Why is Sinemet Plus prescribed?

Levodopa and Carbidopa (Sinemet) is a combination drug prescribed for the treatment of symptoms of Parkinson’s disease and Parkinson’s-like symptoms caused by carbon monoxide or manganese poisoning.

What does it do?

Parkinson’s disease is caused by low or inadequate levels of dopamine (a chemical messenger) in the brain. When dopamine levels are low, symptoms such as muscle stiffness, tremors, and slow movement and balance problems may occur.

Levodopa is classified as a central nervous system agent. It is a dopamine precursor, and it is converted into dopamine in the brain. Carbidopa is classified as a decarboxylase inhibitor and it prevents the premature breakdown of Levodopa so it can reach the brain and exert its effect.

How should I take it?

Sinemet Plus is available in 25/100mg tablets intended for oral administration.

It should be taken with a full glass of water with or without food. Swallow the tablet as a whole and do not crush, chew, break it in half, or tamper the tablet in any way unless instructed by your doctor. Take it at the same time every day.

Take Sinemet Plus exactly as your doctor instructed and do not make alterations in the dosage or frequency. Your doctor will make adjustments to your dosage as necessary.

Sinemet Plus does not treat your condition, it only controls it. Continue taking the medication even if you feel well. The full effect of Sinemet Plus may take several weeks before it is evident. Tell your doctor if the effects seem to subside quickly after taking the medication or in between doses.

Do not stop taking Sinemet Plus suddenly as this may cause withdrawal symptoms such as fever, stiff muscles, unusual body movements, and confusion. Consult your doctor before stopping the medication.

Always consult your doctor or pharmacist for any concerns you may have when taking Sinemet Plus.

What if I missed a dose?

Taking the dose properly at the scheduled time is needed to attain the desired effect of the drug. If you miss a dose, take it as soon as you remember. However, if it is near the time of the next dose, skip the missed dose and catch the next dose at the regular time. Do not take two doses just to make up for your missed dose.

What are the special precautions before taking Sinemet Plus?

Inform your doctor if you are allergic to Levodopa and Carbidopa, any component of Sinemet Plus, or any other medications.

Tell your doctor if you have or have had glaucoma, skin cancer (melanoma), or any skin problems or growths that have not been diagnosed. Your doctor may not recommend you take Levodopa and Carbidopa.

Also inform your doctor if you have or ever had heart disease, high blood pressure, a heart attack, liver disease, kidney disease, hormonal disorders, asthma, breathing problems, stomach or intestinal ulcers, or any mental illness.

Taking Levodopa and Carbidopa may cause drowsiness and make you fall asleep suddenly. Do not perform activities that require your full attention such as driving, operating machinery, or working at heights. If you feel very drowsy and suddenly fall asleep while doing your regular daily activities, discuss these effects with your doctor.

Avoid alcohol intake when taking Levodopa and Carbidopa to prevent the occurrence of side effects.

Avoid getting up too quickly from a lying position when taking Levodopa and Carbidopa as it may cause lightheadedness, dizziness, or fainting when doing so. To avoid this, get up slowly, sit down, and place your feet on the floor for a few minutes before standing up.

Levodopa and Carbidopa may color your urine, sweat, or saliva into a red, brown, or black color. Do not be alarmed as this is not harmful, however it may stain your clothing.

For the drug label information of Sinemet Plus, click here.

Does it have any side effects?

It is important to note that all drugs have corresponding side effects and adverse reactions. Additional information may be obtained when you ask your doctor or pharmacist.

Common side effects may include:
• Anxiety
• Constipation
• Dry mouth
• Headache
• Insomnia
• Nausea
• Vomiting

Serious side effects may include:
• Chest pain
• Difficulty breathing
• Hallucinations
• Involuntary and repetitive movements of the arms or legs
• Irregular heartbeats
• Numbness or loss of sensation in the hands or feet
• Suicidal thoughts
• Twitching or twisting of the tongue, lips or face
• Vomit that looks like coffee grounds
• Vomiting up blood

Is it safe to take it with another drug?

Some drug interactions may cause serious or life-threatening reactions when administered together. Immediately inform your doctor if you are taking Sinemet Plus with any of the following medications:

• Amisulpride
• Anafranil
• Asendin
• Atrovent
• Azilect
• Clonazepam
• Clozapine
• Cordarone
• Coreg
• Cozaar
• Crestor
• Desipramine
• Diazoxide
• Elavil
• Ferrous sulfate
• Fluphenazine
• Furazolidone
• Haloperidol
• Hydralazine
• Hyoscyamine
• Imipramine
• Isocarboxazid
• Lasix
• Linezolid
• Lipitor
• Methylene blue injection
• Metoclopramide
• Mevacor
• Midazolam
• Nitroprusside
• Nortriptyline
• Norvasc
• Ozanimod
• Paclitaxel
• Parnate
• Phenelzine
• Phenylephrine
• Pindolol
• Prograf
• Propoxyphene
• Protriptyline
• Pyridoxine
• Selegiline
• Seroquel
• Silenor
• Sodium oxybate
• Tenormin
• Trimipramine
• Vinblastine
• Zafirlukast
• Zebeta

Tell your doctor of any prescription and non-prescription medications, vitamins, supplements, and herbal products you are taking to prevent interactions with these medications. Ask your doctor or pharmacist for other possible interactions not listed within this section.

How should I store it?

Store Sinemet Plus at room temperature (25 °C) in a clean environment away from light and moisture. Do not keep it in the bathroom. Always keep it in the container it came in and keep it tightly closed. Keep out of reach from children and pets. Throw away unused or expired medications. Do not flush it in the toilet or down the sink. Consult your pharmacist on the proper disposal of this medication.

What action should I take in case of overdose?

In the event of an overdose, inform your doctor and seek immediate medical attention to prevent further complications.

Is it safe for pregnant or breastfeeding women?

There are limited studies and data regarding the safety of Levodopa and Carbidopa in pregnant women. According to the US FDA, Levodopa and Carbidopa are categorized as Pregnancy Category C. It is unknown if both medications will cause harm to the fetus.

Levodopa and Carbidopa are both excreted in human milk and may harm the breastfeeding infant. The use of Levodopa and Carbidopa is not recommended unless instructed by your doctor.

The use of Levodopa and Carbidopa in pregnant and breastfeeding women should be avoided unless the potential benefits outweigh the risks.

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