What is this medication?
Anti-Parkinson Agents; Decarboxylase Inhibitor; Dopamine Precursor
Levodopa+Carbidopa/Sinemet is officially indicated for Parkinson disease, but is also prescribed off-label to treat intermittent restless leg syndrome. (may be used for other conditions not listed)
How does this medication work?
Levodopa is a dopamine precursor that crosses the blood brain barrier and gets converted to dopamine in the corpus striatum in the forebrain. A lack of dopamine in the corpus striatum is the cause of most symptoms of Parkinson’s disease. Carbidopa prevents the levodopa from being broken down in the blood by decarboxylation before it can pass the blood brain barrier.
How should I take this medication?
Levodopa+Carbidopa/Sinemet are in either a 1:4 or 1:10 ratio. There is not a set maximum dosage but the minimum amount to treat the patient’s symptoms should be used and daily dosages should be divided into 2-4 daily dosages depending on dosage required and patient symptoms. As the condition worsens and dosages increase a balance between Parkinson’s symptoms and levodopa induced dyskinesia will have to be accounted for.
How to Take: Follow instructions provided by physician/pharmacy label, swallow whole (controlled release), take consistently at same times each day unless otherwise directed, store at room temperature
You Need to Avoid: Do not stop this medication abruptly unless told to do so by medical professional, avoid a high protein diet (>2g/kg) as it may decrease absorption. Daily protein should be evenly distributed between meals to keep absorption consistent.
What should I watch for while using this medication?
Before starting Levodopa+Carbidopa/Sinemet make sure your physician is aware of any allergies, medications you currently take, if you have kidney disease, liver disease, cardiovascular disease, glaucoma, neuropathy, peptic ulcer disease, respiratory disease, psychotic disorders, or are pregnant or breastfeeding.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Orthostatic hypotension, dizziness, depression, headache, nausea, constipation, dyskinesia (movement disorder from extended use of levodopa)
Patients or their families should monitor for behavioral changes or abnormal thinking which may present as aggression, agitation, delirium, paranoia, disorientation, or a lack of impulse control which may result in hypersexualization, gambling, binge eating, spending money etc. Another rare occurrence is neuroleptic malignant syndrome which may occur when starting the medication or if dosage is rapidly decreased or stopped. This may present as altered consciousness, hyperthermia, muscle rigidity, involuntary movement, mental status change, etc. If these occur or are suspected, seek medical attention immediately.
Note this is not a complete list of side effects, only common ones.
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