Sinemet is composed of 2 active ingredients, carbidopa and levodopa and several other inactive ingredients. Sinemet [carbidopa, levodopa] is used for the treatment of symptoms of idiopathic Parkinson’s disease (paralysis agitans), post-encephaletic Parkinsonism and symptomatic Parkinsonism which may follow injury to the nervous system of the body by manganese intoxication or carbon monoxide intoxication. Dopamine deficiency caused by the loss of dopamine-producing cells in certain parts of the brain is responsible for many symptoms of Parkinson’s disease. But dopamine cannot be given directly as it cannot cross the blood-brain barrier. Here levodopa acts as a precursor of dopamine which means the body can use levodopa to make dopamine. Levodopa can cross blood-brain barrier. Levodopa is converted to dopamine. Levodopa is almost always given in combination with carbidopa. Carbidopa delays the conversion of levodopa to dopamine until it reaches the brain. It also reduces the amount of levodopa needed to treat Parkinson’s disease. Sinemet [carbidopa, levodopa] comes in a form of tablets.
How to use
Sinemet [carbidopa, levodopa] tablet is categorized according to the proportional strength of carbidopa and levodopa. It is categorized into three; such as, Sinemet 25-100 (25mg of carbidopa and 100mg of levodopa), Sinemet 25-250 (25mg of carbidopa and 250mg of levodopa) and Sinemet 25-100 (25mg of carbidopa and 100mg of levodopa).
There is no standardized dosage for almost all patients. Instead, the dosage must be individualized. Usually, the dosage is started with Sinemet 25-100 tablets thrice a day. The physician may recommend increasing the dosage gradually, one tablet each day or one tablet each alternate day. Until it reaches 8 tablets a day i.e. 2 Sinemet 25-100 tablets four times daily.
Dosage could be less or more according to the individual or with different combination as it will be directed by the physician.
Usually most of the patients need 70mg to 100mg of carbidopa in a day to avoid severe nausea and vomiting caused by levodopa present in Sinemet [carbidopa, levodopa] tablets.
Physicians recommend low protein diet as protein in food may decrease absorption of Sinemet [carbidopa, levodopa] in the body.
Side Effects
The most common side effects indicated using Sinemet [carbidopa, levodopa] tablets are; nausea, vomiting, abdominal pain, diarrhea, constipation, fatigue, dark urine, loss of appetite, weight loss, heartburn, dry mouth, back pain, insomnia, muscle cramps, headache, increased libido, hair loss, hiccups, teeth grinding, urinary tract infections, coughing and flushing.
Serious side effects indicated are hypotension or hypertension, fainting, bleeding in digestive tract, duodenal ulcers, psychiatric problems, seizures, heart attack, malignant melanoma, priapism, body balance problem, symptoms of neuroleptic malignant syndrome (NMS) and signs of allergic reactions.
Drug Interaction
Concomitant use of Sinemet [carbidopa, levodopa] and antipsychotic or iron or isoniazid medications may decrease the absorption in the body and make Sinemet less effective.
Concomitant use of Sinemet [carbidopa, levodopa] and high blood pressure medication or monoamine oxidase inhibitors (MAOIs) can increase the risk of low blood pressure (hypotension).
Concomitant use of Sinemet [carbidopa, levodopa] and metoclopramide can either increase or decrease the absorption of Sinemet [carbidopa, levodopa] in the body may make it less effective or increase the risk of sinemet side effects. It is difficult to predict what will happen when these medications are combined.
Uses
Sinemet [carbidopa, levodopa] is used for the treatment of Parkinson’s disease and also treat the Parkinson-like symptoms (Parkinsonism) due to carbon monoxide poisoning, manganese poisoning or inflammation or infection of the brain (encephalitis).
Storage
Sinemet [carbidopa, levodopa] should be stored at a temperature of 25°C (77°F), excursions permitted at 15°-30°C (59°-86°F). Protect from heat, light and moisture.
Precaution
Parkinson’s disease patient has increased risk of melanoma. Regular skin check up is necessary.
The physician should need to decrease the dose if dyskinesia occurs.
Sinemet [carbidopa, levodopa] can cause or worsen many mental illnesses. Consult the physician before if any medical history is there.
Patients with heart problems, lungs problems, ulcers, kidney or liver diseases should inform the physician prior to the administration of Sinemet [carbidopa, levodopa] medication.
Stopping of medication too quickly can cause neuroleptic malignant syndrome.
It is recommended not to take this medication during pregnancy.
Nursing mothers should consult the physician before taking this drug.
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