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Sinemet Consumer Information

SINEMET

Generic Name: carbidopa and levodopa (oral) (kar bi DOE pa and lee voe DOE pa)

Brand Names: Atamet, Sinemet, Sinemet CR

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

• Do 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.
• Do 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.
• 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.
• Call your doctor immediately if you have uncontrollable movements of the mouth, tongue, cheeks, jaw, arms, or legs; fever; or increased body heat.

What is carbidopa and levodopa?

• Carbidopa and levodopa is a medication used to treat Parkinson's disease. Parkinson's disease is believed to be related to low levels of a chemical called dopamine (DOE pa meen) in the brain. Levodopa is turned into dopamine in the body. Carbidopa is used with levodopa to prevent the breakdown (metabolism) of levodopa before it can reach the brain and take effect.
• 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.
• Carbidopa and levodopa may also be used for purposes other than those listed in this medication guide.

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

• 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.
• 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.
• You cannot take this medication if you have
• narrow-angle glaucoma (angle closure glaucoma), or
• current or past history of malignant melanoma (a type of skin cancer).
• Before taking this medication, tell your doctor if you have :
• any kind of heart disease, including high blood pressure, arteriosclerosis, hardening of the arteries, a previous heart attack, or an irregular heartbeat;
• respiratory disease, including asthma and chronic obstructive pulmonary disease (COPD);
• liver disease;
• kidney disease;
• an endocrine (hormonal) disease;
• a stomach or intestinal ulcer;
• wide-angle glaucoma; or
• depression 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.
• Carbidopa and levodopa is in the FDA 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.

How should I take carbidopa and levodopa?

• Take carbidopa and levodopa exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Do 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.
• The regular-release formulations can be broken or crushed to make them easier to swallow.
• Store carbidopa and levodopa at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical attention.
• 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.

What should I avoid 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.