Carbidopa (kar-bi-DOE-pa), Levodopa (lee-voe-DOE-pa)

Treats Parkinson disease, parkinsonism caused by encephalitis, or parkinsonism caused by carbon monoxide or manganese poisoning.

Brand Name(s):

Dhivy, Rytary, Sinemet 10-100, Sinemet 25-100

When This Medicine Should Not Be Used:

How to Use This Medicine:

Long Acting Capsule, Tablet, Dissolving Tablet, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• This medicine will take longer to work if you take it with a high-fat or high-protein meal. Ask your doctor or pharmacist if you should take it 1 or 2 hours before a meal.
• Disintegrating tablet: Make sure your hands are dry before you handle the tablet. Do not remove the tablet from the bottle until you are ready to take it. Place the tablet on top of your tongue, where it will melt quickly.
• Extended-release capsule or sustained-release tablet: Swallow the capsule or tablet whole. Do not crush, break, or chew it.
• Swallow the Dhivy™ tablet whole. If you are unable to swallow it, you may also break the tablet at the score lines.
• If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as pudding, yogurt, or applesauce. Stir this mixture well and swallow it without chewing.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you have used an MAO inhibitor (MAOI) within the past 14 days.
• Some foods and medicines can affect how carbidopa/levodopa works. Tell your doctor if you are using any of the following:
  • Isoniazid, metoclopramide, papaverine, phenytoin, rasagiline, reserpine, risperidone, selegiline, tetrabenazine
  • Blood pressure medicine
  • Medicine to treat depression or mental illness
  • Phenothiazine medicine (including chlorpromazine, perphenazine, promethazine, prochlorperazine, thioridazine)
• Tell your doctor if you are using any mineral supplements or multivitamins with iron.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, endocrine problems, lung or breathing problems (including asthma), a sleep disorder, heart or blood vessel problems, heart rhythm problems, or a history of heart attack. Tell your doctor if you have wide-angle glaucoma, phenylketonuria (PKU), or a history of stomach ulcer, or mental illness.
• This medicine may cause the following problems:
  • Mental health problems (including thoughts of suicide, depression, hallucinations)
  • Dyskinesia (trouble controlling movements)
  • Increased risk for skin cancer
  • Unusual changes in thoughts or behavior, including the urge to gamble or an increased sex drive
• This medicine may make you dizzy or drowsy, or even cause you to fall asleep without warning. This could happen while you are driving, eating, or talking. Tell your doctor right away if this happens. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• If you are already taking levodopa, stop taking it at least 12 hours before starting treatment with carbidopa/levodopa combination.
• This medicine might cause your saliva, sweat, or urine to become dark red, brown, or black. This is nothing to worry about, but it could stain your clothes.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Changes in mood or behavior, thoughts of hurting yourself
• Chest pain, trouble breathing, fast or uneven heartbeat
• Compulsive behavior or intense urges you cannot control
• Falling asleep in the middle of an activity
• Jerky muscle movement you cannot control (often in your face, tongue, or jaw)

If you notice these less serious side effects, talk with your doctor:

• Drowsiness or sleepiness
• Headache, trouble sleeping
• Lightheadedness, dizziness, or fainting
• Nausea
• Pink or red urine, dark sweat or saliva, or heavy sweating

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088