Sinemet (Carbidopa/Levodopa)

Sinemet is used for treating symptoms associated with Parkinson disease and parkinsonism-like symptoms caused by other conditions. It may also be used for other conditions as determined by your doctor.

Use Sinemet as directed by your doctor.

• Take Sinemet by mouth on an empty stomach at least 1 hour before or 2 hours after eating.
• Carefully follow the dosing schedule given to you by your health care provider. It may take several weeks to a few months to notice benefit from use because the dose is carefully adjusted over time.
• If you are also taking iron salts (eg, ferrous sulfate), do not take them within 2 hours before or 2 hours after taking Sinemet . Check with your doctor if you have questions.
• Take Sinemet on a regular schedule to get the most benefit from it. Taking Sinemet at the same times each day will help you to remember to take it.
• Continue to take Sinemet even if you feel well. Do not miss any doses.
• If you have been taking levodopa, do not start taking Sinemet until at least 12 hours after your final dose of levodopa.

Sinemet is an antidyskinetic combination. Levodopa is transformed by the body and the brain into a substance that helps to decrease tremors and other symptoms of Parkinson disease. Carbidopa helps levodopa to reach the brain.

If you miss a dose of Sinemet, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Store Sinemet at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed container. Brief periods at temperatures of 59 to 86 degrees F (15 to 30 degrees C) are permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Sinemet out of the reach of children and away from pets.

Do not use Sinemet if:

• you are allergic to any ingredient in Sinemet;
• you have narrow-angle glaucoma, undiagnosed skin growths, skin cancer, or a history of skin cancer;
• you have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days.

• Sinemet may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Sinemet with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol or use medicines that may cause drowsiness (e.g., sleep aids, muscle relaxers) while you are using Sinemet; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Sinemet may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
• Tell your doctor or dentist that you take Sinemet before you receive any medical or dental care, emergency care, or surgery.
• Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Sinemet . Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
• Diabetes patients - Sinemet may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Diabetes patients - Sinemet may cause the results of some tests for urine ketones to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.
• Do not suddenly stop taking Sinemet . Some conditions may become worse when Sinemet is suddenly stopped. Your dose may need to be slowly lowered by your doctor to avoid side effects.
• Gradually increase physical activity as your symptoms improve.
• A dark color (red, brown, or black) may appear in your saliva, urine, or sweat after taking Sinemet. This is not harmful.
• The effects of Sinemet might start to wear off between doses. Talk with your doctor if Sinemet stops working well or if your condition worsens.
• Sinemet may affect certain lab test results. Make sure your doctors and lab personnel know you use Sinemet.
• Lab tests, including complete blood cell counts and liver function tests, may be performed while you use Sinemet . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Sinemet with caution in elderly patients; they may be more sensitive to its effects.
• Sinemet should not be used in children; safety and effectiveness have not been confirmed.
• Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Sinemet while pregnant. It is not known if Sinemet is found in breast milk. If you are or will be breast-feeding while you are using Sinemet, check with your doctor. Discuss any possible risks to your baby.

Check with your doctor if any of these most common side effects persist or become bothersome:

• confusion; constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; loss of appetite; nausea; taste changes; trouble sleeping; upset stomach; urinary tract infection; vomiting.

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood in vomit; chest pain; confusion; depression; fast or irregular heartbeat; fever; hallucinations; mental or mood changes; muscle pain or unusual stiffness; severe abdominal pain; severe lightheadedness or fainting; sore throat; thoughts of suicide; unexplained fever or sweating; unusual bruising or bleeding; unusual or painful movements or spasms of the face, eyelids, mouth, tongue, arms, hands, or legs; vision changes (blurred/double vision); yellowing of the skin or eyes.

Sinemet is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.