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Sinemet (Carbidopa Levodopa)

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Generic Sinemet is a high-quality medication which is used to treat symptoms of Parkinson's disease. Generic Sinemet can also be used to treat Parkinson-like symptoms caused by manganese poisoning, encephalitis, carbon monoxide poisoning. Levodopa is central nervous system agent. Carbidopa is decarboxylase inhibitor. Levodopa gives anti-Parkinson's effect and carbidopa work by protecting levodopa effectiveness.

Other names for this medication:
Apo-levocarb, Atamet, Carbidopa-levodopa, Carbilev, Carcopa, Cardopar, Carlevod, Cinetol, Cloisone, Co-careldopa, Co-dopa, Credanil, D-dopa plus, Dopacol, Dopadura c, Dopamar, Dopicar, Duellin, Duodopa, Grifoparkin, Isicom, Karbidopa-levodopa, Kardopal, Kinson, Lebocar, Lecardop, Lecarge, Ledopsan, Leprinton, Levo-c al, Levobeta, Levocarb, Levocomp, Levomed, Levomet, Lodosyn, Menesit, Nakom, Neodopaston, Nervocur, Nu-levocarb, Parcopa, Parken, Parkidopa, Parkinel, Parkiston, Prikap, Sindopa, Sindrob, Sinepar, Stalevo, Striaton, Sulconar, Syndopa, Tidomet

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Also known as:  Carbidopa Levodopa.


Generic Sinemet is a perfect remedy which is used to treat symptoms of Parkinson's disease caused by manganese poisoning, encephalitis, carbon monoxide poisoning. Levodopa is central nervous system agent. Carbidopa is decarboxylase inhibitor. Levodopa gives anti-Parkinson's effect and carbidopa work by protecting levodopa effectiveness.

Generic name of Generic Sinemet is Levodopa and Carbidopa.

Sinemet is also known as Carbidopa-Levodopa, Parcopa, Syndopa.

Brand names of Generic Sinemet are Sinemet, Parcopa, Sinemet CR, Stalevo.


Generic Sinemet is available in tablets (10mg + 100mg, 25mg + 100mg, 25mg + 250mg), orally disintegrating tablets, extended-release tablets orally.

Usually tablets and disintegrating tablets are taken 3-4 times a day. The extended-release tablets are usually taken 2-4 times a day. Take Generic Sinemet before meal with water.

Do not take Generic Sinemet if you are under 18.

Do not crush or chew it.

If you want to achieve most effective results do not stop taking Generic Sinemet suddenly.


If you overdose Generic Sinemet and you don't feel good you should visit your doctor or health care provider immediately. Symptoms of Generic Sinemet overdosage: muscle twitches, inability to open the eyes.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Sinemet are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Do not take Generic Sinemet if you are allergic to Generic Sinemet components.

Do not take Generic Sinemet if you are pregnant, planning to become pregnant or breast-feeding.

Be careful using Generic Sinemet if you take iron pills and vitamins containing iron; metoclopramide (such as Reglan); isoniazid (such as Nydrazid, INH); isocarboxazid (such as Marplan); phenytoin (such as Dilantin); antihistamines; risperidone (such as Risperdal); antidepressants (protriptyline (such as Vivactil), clomipramine (such as Anafranil), doxepin (such as Sinequan, Adapin), amitriptyline (such as Elavil), desipramine (such as Norpramin), trimipramine (such as Surmontil), amoxapine (such as Asendin), nortriptyline (such as Pamelor, Aventyl), imipramine (such as Tofranil); selegiline (such as Eldepryl); ipratropium (such as Atrovent); rasagiline (such as Azilect); haloperidol (such as Haldol); high blood pressure medicines; motion sickness, ulcers, irritable bowel disease, nausea, urinary problems, mental illness medications; papaverine (such as Pavabid), tranyllcypromine (such as Parnate) or phenelzine (such as Nardil).

It can be dangerous to use Generic Sinemet if you suffer from or have a history of glaucoma, undiagnosed mole, melanoma, suspicious, phenylketonuria, mental illness; diabetes; heart attacks; asthma; bronchial asthma; endocrine disorder; emphysema; ulcers; active peptic ulcer; hormone problems; irregular heartbeat; kidney, liver, blood vessel, lung or heart disease.

Be careful with Generic Sinemet if you are going to have a surgery.

Do not take Generic Sinemet if you are under 18.

Avoid driving machine.

It can be dangerous to stop Generic Sinemet taking suddenly.

sinemet dosing question

L-Dopa is the major symptomatic therapy for Parkinson's disease, which commonly occurs in elderly patients. However, the effects of chronic use on mood and cognition in old subjects remain elusive. In order to compare the effects of a chronic pulsatile L-Dopa treatment on emotional and cognitive functions in young (3 months) and old (18 months) intact rats, an L-Dopa/carbidopa treatment was administered every 12 h over 4 weeks. Rats were assessed for behavioural despair (repeated forced swimming test, RFST), anhedonia (sucrose preference test, SPT) and spatial learning (Morris water maze, MWM) in the late phase of treatment (T). Neuronal expression of Fos in the hippocampus at the early and late phases of T, as well as after MWM was studied. The density and ratio of dopamine D5r, D3r and D2r receptors were also evaluated in the hippocampus using immunohistochemistry and confocal microscopy. Young rats showed similar patterns during behavioural tests, whereas aged treated rats showed increased immobility counts in RFST, diminished sucrose liquid intake in SPT, and spatial learning impairment during MWM. Fos expression was significantly blunted in the aged treated group after MWM. The density of D5r, D3r and D2r was increased in both aged groups. The treatment reduced the ratio of D5r/D3r and D5r/D2r in both groups. Moreover, aged treated subjects had significant lower values of D5r/D3r and higher values of D5r/D2r when compared with young treated subjects. These results indicate that chronic L-Dopa treatment in itself could trigger emotional and cognitive dysfunctions in elderly subjects through dopamine receptor dysregulation.

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Motor fluctuations and non-response to carbidopa-levodopa (Sinemet) therapy are major problems in the long-term management of Parkinson's disease. Levodopa manipulation, addition of adjuvants, and drug holidays are often unsuccessful. Others have shown that the clinical state of stabilized Parkinsonians can be reversed with intravenous administration of large neutral amino acids. Reasoning that dietary protein might precipitate motor oscillations and non-response, a low-protein daytime diet (7 g) was offered to fifteen patients. Eighty-six percent of this sample demonstrated immediate sensitivity to Sinemet. While on a low-protein diet, patients' clinical function was predominantly choreatic. Eight patients required a 10-60 percent reduction in their daily levodopa dose in order to minimize this choreatic tendency. Discontinuation of adjuvants did not compromise motor independence. Conversely, while on a high-protein diet (160 g), patients were predominantly immobile with markedly elevated plasma amino acid and levodopa levels. Consequently, elimination of dietary protein from breakfast and lunch can offer an effective and easily modified method for the amelioration of motor fluctuations and non-response to Sinemet in Parkinson's disease during working hours.

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The present report describes a case of choreoathetotic movements which were most probably induced by sildenafil in a patient with Parkinson's disease (PD) treated with levodopa/carbidopa (LD/CD).

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Thirty-eight patients newly diagnosed as having Parkinson's disease (mean age, 57.3 years; mean Parkinson's disease duration, 2.7 years) in the earlier phase of the disease (mean Hoehn/Yahr stage, 2; mean motor scores, 11.4) were given selegiline (Deprenyl), 10 mg daily, and maintained on this drug alone until significant clinical worsening warranted the addition of low-dose levodopa (Sinemet, 25/100 three to four doses per day). Five of these patients were not yet receiving additional levodopa despite some worsening of motor scores. Of the 33 patients now taking combined therapy, seven have been followed up for 6 months or less. Twenty-four (92%) of the 26 patients taking combined therapy for a mean of 26 months (8.5 to 99 months) who have had Parkinson's disease for 6 years showed a dramatic improvement in their parkinsonism shortly after the addition of levodopa, with significant decreases in their rated motor scores, such improvement being maintained at their latest neurologic evaluation. Eighteen (75%) of these 24 patients responded to the combined selegiline/levodopa therapy with degrees of improvement equal to or greater than 50%, compared with their motor status at the start of combined therapy just before the addition of levodopa. This degree of "reversal" of parkinsonism on addition of levodopa (mean carbidopa/levodopa dose, 98/389 mg) was not observed in any of these same patients receiving selegiline alone for an average of 13.8 months. Four patients taking combined therapy developed mild, transient, abnormal involuntary movements, and end-of-dose pattern of response after more than 2 years of combined therapy (24.75 and 33.5 months, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

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This case report describes a 15-year-old male patient with spastic diplegic cerebral palsy, Gross Motor Function Classification System Level III, who developed severe new cognitive and motoric impairments after the administration of haloperidol. He received this dopamine antagonist and typical antipsychotic medication for an acute postoperative episode of agitation. He improved when he received the dopamine agonists amantadine and carbidopa/levodopa. This case suggests that dopamine blockade may be deleterious for individuals with cerebral palsy. Potential explanations for the events observed in this case are also presented.

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DL-threo-3,4-dihydroxyphenylserine (DL-threo-DOPS) was administered during 10 days to 4 patients with longstanding Parkinson's disease in addition to their treatment with L-3,4-dihydroxyphenyl-L-alanine (L-DOPA)-carbidopa (Sinemet). All patients tended to improve in their symptoms freezing, all day life activity and mood. There were no improvements in rigidity, tremor, and akinesia (in general). During the DL-threo-DOPS-treatment cerebrospinal fluid (CSF), serum and urine concentrations of catecholamines were measured. The results show that DL-threo-DOPS is transported to the brain and CSF in a way comparable with L-DOPA. However, no measurable increase of 3-methoxy-4-hydroxyphenylethyleneglycol (MOPEG) in CSF could be demonstrated. This suggests that the synthesis of noradrenaline from DL-threo-DOPS in the brain is doubtful. In addition measurements in urine reveals that at the dose used Sinemet prevents peripheral decarboxylation of DL-threo-DOPS into noradrenaline. Other possible metabolic pathways of DL-threo-DOPS are discussed.

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Together these results support the hypothesis that, in healthy men, dopamine is not closely linked to euphorogenic effects of abused substances but does affect the salience of reward-related cues and the ability to respond to them preferentially.

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Economic appraisal differs from clinical assessment, and decision makers benefit from analysis of naturalistic, actual practice data. Despite reviewing the initial trial-based, 'piggy-back' economic analysis, TLV was uncertain of the cost effectiveness in actual practice and deferred a final decision until observational data from the DAPHNE study became available. Second, acceptance of economic modelling and use of temporary reimbursement conditional on additional evidence development provide a mechanism for risk sharing between TLV and manufacturers, which enabled patient access to a drug with proven clinical benefit while necessary evidence to support claims of cost effectiveness could be generated.

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Peak plasma concentrations (Cmax) and systemic exposure (AUCt, AUCinf) for LD and CD increased dose-proportionally over the range of the IPX066 capsule strengths. Comparison of 1 and 2 IPX066 245-mg LD capsules showed dose-proportional pharmacokinetics for Cmax and AUCt. Sprinkling the capsule contents on applesauce did not affect the pharmacokinetics. A high-fat, high-calorie meal delayed the initial increase in LD concentration by approximately 1 to 2 hours, reduced Cmax by 21%, and increased AUCinf by 13% compared with the fasted state.

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Following concomitant administration with levodopa/carbidopa CR 200 mg/50 mg, single doses of nebicapone 50 mg, 100 mg and 200 mg significantly and dose-dependently inhibited S-COMT activity, increased systemic exposure to levodopa, and reduced 3-OMD formation.

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Parkinson's disease clinic at a tertiary care university teaching hospital.

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sinemet dosage 2016-08-25

The unique needs of patients with Parkinson disease challenge staff when such patients are admitted to hospitals or nursing facilities. Prolongation of the hospital stay, falls with injuries, fainting, or declining motor function may result from therapeutic misadventures or failure to anticipate common problems. Staff familiarity with Parkinson disease, and especially carbidopa-levodopa dosing and dynamics, may prevent such Buspar Generic problems and streamline hospital and nursing home care.

sinemet dosage frequency 2017-09-03

Controlled release carbidopa/levodopa (CSR-1) was compared to standard carbidopa/levodopa in a double-blind, crossover study of 20 Parkinson's disease patients. The most consistent finding in a variety of clinical Aldactone Max Dosage measurements was the superiority of standard carbidopa/levodopa to CSR-1. Increased dosages of CSR-1 resulted in reduced Parkinson symptoms, suggesting that a more potent controlled-release formulation might prove to be more efficacious than CSR-1.

sinemet dosage interval 2016-02-19

Entacapone is frequently used together with levodopa/carbidopa (LC) and levodopa/benserazide (LB) in the treatment of Parkinson's disease (PD) patients with wearing-off symptoms. It is generally assumed that the effects of entacapone are independent of the type of decarboxylase inhibitor used, but there is very little published data available on the efficacy of entacapone administered with LB versus LC. We have performed a pooled analysis of three randomized, double-blind, 6-month, phase III studies to compare the treatment effects of entacapone (compared to placebo) in PD patients Imitrex Tab Dosage receiving LC or LB. A total of 551 PD patients experiencing wearing-off were included in the analysis. 300 patients were on LB and 251 on LC at baseline. At 6 months, entacapone (compared to placebo) improved mean daily OFF-time in patients on LB and LC by 0.76 (p = 0.016) and 0.95 (p = 0.011) hours, respectively. The corresponding improvements in ON-time were 0.97 (p = 0.002) and 0.83 h (p = 0.022), respectively. The treatment effects of entacapone both in LB and LC users were statistically significant (p < 0.05) also in UPDRS II and III scores, except in UPDRS II scores in patients receiving LC (p = 0.20). None of the treatment effects of entacapone were statistically significantly different between patients receiving LB or LC. Reported adverse events were comparable between LB and LC users. We conclude that entacapone provided comparable benefits in PD patients with wearing-off symptoms using either LB or LC.

sinemet online 2016-04-18

The objective of this study was to assess the efficacy, safety, and pharmacokinetics of XP21279-carbidopa in patients with Parkinson's disease who experience motor fluctuations compared with immediate-release carbidopa-levodopa tablets. XP21279 is a levodopa prodrug that is actively absorbed by high-capacity nutrient transporters expressed throughout the gastrointestinal tract and then rapidly converted to levodopa by carboxylesterases. XP21279-carbidopa sustained-release bilayer tablets were developed to overcome pharmacokinetic limitations of levodopa by providing more continuous exposure. Patients with motor fluctuations who required carbidopa-levodopa four or five times daily were optimized for 2 weeks each on carbidopa-levodopa four or five times daily and XP21279-carbidopa three times daily in a randomized sequence. Next, they received each optimized treatment for 2 weeks in a double-blind/double-dummy, randomized sequence. The primary outcome measure was change from baseline in daily off time at the end of each double-blind treatment period Nexium 75 Mg . All patients at 2 sites underwent pharmacokinetic analyses. Twenty-eight of 35 enrolled patients completed both double-blind treatments. The mean total daily off time was reduced from baseline by a mean (± standard error) of 2.7 hours (± 0.48 hours) for immediate-release carbidopa-levodopa and 3.0 hours (± 0.57 hours) for XP21279-carbidopa (P = 0.49). Among 11 patients who completed pharmacokinetic sampling on each optimized treatment, the percentage deviation from the mean levodopa concentration was lower (P < 0.05) for XP21279-carbidopa than carbidopa-levodopa. Both treatments had a similar incidence of new or worsening dyskinesias. XP21279-carbidopa administered three times daily produced a reduction in off time similar to that of carbidopa-levodopa administered four or five times daily, and the difference was not statistically significant. XP21279-carbidopa significantly reduced variability in levodopa concentrations compared with carbidopa-levodopa.

sinemet overdose symptoms 2015-04-16

Dominantly inherited ataxias resulting from different gene mutations are difficult to distinguish based on clinical phenotypes. We believe the phenotypic variability within families can be a clue to clinical diagnosis. We illustrate the range of phenotypes extending from levodopa-responsive extrapyramidal disease to more purely ataxic syndromes seen in two families with molecularly proven Machado-Joseph disease. Augmentin 600 Suspension

sinemet drug company 2017-03-24

The efficacy of low-dose bromocriptine mesylate administration (20 mg daily or less) was evaluated in a double-blind study. Nine of 16 individuals receiving bromocriptine completed the 40-week study. Modest, but significant, improvement was derived from bromocriptine therapy. Improvement was most evident in tremor. Maximum improvement was achieved with doses between 7.5 and 15.0 mg daily, with some decline in efficacy as doses approached 20 mg. Adverse effects were common, but were generally mild in severity. Our results suggest that bromocriptine in low Zanaflex Usual Dosage doses may be an effective adjunct to carbidopa and levodopa (Sinemet) in the treatment of Parkinson's disease.

sinemet storage temperature 2015-09-07

A 42-year-old female applied for life insurance. She was diagnosed with dopa-responsive dystonia as a child. Zoloft 40 Mg Just prior to applying for insurance, she attempted to go off her carbidopa-levodopa resulting in increased symptoms of stiffness with some imbalance. Her neurologist advised her to restart her Sinemet and titrate dosages to maintain her best function. The diagnosis and risks are discussed.

sinemet with alcohol 2015-11-10

The prevalence of persistent vegetative state (PVS) is estimated to be 40 to 168 per million person-years in the United States. Studies in the industrialized world have shown that the quality of life of persons with PVS is severely compromised and with paucity of data on treatment of persons with PVS. Levaquin Drug This is the first time a report of treatment of PVS with a known medication is being reported from Nigeria or sub-Saharan Africa. Our objectives were to prospectively follow up some cohorts of patients diagnosed to have PVS by a reliable and valid criteria and to look out for any response to L-dopa/carbidopa administration.

sinemet 200 mg 2016-01-24

The main focus of the present study was to define the rotational response of 6-hydroxydopamine-lesioned rats to dopaminergic agonists to separate the partially lesioned rats from those having complete substantia nigra (SN) and ventral tegmental area (VTA) lesions. Animals were challenged by amphetamine and L-DOPA for 10 consecutive weeks. There was a correlation between rotational behavior and extent of midbrain cell loss. Rats with complete SN and < 40% VTA lesion turned more than 5 times/min after amphetamine administration, but not after L-DOPA; animals with complete SN and 40-80% VTA lesions turned vigorously following amphetamine and began turning after L-DOPA administration. Rats with complete SN and VTA lesions turned less after amphetamine than the other two groups, while their turning after L-DOPA administration increased. Extracellular dopamine (DA) measured by microdialysis, intracellular DA measured by postmortem tissue punches, and tyrosine hydroxylase-immunoreactive cell count in SN and VTA were also evaluated. It appears that the dopaminergic cells in the lateral VTA affect DA Levitra 20mg Pills concentration in the medial caudate nucleus. In the nucleus accumbens of the lesioned side, DA release and metabolism substantially increased with the larger VTA lesion. Dopamine turnover rate in the caudate was also higher in the group with < 40% VTA lesion.

sinemet max dose 2017-10-23

LCIG, an aqueous gel, is continuously infused (daytime only or 24 h) via a portable pump and tube permanently inserted into the duodenum through percutaneous endoscopic gastrostomy (PEG). LCIG infusion provides stable levodopa plasma levels, which are significantly less variable than those with oral levodopa. Clinical trials indicate LCIG may significantly improve motor complications (reduction of time in 'off' and time in 'on with dyskinesias'), motor scores using the Unified Parkinson's Disease Rating Scale (UPDRS), non-motor symptomatology (Non-motor Symptom Scale) and health-related quality of life (HRQOL) in advanced PD patients. The adverse-event profile of LCIG is similar to that of oral levodopa, although technical problems with the infusion device have occurred in up to 70% of patients.

sinemet dosage schedule 2016-10-15

New concepts about the pathogenesis and pathophysiology of Parkinson's disease have emerged. For these concepts to be useful, they must be understood, and for them to be applied, the psychology of the patient and the patient's family must be understood. The initial consultation is crucial in establishing a successful relationship between a patient, family, and physician. This consultation is analyzed and ways of avoiding errors and misconceptions delineated. Emphasis is placed on imaginitive questioning using the format of the ADL portion of the UPDRS in establishing the diagnosis and following treatment. The rational for starting treatment with selegiline at this time is discussed in the context of the role that increased MAO-B activity plays in the progression of Parkinson's disease. After making the diagnosis and starting treatment with selegiline, deciding when to start levodopa is the next crucial decision. Often as important as deciding when to start levodopa is overcoming the resistance of the patient to accept this treatment. The next crucial decision occurs after the patient develops response fluctuations on levodopa. A format for assessing the fluctuations is presented, and the merits of different treatments, including selegiline, dopamine agonists (bromocriptine and pergolide), and sustained-release or controlled-release levodopa preparations (Sinemet CR), discussed. The management of patients with depression, sleep problems, and advanced disease including postural instability and mental changes are reviewed.

sinemet 500 mg 2015-08-17

The femurs of 30% of the Sham rats healed compared with 50% of the L-dopa/carbidopa and 84% of the L-dopa treated femurs. The healed L-dopa rat femurs had significantly greater ultimate load (P = 0.037) and energy to failure (P = 0.004) than the healed Sham rats. There were no significant differences between the L-dopa/carbidopa group and either the Sham or L-dopa group.