Sinemet (Carbidopa/Levodopa)

Do’s

• The dosage of Sinemet is based on your medical condition and response to treatment. Your healthcare provider may direct you to start this medication at a low dose and gradually increase your dose to reduce the risk of side effects.
• This medication comes in different strengths with different amounts of carbidopa and levodopa in each tablet. Be sure you have the correct strength of both drugs. Your doctor may also prescribe carbidopa alone to be taken with this combination.
• Take Sinemet by mouth with or without food as directed by your healthcare provider, usually 3 to 4 times a day. Taking this medication with food may help to decrease nausea.
• Separate your dose of this medication by as many hours as possible from any iron supplements or products containing iron you may take, as iron can reduce the amount of this medication absorbed by the body.
• Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.
• Some patients may experience a "wearing-off" (worsening of symptoms) before the next dose is due. If these effects occur, contact your healthcare provider for possible dose adjustments that may help to lessen this effect.

Don’ts

• Avoid a high-protein diet during treatment, unless directed otherwise by your healthcare provider. 
• Do not stop taking this medication without consulting your healthcare provider. Some conditions may become worse when this medication is suddenly stopped. Your healthcare provider may lower your dose slowly to help prevent withdrawal symptoms.

Mild Side Effects:

• Blood pressure changes, which may be higher or lower than usual
• Hair loss
• Digestive problems
• Skin rash
• Jerky or twisting muscle movements
• Headache, dizziness
• Low blood pressure (feeling light-headed)
• Sleep problems, strange dreams
• Dry mouth
• Muscle contractions
• Nausea, vomiting, constipation

Serious Side Effects

• Encephalitis (swelling of the brain)
• Increased risk of melanoma (a type of skin cancer)
• Worsening of symptoms before the next dose is due
• "On-off" effect, where sudden short periods of stiffness occur

Discuss any ongoing or bothersome symptoms with your healthcare provider. 

For more detailed information about the potential side effects of Sinemet, consult your healthcare provider.

You should not use Sinemet if you have narrow-angle glaucoma

Do not use Sinemet if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.

You should not use Sinemet if you are allergic to carbidopa or levodopa.

If you are pregnant or breastfeeding, discuss the use of Sinemet with your healthcare provider.

Involuntary movements may occur more rapidly with Sinemet than with levodopa alone. The occurrence of involuntary movements may require dosage reduction.

Standard drugs for Parkinson's disease, other than levodopa without a decarboxylase inhibitor, may be used concomitantly while Sinemet is being administered, although dosage adjustments may be required.

Sporadic cases of hyperpyrexia and confusion have been associated with dose reductions and withdrawal of Sinemet. Patients should be observed carefully if abrupt reduction or discontinuation of Sinemet is required, especially if the patient is receiving neuroleptics.

If general anesthesia is required, Sinemet may be continued as long as the patient is permitted to take fluids and medication by mouth.

These are general warnings and precautions, and individual circumstances may vary. Always consult your healthcare provider for personalized advice and guidance regarding the use of Sinemet.