carbidopa and levodopa

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Pronunciation: KAR bi DOE pa and LEE voe DOE pa

Brand: Parcopa, Rytary, Sinemet, Sinemet CR

Carbidopa-Levodopa 10 mg-100 mg-TEV

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Carbidopa-Levodopa 10-100mg-APO

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Carbidopa-Levodopa 25 mg-100 mg SR-APO

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Carbidopa-Levodopa 25 mg-100 mg

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Carbidopa-Levodopa 25 mg-100 mg-TEV

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Carbidopa-Levodopa 25 mg-250 mg-TEV

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Carbidopa-Levodopa 25-100 mg-APO

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Carbidopa-Levodopa 25-100-END

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Carbidopa-Levodopa 25-100mg ER-MYL

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Carbidopa-Levodopa 25-250 mg-APO

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Carbidopa-Levodopa 25-250-END

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Carbidopa-Levodopa 50 mg-200 mg SR-APO

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round, tan, imprinted with APO 132

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Carbidopa-Levodopa 50-200mg ER-MYL

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Carbidopa-Levodopa CR 50 mg-200 mg-ETH

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Carbidopa-Levodopa DT 10 mg-100 mg-MYL

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Carbidopa-Levodopa DT 25 mg-100 mg-MYL

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Carbidopa-Levodopa DT 25 mg-250 mg-MYL

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Carbidopa-Levodopa ER 25 mg-100 mg-GLO

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Carbidopa-Levodopa ER 50 mg-200 mg-GLO

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Parcopa 10 mg-100 mg

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Parcopa 25 mg-100 mg

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Parcopa 25 mg-250 mg

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Sinemet 10 mg-100 mg

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Sinemet 10-100 mg

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Sinemet 25 mg-100 mg

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Sinemet 25 mg-250 mg

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Sinemet 25-250

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Sinemet CR 25 mg-100 mg

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Sinemet CR 25-100

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Sinemet CR 25-250

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Sinemet CR 50 mg-200 mg

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

You should not use carbidopa and levodopa if you have narrow-angle glaucoma.

Do not use carbidopa and levodopa if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

What is carbidopa and levodopa?

Carbidopa and levodopa is a combination medicine used to treat symptoms of Parkinson's disease, such as muscle stiffness, tremors, spasms, and poor muscle control. Parkinson's disease may be caused by low levels of a chemical called dopamine (DOE pa meen) in the brain.

Levodopa is converted to dopamine in the brain. Carbidopa helps prevent the breakdown of levodopa before it can reach the brain and take effect.

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 purposes not listed in this medication guide.

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

You should not use carbidopa and levodopa if you are allergic to it, or if you have:

narrow-angle glaucoma.

To make sure carbidopa and levodopa is safe for you, tell your doctor if you have:

heart disease, high blood pressure, history of heart attack;
liver or kidney disease;
an endocrine (hormonal) disorder;
asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder;
a stomach or intestinal ulcer;
open-angle glaucoma; or
a history of depression, mental illness, or psychosis.

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Carbidopa and levodopa can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

The carbidopa and levodopa disintegrating tablet 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?

If you already take levodopa, you must stop taking it at least 12 hours before you start taking carbidopa and levodopa.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Carbidopa and levodopa can be taken with or without food. Take your doses at regular intervals to keep a steady amount of the drug in your body at all times. Get your prescription refilled before you run out of medicine completely.

Do not crush, chew, break, or open a carbidopa and levodopa capsule. Swallow it whole.

The tablet is sometimes broken in half to give the correct dose. Always swallow a whole or half tablet without chewing or crushing.

To take the orally disintegrating tablet (Parcopa):

Keep the tablet in the bottle until you are ready to take it.
Use dry hands to remove the tablet and place it on your tongue.
Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves.

It may take up to several weeks of using carbidopa and levodopa before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after a few weeks of treatment. Also tell your doctor if the effects of this medication seem to wear off quickly in between doses.

If you use this medicine long-term, you may need frequent medical tests at your doctor's office.

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

Do not stop using carbidopa and levodopa suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using carbidopa and levodopa.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking carbidopa and levodopa?

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

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 medicine.

What are the possible side effects of carbidopa and levodopa?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
worsening of tremors (uncontrolled shaking);
severe or ongoing vomiting or diarrhea;
confusion, hallucinations, unusual changes in mood or behavior;
depression or suicidal thoughts; or
severe nervous system reaction --very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Some people taking carbidopa and levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

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.

Common side effects may include:

jerky or twisting muscle movements;
muscle contractions; or
nausea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect carbidopa and levodopa?

Other drugs may interact with carbidopa and levodopa, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about carbidopa and levodopa.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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