion, agitation, hallucination, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to- mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

• Mood changes, uncontrollable body movements, diarrhea.
• Dry mouth, body odor.

Infrequent:

• Fainting, severe dizziness, headache, insomnia, nightmares, rash, itch, nausea, vomiting, irregular heartbeat.
• Flushed face, blurred vision, muscle twitching, discolored or dark urine, difficult urination.
• Constipation, tiredness.

Rare:

• High blood pressure.
• Upper abdominal pain, anemia.

Warnings & Precautions

Don't take if:

• You are allergic to levodopa or carbidopa.
• You have taken MAO inhibitors in past 2 weeks.
• You have glaucoma (narrow-angle type).

Before you start, consult your doctor:

• You have diabetes or epilepsy.
• If you have had high blood pressure, heart or lung disease.
• If you have had liver or kidney disease.
• If you have a peptic ulcer.
• If you have malignant melanoma.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug filters into milk. May harm child. Avoid.

Infants & children:
Not recommended.

Prolonged use:

• May lead to uncontrolled movements of head, face, mouth, tongue, arms or legs.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit), liver function, eyes, kidney function.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:
Expect to start with small dose and increase gradually to lessen frequency and severity of adverse reactions.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticonvulsants*,	Decreased effect of carbidopa and
hydantoin	levodopa.
Antidepressants*	Weakness or faintness when arising
	from bed or chair.
Antihypertensives*	Decreased blood pressure and effect
	of carbidopa and levodopa.
Antiparkinsonism	Increased effect
drugs, other*	of carbidopa and levodopa.
Haloperidol	Decreased effect of carbidopa and
	levodopa.
MAO inhibitors*	Dangerous rise in blood pressure.
Methyldopa	Decreased effect of carbidopa and
	levodopa.
Papaverine	Decreased effect of carbidopa and
	levodopa.
Phenothiazines*	Decreased effect of carbidopa and
	levodopa.
Phenytoin	Decreased effect of carbidopa and
	levodopa.
Pyridoxine	Decreased effect of
(Vitamin B-6)	carbidopa and levodopa.
Rauwolfia	Decreased effect of
alkaloids*	carbidopa and levodopa.
Selegiline	May require adjustment in dosage of
	carbidopa and levodopa.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Beverages:	None expected.
Cocaine:	Decreased carbidopa and levodopa
	effect. High rise of heartbeat
	irregularities. Avoid.
Foods:	None expected.
Marijuana:	Increased fatigue, lethargy,
	fainting.
Tobacco:	None expected.