Prescription Required 
Formulation : 
Description
Indications
Levodopa and carbidopa are combined to alleviate Parkinson’s disease symptoms, as well as Parkinson’s-like symptoms that may arise after encephalitis (brain inflammation), or nervous system damage due to carbon monoxide or manganese poisoning.
Parkinson’s symptoms, which include tremors, stiffness, and slow movement, are caused by a deficiency of dopamine, a natural substance typically present in the brain.
Levodopa falls into the category of central nervous system agents and is transformed into dopamine in the brain. Carbidopa is a decarboxylase inhibitor, preventing levodopa from breaking down before it reaches the brain. This allows for a lower levodopa dose, which results in less nausea and vomiting.
Uses and Dosage
Follow your doctor’s instructions and take this medication orally, with or without food, typically 3 to 4 times a day.
Ingesting the medication with food may help to minimize nausea. Unless otherwise instructed by your doctor, avoid consuming high-protein foods that could decrease the absorption of levodopa.
If you take iron supplements or iron-containing products, such as multivitamins with minerals, separate the dosage of this medication from them by several hours, as iron can impede absorption.
Your medical condition and response to therapy determine the dosage, which your doctor may increase gradually to decrease the risk of side effects. Different strengths of this combination medication, containing varying amounts of levodopa and carbidopa per tablet, are available, so ensure that you have the correct strength of both drugs.
Your doctor may prescribe carbidopa alone to take in combination with this medication. Take this medication at the same time each day to obtain the most benefit from it.
Occasionally, patients may experience “wearing-off,” which causes symptoms to worsen before the next dosage, or an “on-off” effect, which causes sudden short periods of stiffness. If you notice these symptoms, contact your doctor to discuss possible dose adjustments to reduce these effects.
Do not stop taking this medication without consulting your doctor, as abruptly discontinuing it may exacerbate certain conditions.
Withdrawal symptoms, such as anxiety, depression, confusion, fever, and muscle stiffness, may also occur if you suddenly stop taking this medication. To prevent withdrawal symptoms, your doctor may gradually reduce your dosage. Withdrawal is more likely if you have used this medication for a prolonged period or in high doses. Contact your doctor or pharmacist immediately if you experience any withdrawal symptoms.
Inform your doctor if your condition does not improve or deteriorates.
Side Effects
Some side effects may occur that usually do not need medical attention:
- dizziness
- loss of appetite
- diarrhea
- dry mouth
- mouth and throat pain
- constipation
- change in sense of taste
- forgetfulness or confusion
- nervousness
- nightmares
- difficulty falling asleep or staying asleep
- headache
- weakness
Inform your healthcare provider immediately if you experience any serious side effects:
- unusual or uncontrolled movements of the mouth, tongue, face, head, neck, arms, and legs
- fast, irregular, or pounding heartbeat
- increased sweating
- chest pain
- depression
- thoughts of death or killing oneself
- hallucinating (seeing things or hearing voices that do not exist)
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
- difficulty swallowing or breathing
- hives
- weakness, numbness, or loss of sensation in the fingers or feet
- drainage, redness, swelling, pain, or warmth in the area around your PEG-J tube
- black and tarry stools
- red blood in stools
- fever
- abdominal pain
- nausea
- vomiting
- bloody vomit
- vomit that looks like coffee grounds
Caution
- Before taking this medication, inform your doctor or pharmacist about any allergies you may have to carbidopa, levodopa, or other substances. This medication may contain inactive ingredients that can cause allergic reactions or other complications.
- Prior to using this medication, tell your doctor or pharmacist about your medical history, particularly if you have a history of liver disease, glaucoma, breathing problems, heart disease, kidney disease, stomach/intestinal ulcers, mental/mood disorders, blood disorders, seizures, or sleep disorders.
- This medication may cause dizziness or drowsiness. Consuming alcohol or marijuana can increase dizziness or drowsiness. Refrain from driving, operating machinery, or performing any activity that requires alertness until you can do so safely.
- During pregnancy, this medication should only be used when it is clearly necessary. Discuss the potential risks and benefits with your doctor.
- Levodopa may pass into breast milk in small amounts, which could affect the amount of milk you produce. It is unknown if carbidopa passes into breast milk. Consult with your doctor before breastfeeding.
Form and Strength
Sinemet CR is available in the following forms and strengths:
- carbidopa and levodopa prolonged-release tablet:
- 25 / 100 mg
- 50 / 200 mg
FAQ
Does Sinemet CR improve walking?
For some, the drug Sinemet can help prevent freezing, but does not improve balance.
Does Sinemet CR interfere with sleep?
Sinemet can contribute to insomnia for some people.
Resources
- https://www.parkinson.org/blog/awareness/freezing#:~:text=The%20brain%20changes%20from%20PD,pay%20more%20attention%20while%20walking
- https://www.everydayhealth.com/parkinsons-disease/parkinsons-disease-and-sleep-problems-and-solutions/#:~:text=The%20common%20Parkinson%27s%20disease%20medication,play%20a%20role%20in%20wakefulness
- https://www.medbroadcast.com/drug/getdrug/sinemet-cr
- https://www.webmd.com/drugs/2/drug-16166/sinemet-cr-oral/details
- https://www.rxlist.com/sinemet-cr-drug.htm
- https://www.drugs.com/sinemet.html
