Carbidopa (kar-bi-DOE-pa), Levodopa (lee-voe-DOE-pa)
Treats symptoms of Parkinson's disease and parkinsonism, such as shaking, stiffness, and slow movement.
There may be other brand names for this medicine.
Parcopa, Sinemet 10-100, Sinemet 25-100, Sinemet 25-250, Sinemet CR
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to levodopa or carbidopa, or if you have narrow-angle glaucoma (high pressure in your eyes). You should not use this medicine if you have melanoma (skin cancer), or if you have had melanoma in the past. Do not use this medicine if you have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
How to Use This Medicine
Tablet, Dissolving Tablet, Long Acting Tablet
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- Swallow the extended-release tablet whole. Do not crush, break, or chew it.
- If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, swallow or take a drink of water.
If a dose is missed:
- If you miss a dose, or forget to take your medicine, use it as soon as you can. If the time for your next dose is less than 2 hours away, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using other Parkinson medicines, such as levodopa, or if you have used one recently.
- Make sure your doctor knows if you are also using haloperidol (Haldol®), isoniazid (Nydrazid®), metoclopramide (Reglan®), papaverine (Pavabid®), phenytoin (Dilantin®), or risperidone (Risperdal®). Tell your doctor if you are also using medicine to treat depression (such as amitriptyline, doxepin, nortriptyline, Elavil®, Pamelor®, or Sinequan®) or a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®).
- Make sure your doctor knows if you are also using medicine to lower your blood pressure (such as atenolol, hydrochlorothiazide, lisinopril, metoprolol, quinapril, Accupril®, Cozaar®, Diovan®, Lotrel®, Norvasc®, Toprol®, or Zestril®).
- Make sure your doctor knows if you are also using any mineral supplements or multivitamins with iron. Eating high-protein foods, such as meat, fish, poultry, eggs, cheese, beans, or milk, while you are using this medicine may cause it not to work as well. Carefully follow your doctor's instructions about any special diet.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney problems, liver problems, heart or blood vessel problems, heart rhythm problems, lung or breathing problems (such as asthma), endocrine problems (such as diabetes, thyroid problems, or growth problems), severe mental illness, dyskinesia (trouble controlling your muscles), or a history of heart attack. Tell your doctor if you have wide-angle glaucoma, or a history of stomach ulcer or neuroleptic malignant syndrome (NMS).
- When you first start using this medicine or if your dose is increased, you might feel dizzy, lightheaded, hot, or sick to your stomach if you stand up quickly. Get up slowly to give your body some time to adjust, especially if you have been sitting or lying down for a long time.
- This medicine contains phenylalanine. Make sure your doctor knows if you have phenylketonuria (PKU).
- Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Your doctor may also need to check your skin regularly. Be sure to keep all appointments.
- This medicine may make you dizzy, drowsy, or less alert. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. To avoid dizziness from this medicine, stand up slowly from a sitting or lying position.
- You may experience a "wearing-off" effect towards the end of the dosing interval. Tell your doctor if you have problems with this that affect your every day life. Your doctor may want to adjust your dose.
- A dark color (red, brown, or black) may appear in your saliva, urine, or sweat after taking this medicine. The color may cause some of your clothes to become discolored.
- Some patients who have used this medicine had unusual changes in their behavior, such as having problems with gambling or an increased sex drive. Talk with your doctor if this is a concern for you.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Change in how much or how often you urinate.
- Chest pain, shortness of breath, or fast or uneven heartbeat.
- Chills, cough, sore throat, and body aches.
- Feeling unusually sad, suicidal thoughts (wanting to hurt yourself).
- Fever, sweating, confusion, irregular heartbeat, or muscle stiffness.
- Lightheadedness, dizziness, or fainting when getting up from lying or sitting position.
- Numbness or tingling in your hands or feet.
- Severe nausea or vomiting.
- Uncontrolled or jerky body movement, or eyelid twitch.
- Unusual behavior, mood changes, or seeing or hearing things that are not there.
- Unusual bleeding, bruising, or weakness.
If you notice these less serious side effects, talk with your doctor:
- Back pain or shoulder pain.
- Blurred vision.
- Changes in sexual desire.
- Constipation, diarrhea, mild nausea or vomiting, loss of appetite, or stomach pain.
- Dry mouth, or bad or unpleasant taste.
- Feeling unusually confused, nervous, or upset.
- Hair loss.
- Pink or red colored urine, dark colored sweat or saliva, or heavy sweating.
- Skin rash.
- Trouble sleeping, sleeping too much, or nightmares.