Brand Name

Sinemet {Merck}

Generic Name

levodopa and carbidopa , pronounced LEE voe DOE pa and KAR bi DOE pa

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Drug Guide

The information contained in the following drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.

What is Sinemet?

Sinemet treats the symptoms of Parkinson’s disease like muscle stiffness, spasms, tremors and poor muscle control. This medication may also be used to treat Parkinson’s-like symptoms which are caused by carbon monoxide poisoning or manganese intoxication.

Sinemet may be used for purposes not indicated in this medication guide.

Key Facts About Sinemet

Sinemet is comprised of two medications, Levodopa and Carbidopa. Levodopa is helpful as it is converted to a chemical called dopamine in your brain. Patients with Parkinson’s disease have low levels of dopamine in their brain. The Carbidopa in Sinemet helps to prevent the breakdown of levodopa before it can reach your brain and take effect.

You should wait at least 12 hours after taking levodopa (Larodopa, Dopar) before you take Sinemet.

Sinemet may cause an increase in sexual urges, unusual urges to gamble or other intense urges. While it is not definite that Sinemet may be responsible for these urges you should tell your doctor immediately if you believe that you have any intense or unusual urges while taking this medication.

Taking Sinemet may make you unusually drowsy or cause you to have issues with normal daytime activities like working, talking, eating or driving. You should take care when doing anything that requires you to be alert, especially when you first start taking Sinemet.

Tell your doctor if you are pregnant or plan to become pregnant. Sinemet is in FDA pregnancy category C. Sinemet is not known to harm an unborn baby. If you are breast-feeding you should ask your doctor about taking Sinemet. Sinemet may affect a breast-feeding baby as it is known to pass into breast milk.

Some patients who take Sinemet and other medications for Parkinson’s disease have developed skin cancer of the melanoma type. However, it is not determined if people with Parkinson’s disease have a higher risk than most people for developing melanoma, or if the medications relate to this finding. You should talk to your doctor about your individual risks for melanoma, as well as what skin symptoms to watch for. You should continue having regular skin exams while taking Sinemet.

Before You Take Sinemet

If you are allergic to carbidopa (Lodosyn) or levodopa (Larodopa) you should not take Sinemet.

You should wait at least 12 hours after taking levodopa (Larodopa, Dopar) before you take Sinemet.

Do not take Sinemet if you have used an MAO inhibitor like isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the past 14 days. You can experience serious or life-threatening side effects if you take Sinemet before the MAO inhibitor has been cleared from your body.

You should not take Sinemet if you have narrow-angle glaucoma, unusual skin lesions that have not been checked by your doctor or a history of malignant melanoma, which is a type of skin cancer.

If you have high or low blood pressure, heart disease, a heart rhythm disorder, kidney disease or liver disease you should tell your doctor before taking Sinemet.

If you have a history of a heart attack, asthma, chronic obstructive pulmonary disease (COPD), or another breathing disorder tell your doctor before starting treatment with Sinemet.

If you have an endocrine or hormonal disorder, stomach or intestinal ulcer, wide-angle glaucoma, depression or another mental illness you should inform your doctor before taking Sinemet.

You should not stop taking Sinemet without talking to your doctor. It may take a few weeks before you notice a substantial improvement in your symptoms. Talk to your doctor if you do not notice any improvements after a few weeks of treatment with Sinemet.

Sinemet Drug Interactions

You should inform your doctor if you are taking any of the following:

• antidepressants like amitriptyline (Elavil, Vanatrip), doxepin (Sinequan) and nortriptyline (Pamelor)
• blood pressure medications
• isoniazid (Nydrazid)
• metoclopramide (Reglan)
• papaverine (Pavabid, Papacon, Pavagen, Pavacot)
• Parkinson’s disease medications
• phenytoin (Dilantin)
• psychiatric disorder medications like chlorpromazine (Thorazine), haloperidol (Haldol), prochlorperazine (Compazine) and risperidone (Risperdal)

Other drugs you take that are not listed may interact with Sinemet. You should tell your doctor about all of the medications you use. This includes prescription drugs, vitamins, supplements and herbal products, and over the counter medications. You should not begin taking a new medication without telling your doctor first.

Directions for Taking Sinemet

You should not take iron supplements or eat a diet that is high in protein as it may make it harder for your body to digest and absorb Sinemet. Talk with your doctor about the best foods to eat while you are taking this medication.

You should take Sinemet exactly your doctor has told you to. It is important that you do not take Sinemet in larger or smaller amounts, or for longer or shorter than recommended. Follow the directions on your prescription label and follow any dose changes carefully if your doctor instructs you to change your dose.

You can take Sinemet with or without food, but it is important to take your doses at regular intervals to keep a steady amount of this drug in your body at all times.

You should wait at least 12 hours after taking levodopa (Larodopa, Dopar) before you take Sinemet.

Your doctor may have your blood tested regularly while you are taking Sinemet. This medication may cause abnormal results on certain blood tests, so be sure to tell all doctors that treat you that you are taking Sinemet.

You should store Sinemet at room temperature away from moisture and heat.

If you miss a dose of Sinemet you should attempt to take the missed dose as soon as you remember. However, if it is almost time for your next scheduled dose you should skip the dose you missed.

Sinemet Side Effects

If you experience any of the following adverse effects you should stop taking Sinemet and seek emergency medical help immediately:

• allergic reaction symptoms like breathing difficulties, hives, and swelling of your face, lips, throat or tongue
• faint feeling
• fast or uneven heartbeats, fluttering of your heart
• fever
• hallucinations, agitation, anxiety, depressed mood or thoughts of suicide
• nausea, vomiting or diarrhea that is severe
• seizures or convulsions
• stiff muscles
• sweating and confusion
• tightness in your chest and trouble breathing, with pain that may spread to your arm
• tremors that are worsening
• urination that is difficult or painful
• Sudden tiredness or episodes of falling asleep unexpectedly.

Less serious side effects of Sinemet may include:

• appetite loss
• blurry vision
• constipation
• cough and cold symptoms, like a stuffy or runny nose
• diarrhea
• dizziness
• drowsiness
• dry mouth
• headache
• heartburn
• insomnia or strange dreams
• muscle pain with numbness and tingling
• nausea
• skin rash and itching, mild

It should be noted that this is not a complete list of possible side effects of Sinemet. You should contact your physician for a complete list and medical advice regarding these effects.

Sinemet Description and Dosing

Sinemet is available as a tablet, in dosages of Sinemet 25-100, containing 25 mg of carbidopa and 100 mg of levodopa; Sinemet 10-100, containing 10 mg of carbidopa and 100 mg of levodopa; and Sinemet 25-250, containing 25 mg of carbidopa and 250 mg of levodopa. Sinemet 25-100 tablets are yellow, round, uncoated and are coded “650” on one side and are plain on the other side. Sinemet 10-100 tablets are light dapple-blue, round, uncoated and are coded “647” on one side and are plain on the other side. Sinemet 25-250 tablets are light dapple-blue, round, uncoated and are coded “654” on one side and are plain on the other side.

If you suspect that you have overdosed with Sinemet you should seek emergency help immediately.

Ingredients in Sinemet

The active ingredients in Sinemet are carbidopa and levodopa. Inactive ingredients include hydroxypropyl cellulose, pregelatinized starch, crospovidone, microcrystalline cellulose, and magnesium stearate. Sinemet 10-100 and 25-250 Tablets also contain FD&C Blue #2/Indigo Carmine AL. Sinemet 25-100 Tablets also contain D&C Yellow #10 Lake.

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The information contained in this drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.