Sinemet (as a combination product containing Carbidopa, Levodopa)

Name: Sinemet (as a combination product containing Carbidopa, Levodopa)

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking levodopa and carbidopa,

  • tell your doctor and pharmacist if you are allergic to levodopa and carbidopa any other medications, or any of the ingredients in levodopa and carbidopa tablets, capsules, or suspension. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking phenelzine (Nardil) or tranylcypromine (Parnate) or if you have stopped taking them in the past 2 weeks. Your doctor will probably tell you not to take levodopa and carbidopa.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants ('mood elevators') such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; haloperidol (Haldol); ipratropium (Atrovent); iron pills and vitamins containing iron; isocarboxazid (Marplan); isoniazid (INH, Nydrazid); medications for high blood pressure, irritable bowel disease, mental illness, motion sickness, nausea, ulcers, or urinary problems; metoclopramide (Reglan); other medications for Parkinson's disease; papaverine (Pavabid); phenytoin (Dilantin); rasagiline (Azilect); risperidone (Risperdal); sedatives; selegiline (Emsam, Eldepryl, Zelapar); sleeping pills; tetrabenazine (Xenazine); and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had glaucoma, melanoma (skin cancer), or a skin growth that has not been diagnosed. Your doctor may tell you not to take levodopa and carbidopa.
  • tell your doctor if you have or have ever had hormone problems; asthma; emphysema; mental illness; diabetes; stomach ulcers; heart attacks; an irregular heartbeat; or blood vessel, heart, kidney, liver or lung disease. If you are using levodopa and carbidopa suspension, also tell your doctor if you have or have ever had stomach surgery, nerve problems, low blood pressure, or fainting.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking levodopa and carbidopa, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking levodopa and carbidopa.
  • you should know that levodopa and carbidopa may make you drowsy or may cause you to suddenly fall asleep during your regular daily activities. You might not feel drowsy or have any other warning signs before you suddenly fall asleep. Do not drive a car, operate machinery, work at heights, or participate in potentially dangerous activities at the beginning of your treatment until you know how the medication affects you. If you suddenly fall asleep while you are doing something such as watching television, talking, eating, or riding in a car, or if you become very drowsy, especially during the daytime, call your doctor. Do not drive, work in high places, or operate machinery until you talk to your doctor.
  • ask your doctor about the safe use of alcoholic beverages while you are taking levodopa and carbidopa. Alcohol can make the side effects from levodopa and carbidopa worse.
  • you should know that some people who took medications such as levodopa and carbidopa developed gambling problems or other intense urges or behaviors that were compulsive or unusual for them, such as increased sexual urges or behaviors. There is not enough information to tell whether the people developed these problems because they took the medication or for other reasons. Call your doctor if you have an urge to gamble that is difficult to control, you have intense urges, or you are unable to control your behavior. Tell your family members about this risk so that they can call the doctor even if you do not realize that your gambling or any other intense urges or unusual behaviors have become a problem.
  • you should know that while taking levodopa and carbidopa, your saliva, urine, or sweat may become a dark color (red, brown, or black). This is harmless, but your clothing may become stained.
  • you should know that levodopa and carbidopa may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking levodopa and carbidopa. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
  • if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the orally disintegrating tablets contain aspartame that forms phenylalanine.

What special dietary instructions should I follow?

Talk to your doctor if you plan on changing your diet to foods that are high in protein, such as meat, poultry, and dairy products.

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Store cassettes containing levodopa and carbidopa enteral suspension in the refrigerator in their original carton, protected from light. Do not freeze the suspension.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to levodopa and carbidopa.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking levodopa and carbidopa.

Levodopa and carbidopa can lose its effect completely over time or only at certain times during the day. Call your doctor if your Parkinson's disease symptoms (shaking, stiffness, and slowness of movement) worsen or vary in severity.

As your condition improves and it is easier for you to move, be careful not to overdo physical activities. Increase your activity gradually to avoid falls and injuries.

Levodopa and carbidopa can cause false results in urine tests for sugar (Clinistix, Clinitest, and Tes-Tape) and ketones (Acetest, Ketostix, and Labstix).

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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