Sinemet Cr Consumer Information

Sinemet CR

Generic Name: carbidopa and levodopa (oral) (kar bi DOE pa and LEE voe DOE pa)
Brand Names: Atamet, Parcopa, Sinemet, Sinemet CR

What is carbidopa and levodopa?

Levodopa is converted to a chemical called dopamine (DOE pa meen) in the brain. Symptoms of Parkinson's disease may be caused by low levels dopamine in the brain. Levodopa is turned into dopamine in the body.

Carbidopa helps prevent the breakdown of levodopa before it can reach the brain and take effect.

The combination of carbidopa and levodopa is used to treat Parkinson symptoms such as muscle stiffness, tremors, spasms, and poor muscle control.

Carbidopa and levodopa is also used to treat Parkinson symptoms caused by carbon monoxide poisoning or manganese intoxication.

Carbidopa and levodopa may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about carbidopa and levodopa?

What should I discuss with my healthcare provider before taking carbidopa and levodopa?

Do not take this medication if you are allergic to carbidopa (Lodosyn) or levodopa (Larodopa), or if you have:

• narrow-angle glaucoma;

• unusual skin lesions that have not been checked by a doctor; or

• a history of malignant melanoma (skin cancer).

Before taking carbidopa and levodopa, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease, high blood pressure, coronary artery disease, a heart rhythm disorder, or a prior heart attack;

• asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder;

• liver disease;
• kidney disease;

• an endocrine (hormonal) disease;

• a stomach or intestinal ulcer;

• wide-angle glaucoma; or

• depression or other mental illness.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take carbidopa and levodopa.

The disintegrating tablet (such as Parcopa) may contain phenylalanine. Talk to your doctor before using this form of carbidopa and levodopa if you have phenylketonuria (PKU).

How should I take carbidopa and levodopa?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Carbidopa and levodopa can be taken with or without food.

The regular tablet can be broken or crushed if needed to make it easier to swallow.

To take the orally disintegrating tablet (Parcopa):

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves.

To be sure this medication is helping your condition and not causing harmful side effects, your blood will need to be tested on a regular basis. Your kidney, heart, and liver function may also need to be tested. Do not miss any scheduled appointments.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using carbidopa and levodopa.

Parkinson's disease is sometimes treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Overdose symptoms may include uneven heart rate, muscle spasms, and severe nausea or vomiting.

What should I avoid while taking carbidopa and levodopa?

Avoid taking iron supplements or eating a diet that is high in protein (protein sources include meat, eggs, and cheese). These things can make it harder for your body to digest and absorb carbidopa and levodopa. Talk with your doctor or nutrition counselor about the best foods to eat while you are taking this medication.

Carbidopa and levodopa side effects

You may notice that your sweat, urine, or saliva appears dark in color, such as red, brown, or black. This is not a harmful side effect, but it may cause staining of your clothes or bed sheets.

• restless muscle movements in your eyes, tongue, jaw, or neck;

• worsening of tremors (uncontrolled shaking);

• fever, stiff muscles, confusion, sweating, fast heart rate, rapid breathing;

• seizure (convulsions);

• severe nausea, vomiting, or diarrhea;

• uneven heart rate or fluttering in your chest;

• confusion, agitation, unusual thoughts or behavior; or

• depressed mood, thoughts of suicide or hurting yourself.

Less serious side effects may include:

• nausea, loss of appetite;

• diarrhea, constipation, upset stomach;

• headache, dizziness, drowsiness;

• nightmares, increased dreaming;

• numbness or tingly feeling;

• muscle pain; or

• skin rash or itching.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect carbidopa and levodopa?

Before taking carbidopa and levodopa, tell your doctor if you are taking any of the following medicines:

• metoclopramide (Reglan);

• isoniazid (Nydrazid);

• phenytoin (Dilantin);

• papaverine (Pavabid, Papacon, Pavagen, Pavacot);

• blood pressure medication;

• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil); or

• phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), or trifluperazine (Stelazine).

This list is not complete and there may be other drugs that can interact with carbidopa and levodopa. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.