Carbidopa and Levodopa are combined in this medicine.
Carbidopa + Levodopa is used on its own or together with other medicines to treat Parkinson's disease. Parkinson's disease is a disorder that affects movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking.
This medicine does not cure Parkinson's disease but it can improve the quality of life for people who have the disease.
Take Carbidopa + Levodopa exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
This medicine is available as a conventional or orally-disintegrating tablet or as an extended-release capsule or tablet.
If you are taking the conventional tablet, take it on an empty stomach. However, you may also take this medicine with food to reduce any stomach discomfort that it may cause.
If you are taking the orally-disintegrating tablet:
- Remove it from the foil only just before you take it. Do not leave the orodispersible tablet exposed to air. Do not push the orodispersible tablet through the foil as it is fragile and easily broken.
- Remove the orodispersible tablet with dry hands by peeling the backing off the foil and tipping the tablet onto your dry hands.
- Place the orodispersible tablet directly on your tongue as soon as it is taken out of the foil. The orodispersible tablet will immediately start to melt on the tongue. It can then be swallowed with or without water.
If you are taking the extended-release type of tablet/ or capsule (usually labeled as "ER"), swallow it whole. Do not divide, chew or crush the tablet or capsule. You may take it with or without food.
Carbidopa + Levodopa must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- mental disorders
- increased pressure in the eye
- history of skin cancer
as Carbidopa + Levodopa may not be suitable for you.
Do not take this medicine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor if you have the following conditions:
- heart disease
- lung disease
- kidney disease
- liver disease
- diseases related to the endocrine system
- diabetes
Let your doctor know if you are pregnant or breastfeeding.
Carbidopa + Levodopa may interfere with the results of urine tests for ketones. Discuss with your doctor how you should monitor your urine tests while taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver, kidney and heart function) may be done while you are being treated with this medicine.
- Your blood pressure may rise or fall to unsafe levels without you noticing it. Monitor your blood pressure while being treated with this medicine.
- Regular monitoring of (e.g. signs of depression, skin reactions and changes in vision) may also be needed.
Your doctor will advise you about how often you need to have these tests.
Carbidopa + Levodopa may cause drowsiness, dizziness or blurred vision. It may also cause you to suddenly fall asleep during your daily activities such as eating and watching television. Do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: nausea, loss of appetite, vomiting, diarrhoea, headache, difficulty sleeping, chest pain or irregular heartbeats, confusion and hallucinations (seeing, hearing or feeling things that are not existent), and unusual changes in mood or behaviour (depressed, agitated, or having compulsive and impulsive behaviour).
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
Notify your doctor if you experience worsening Parkinson's disease (e.g. tremors, slowed movements, stiffness of the arms and legs, imbalance while walking) and other uncontrollable movements such as twitching and jerking.
Your urine may look slightly red, brown, or black in colour. This is normal while you are being treated with this medicine. It may also cause your saliva and sweat to change to the said colours. This is harmless, do not be alarmed.
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not use Carbidopa + Levodopa if you are currently taking or have taken a medicine to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines used for depression e.g. amitriptyline, imipramine
- medicines for mood disorder e.g. chlorpromazine, haloperidol
- medicines for high blood pressure e.g. methyldopa
- medicine for epilepsy e.g. phenytoin
- iron supplements
- metoclopramide (medicine for nausea and vomiting)
This list does not include all medicines that may interact with Carbidopa + Levodopa.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Avoid taking Carbidopa + Levodopa together with protein-rich foods.
Ask your doctor or dietitian about the type of foods you need to avoid.
Store in a cool, dry place away from the reach of children.
Protect from light and moisture.
Medicines must not be used past the expiry date.
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