Sinemet (Levodopa/Carbidopa) for Parkinson's Disease

Overview
Sinemet is a prescription drug approved by the Food and Drug Administration (FDA) in 1975 to treat motor symptoms of Parkinsonism caused by Parkinson’s Disease, encephalitis, or exposure to carbon monoxide or manganese. Sinemet may provide some benefit for those with Progressive Supranuclear Palsy, Vascular Parkinsonism, Multiple System Atrophy, and Corticobasal Degeneration.

Sinemet is not appropriate for people with undiagnosed skin lesions, narrow-angle glaucoma, or a history of melanoma. Sinemet is not suitable for use in people who have previously shown hypersensitivity to Levodopa or Carbidopa. Sinemet must be used with caution in people with wide-angle glaucoma, diabetes, asthma, emphysema, mental illness, or problems with the heart, kidneys, liver, lungs, or blood vessels. Sinemet may not be appropriate for women who are pregnant or breastfeeding.

Sinemet is a combination drug containing both Levodopa and Carbidopa. Levodopa is the precursor molecule to the neurotransmitter Dopamine. Levodopa is believed to treat Parkinsonian motor symptoms by increasing the concentration of Dopamine in the brain. Carbidopa is a molecule that inhibits the breakdown of Levodopa into Dopamine before it reaches the brain. Carbidopa is believed to work by increasing the amount of Levodopa that reaches the brain, making Levodopa effective at significantly lower doses.

Some medications are available both as generic and branded products. Although generic and branded formulations of a drug contain the same active ingredients at the same concentrations, your body may react differently to different formulations. Check with your doctor before switching between drug brands or between generic and branded drugs.

How do I take it?
Do not begin taking Sinemet within two weeks of taking a monoamine oxidase (MAO) inhibitor. If you are switching from Levodopa to Sinemet, wait 12 hours after your final dose of Levodopa before taking your first dose of Sinemet.

While you are on Sinemet, your doctor will order regular blood tests to monitor your liver, kidney, and heart function. Examine your skin regularly for changes and visit your dermatologist regularly to check for signs of melanoma. If you have wide-angle glaucoma, make sure your ophthalmologist regularly monitors your intraocular pressure.

Sinemet is taken orally as a tablet three or four times a day. Sinemet should be taken at the same times each day. Take Sinemet 30 minutes to one hour before eating a meal to encourage efficient absorption. If you experience nausea after taking Sinemet, you may take it with a small amount of carbohydrate food, such as a plain cracker. Ginger tea may help calm your stomach when taking Sinemet. Avoid taking iron supplements or eating a diet high in protein or fat while taking Sinemet. Consuming large amounts of these nutrients can interfere with the body’s absorption of Sinemet.

Avoid driving or operating machinery until you are certain you understand how Sinemet affects you.

You may experience withdrawal symptoms if you stop taking Sinemet suddenly. If you decide to stop taking Sinemet, ask your doctor for a plan to decrease your dosage gradually.

Always follow your doctor’s instructions exactly when taking Sinemet.

Results
Levodopa/Carbidopa (Sinemet) is considered to be the most effective treatment for the motor symptoms of Parkinson’s Disease and some types of Parkinsonism.

Side effects
Common side effects of Sinemet include nausea, vomiting, diarrhea, constipation, dizziness, drowsiness, nervousness, headaches, confusion, memory problems, nightmares, problems sleeping, sweating, loss of appetite, or changes in the sense of taste. Tell your doctor if these side effects become worse. Sinemet may cause your urine, sweat, or saliva to turn dark colors, which can stain clothes.

Inform your doctor immediately if you experience a fast, pounding heartbeat, hallucinations, suicidal thoughts, depression, increased urge to have sex or gamble, stools containing blood or a tarry substance, vomit containing blood or a substance resembling coffee grounds, hoarseness, or abnormal body movements while taking Sinemet.

Many drugs can cause allergic reactions that in the most serious cases, can result in death. Seek immediate medical help if you experience signs of a severe allergic reaction such as hives, difficulty breathing, or swelling in the face, throat, eyes, lips or tongue.