Sinemet

Common use

Sinemet (carbidopa and levodopa) treats the symptoms of Parkinson disease. It works by increasing the amount of dopamine in your brain, a substance which helps manage body movements and coordination. This reduces the symptoms of Parkinson, such as body stiffness and tremors.

Dosage and direction

Take this medication by mouth with a glass of water. Follow the directions on the prescription label. Swallow whole. Do not crush or chew. You may cut the tablets in half. Take your doses at regular intervals. Do not take your medication more often than directed. Do not stop taking except on the advice of your care team.

Precautions

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medication. Avoid alcoholic drinks.
When taking this medication, you may fall asleep without notice. You may be doing activities like driving a car, talking, or eating. You may not feel drowsy before it happens. Contact your care team right away if this happens to you.
There have been reports of increased sexual urges or other strong urges such as gambling while taking this medication. If you experience any of these while taking this medication, you should report this to your care team as soon as possible.
A high protein diet can slow or prevent absorption of this medication. Avoid high protein foods near the time of taking this medication to help to prevent these problems. Take this medication at least 30 minutes before eating or one hour after meals. You may want to eat higher protein foods later in the day or in small amounts. Discuss your diet with your care team.
If you have diabetes, you may get a false-positive result for sugar in your urine. Check with your care team.
This medication may cause a decrease in vitamin B6. You should make sure that you get enough vitamin B6 while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.

Contraindications

If you have any of these conditions:
Depression or other mental illness; Diabetes; Glaucoma; Heart disease, including history of a heart attack; History of irregular heartbeat; Kidney disease; Liver disease; Lung or breathing disease, like asthma; Narcolepsy; Sleep apnea; Stomach or intestine problems; An unusual or allergic reaction to levodopa, carbidopa, other medications, foods, dyes, or preservatives; Pregnant or trying to get pregnant; Breast-feeding.

Possible side effect

Side effects that you should report to your care team as soon as possible:
Allergic reactions - skin rash, itching, hives, swelling of the face, lips, tongue, or throat,
Falling asleep during daily activities,
Heart rhythm changes - fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing,
Low blood pressure - dizziness, feeling faint or lightheaded, blurry vision,
Mood and behavior changes - anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression,
New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body,
Stomach bleeding - bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds,
Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss,
Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you.

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Dark red or black saliva, sweat, or urine,
Dizziness,
Drowsiness,
Headache,
Nausea.

Drug interaction

Do not take this medication with any of the following:
MAOIs like Marplan, Nardil, and Parnate,
Reserpine,
Tetrabenazine.

This medication may also interact with the following:
Alcohol, Droperidol, Entacapone, Iron supplements or multivitamins with iron, Isoniazid, INH, Linezolid, Medications for depression, anxiety, or psychotic disturbances, Medications for high blood pressure, Medications for sleep, Metoclopramide, Papaverine, Procarbazine, Tedizolid, Rasagiline, Selegiline, Tolcapone.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Missed dose

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Overdose

If you think you have taken too much of this medicine contact a poison control center or emergency room at once. This medicine is only for you. Do not share this medicine with others.

Storage

Keep out of the reach of children.
Store below 30 degrees C (86 degrees F). Keep container tightly closed. Throw away any unused medication after the expiration date.