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Parkinson's Disease

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Carbidopa and Levodopa

BRAND: Atamet, Sinemet, Sinemet CR

Carbidopa and levodopa is a medication used to treat Parkinson's disease. Levodopa is turned into dopamine in the body.  When added to levodopa, carbidopa delays the conversion of levodopa into dopamine until it reaches the brain, preventing or diminishing some of the side effects that often accompany levodopa therapy. Carbidopa also reduces the amount of levodopa needed by about 75%.

Carbidopa and levodopa is used to treat the stiffness, tremors, spasms, and poor muscle control associated with Parkinson's disease. This medication is also used to treat the same muscular conditions when they are caused by carbon monoxide and/or manganese intoxication.

Important Information
bulletDo not stop taking carbidopa and levodopa suddenly. It may take several weeks before you feel the full effects of this medicine. Stopping suddenly could make your condition much worse.
bulletDo not crush or chew any controlled-release forms of carbidopa and levodopa (Sinemet CR). They are specially formulated to release slowly into your system. If necessary, the tablets can be split in half where they are scored, then swallowed without crushing or chewing.
bulletUse caution when driving, operating machinery, or performing other hazardous activities. Carbidopa and levodopa may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
bulletCall your doctor immediately if you have uncontrollable movements of the mouth, tongue, cheeks, jaw, arms, or legs; fever; or increased body heat.

Do Not Take Carbidopa and Levodopa If..
bulletIf you are already taking levodopa (Larodopa, Dopar), you will have to stop taking it at least12 hours before you take your first dose of carbidopa and levodopa.
bulletDo not take carbidopa and levodopa if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.

Donot take this medication if you have:
bulletNarrow-angle glaucoma (angle closure glaucoma), or
bulletCurrent or past history of malignant melanoma (a type of skin cancer).
bulletBefore taking this medication, tell your doctor if you have
bulletAny kind of heart disease, including high blood pressure, arteriosclerosis, hardening of the arteries, a previous heart attack, or an irregular heartbeat;
bulletRespiratory disease, including asthma and chronic obstructive pulmonary disease (copd);
bulletLiver disease;
bulletKidney disease;
bulletAn endocrine (hormonal) disease;
bulletA stomach or intestinal ulcer;
bulletWide-angle glaucoma; or
bulletDepression or any other psychiatric disorder.

You may not be able to take carbidopa and levodopa, or you may need a lower dose or special monitoring during treatment if you have any of the conditions listed above.

FDA classifies Carbidopa and levodopa in the   pregnancy category C. This means that it is not known whether carbidopa and levodopa will harm an unborn baby. Do not take carbidopa and levodopa without first talking to your doctor if you are pregnant.

It is also not known whether carbidopa and levodopa will harm a nursing infant. Do not take carbidopa and levodopa without first talking to your doctor if you are breast-feeding a baby.

If You overdose

Seek emergency medical attention immediately

Symptoms of a carbidopa and levodopa overdose include muscle spasms or weakness, spasms of the eyelid, nausea, vomiting, diarrhea, irregular heartbeat, confusion, agitation, hallucinations, and unconsciousness.

Avoid The Following While Taking Carbidopa and Levodopa

Use caution when driving, operating machinery, or performing other hazardous activities. Carbidopa and levodopa may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Do not change the amount of protein in your diet without first talking to your doctor. Protein may reduce the amount of carbidopa and levodopa that gets absorbed into your body.

Side Effects of Carbidopa and Levodopa

If you experience any of the following serious side effects, stop taking carbidopa and levodopa and seek emergency medical attention:
bulletAn allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives)
bulletUncontrolled movements of a part of your body
bulletSeizures
bulletSevere nausea, vomiting, or diarrhea
bulletAn irregular heartbeat or fluttering in your Chest
bulletUnusual changes in mood or behavior or
bulletDepression or suicidal thoughts.

Other Side Effects

The following side reactions are less serious and are more likely to occur. Continue to take carbidopa and levodopa and talk to your doctor if you experience:
bulletMild nausea
bulletVomiting
bulletDecreased Appetite
bulletConstipation
bulletDry mouth
bulletBlurred vision;
bulletHand tremor
bulletMuscle twitches
bulletDizziness or drowsiness
bulletInsomnia
bulletConfusion
bulletNightmares
bulletAgitation
bulletAnxiety
bulletDarkening of your urine, sweat, or saliva
bulletFatigue.

Drug Interactions

Do not take carbidopa and levodopa if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.

If you are already taking levodopa (Larodopa, Dopar) you will have to stop taking it at least 12 hours before you take your first dose of carbidopa and levodopa.

Before taking carbidopa and levodopa, tell your doctor if you are taking any of the following medicines:
bulletAntacids
bulletIron supplements or vitamin supplements containing iron
bulletMetoclopramide (reglan)
bulletIsoniazid (nydrazid)
bulletPhenytoin (dilantin)
bulletA medicine to treat high blood pressure (hypertension)
bulletA tricyclic antidepressant such as amitriptyline (elavil), doxepin (sinequan), nortriptyline (pamelor), desipramine (norpramin), amoxapine (asendin), and others; or
bulletA medicine used to treat psychiatric conditions (and nausea and vomiting) such as chlorpromazine (thorazine), Prochlorperazine (compazine), promethazine (phenergan), fluphenazine (prolixin), mesoridazine (serentil), Thioridazine (mellaril), trifluoperazine (stelazine), or haloperidol (haldol).

You may not be able to take carbidopa and levodopa, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Levodopa may interfere with urine tests for sugar and ketones. If you are diabetic and notice changes in your urine test results, talk to your doctor before making any changes in your diabetes medication.

Drugs other than those listed here may also interact with carbidopa and levodopa. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

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