Carbidopa and Levodopa

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Dhivy; Duopa; Rytary; Sinemet

Brand Names: Canada

AA-Levocarb CR; APO-Levocarb; APO-Levocarb 100/25; APO-Levocarb 250/25; AURO-Levocarb; Duodopa; PMS-Levocarb CR [DSC]; Pro-Lecarb; PRO-Levocarb-100/25 [DSC]; Sinemet 100/25 [DSC]; Sinemet 250/25 [DSC]; TEVA-Levocarbidopa

What is this drug used for?

  • It is used to treat Parkinson’s disease.
  • It is used to treat signs like Parkinson’s disease caused by other health problems.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have any of these health problems: Glaucoma, a skin lump or growth, or a history of skin cancer.
  • If you are taking any of these drugs: Reserpine or tetrabenazine.
  • If you are taking any of these drugs: Linezolid or methylene blue.
  • If you have taken certain drugs for depression or Parkinson’s disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
  • If you are taking another drug that has the same drug in it.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • If you have high blood sugar (diabetes), talk with your doctor about which glucose tests are best to use.
  • This drug may “wear off” as the time for your next dose gets closer. Tell your doctor if this happens and it bothers you.
  • Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
  • The chance of a type of skin cancer called melanoma may be raised in people with Parkinson’s disease. It is not known if this drug may also raise the chance. Have skin exams while you take this drug. Talk with your doctor.
  • Some products may cause a dark red, brown, or black color to appear in your saliva, urine, or sweat. This is not harmful but may discolor your clothes.
  • If you have phenylketonuria (PKU), talk with your doctor. Some products have phenylalanine.
  • Some people have fallen asleep during activities like driving, eating, or talking. Some people did not feel sleepy and felt alert right before falling asleep. This has happened up to 1 year after this drug was started. If you fall asleep during activities, do not drive or do other tasks or actions that call for you to be alert while you take this drug. Call your doctor right away if this happens or you feel very sleepy.
  • Neuroleptic malignant syndrome (NMS) is a very bad and sometimes deadly health problem that has happened when this drug was stopped all of a sudden. NMS has also happened when the dose of this drug was lowered. Call your doctor right away if you have any fever, muscle cramps or stiffness, dizziness, very bad headache, confusion, change in thinking, fast heartbeat, heartbeat that does not feel normal, or are sweating a lot.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

Enteral suspension:

  • If you are 65 or older, use this drug with care. You could have more side effects.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • New or worse behavior or mood changes like depression or thoughts of suicide.
  • Hallucinations (seeing or hearing things that are not there).
  • Feeling confused.
  • Strong urges that are hard to control (such as eating, gambling, sex, or spending money).
  • A skin lump or growth.
  • Change in color or size of a mole.
  • Trouble controlling body movements that is new or worse.
  • Eyelid twitching.
  • Muscle twitching.
  • Stomach pain; black, tarry, or bloody stools; throwing up blood; or throw up that looks like coffee grounds.
  • Chest pain or pressure, a fast heartbeat, or an abnormal heartbeat.
  • Fever, chills, or sore throat; any unexplained bruising or bleeding; or feeling very tired or weak.
  • Dark urine or yellow skin or eyes.
  • Change in eyesight, eye pain, or severe eye irritation.
  • Shortness of breath.

Enteral suspension:

  • A burning, numbness, or tingling feeling that is not normal.
  • Problem with the device or problem where the tube goes into your body.
  • Swelling in the arms or legs.
  • Stomach or bowel problems can happen with this drug. Some of these problems may lead to the need for surgery or may be deadly. This includes problems like stomach or bowel bleeding, blockage, or ulcers; infection or other problems where the tube goes into your body; or pancreatitis. Call your doctor right away if you have dark, tarry, or bloody stools; fever; upset stomach or throwing up; constipation that does not go away; or stomach pain.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

  • Bad dreams.
  • Constipation.
  • Feeling dizzy or sleepy.
  • Dry mouth.
  • Headache.
  • Trouble sleeping.

All oral products:

  • Upset stomach or throwing up.

Enteral suspension:

  • Throat pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All oral products:

  • Take with or without food.

Regular-release tablets:

  • Some tablets may have a score line. If needed, these tablets may be split on the score line.

Extended-release tablets:

  • Swallow whole. Do not chew or crush.
  • Some products may be broken in half. Do not chew or crush. Talk with your pharmacist or doctor.

Extended-release capsules:

  • Swallow whole. Do not chew, break, or crush.
  • If you cannot swallow this drug whole, you may sprinkle the contents on applesauce. If you do this, swallow the mixture right away without chewing.

Oral-disintegrating tablet:

  • Be sure your hands are dry before you touch this drug.
  • Take this drug out of the bottle right before you use it.
  • Place on your tongue and let it dissolve. Water is not needed. Do not swallow it whole. Do not chew, break, or crush it.

Enteral suspension:

  • It is given as an infusion through a tube connected to your bowels.
  • Your doctor will teach you how to take this drug.
  • Take the oral form of this drug as you have been told by your doctor.
  • This drug needs to be at room temperature before use. Take a cassette out of the carton and out of the refrigerator 20 minutes before using.
  • Do not reuse cassettes. Do not use a cassette for longer than 16 hours, even if some drug is left.
  • If you need to disconnect the pump for a short time (less than 2 hours), follow what your doctor has told to do or read the package insert. If you need to disconnect the pump for longer than 2 hours, call your doctor to find out what to do.

All products:

  • If you take an iron product or a multivitamin that has iron, ask your doctor or pharmacist how to take it with this drug. Iron may lower how well your body is able to absorb this drug.
  • Diets high in protein, fat, or calories may lower how well your body absorbs this drug. Eating acidic foods may also do this. Talk with your doctor about your diet or if you will be changing your diet.
  • Do not stop taking this drug all of a sudden or lower your dose without talking to your doctor. Side effects may happen.
  • Keep taking this drug even when you are not having symptoms.
  • Keep a diary of your signs.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
  • Take this drug at the same time of day.

What do I do if I miss a dose?

All oral products:

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

Enteral suspension:

  • Call your doctor to find out what to do.

How do I store and/or throw out this drug?

All oral products:

  • Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.

Enteral suspension:

  • Store in a refrigerator. Do not freeze.
  • Store in original container.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-08-01

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022