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Precautions and Warnings With Carbidopa-Levodopa

Specific Precautions and Warnings With Carbidopa-Levodopa

Warnings and precautions to be aware of prior to taking carbidopa-levodopa include the following:
  • Intense, unusual urges have been reported in people taking Parkinson's disease medications (including carbidopa-levodopa). Examples include an intense desire to gamble or to engage in risky sexual behavior. Let your healthcare provider know right away if you experience any of these urges.
  • People with Parkinson's disease have an increased risk for melanoma (a type of skin cancer). At this time, it is not clear if this is caused by Parkinson's disease medications (such as carbidopa-levodopa) or other factors. It is a good idea to have regular skin checks to monitor for this problem.
  • Carbidopa-levodopa can cause involuntary muscle movements called dyskinesia. Although not typically dangerous, dyskinesia can be quite disturbing and intolerable. If you develop a dyskinesia while taking the drug, your healthcare provider may need to decrease your carbidopa-levodopa dosage, or you may need to stop taking the drug.
  • Carbidopa-levodopa can cause or worsen many mental illnesses, due to its effects on dopamine (a brain chemical). Let your healthcare provider know if you have a history of such problems before taking the drug.
  • If you have heart problems, lung problems, ulcers, or kidney or liver disease, check with your healthcare provider before taking carbidopa-levodopa. In some cases, the drug may not be the best choice for you.
  • Stopping carbidopa-levodopa too quickly can cause a dangerous condition known as neuroleptic malignant syndrome (NMS). Do not stop taking the drug without your healthcare provider's approval and supervision. Let your healthcare provider know if you develop any signs of NMS, such as:
    • A high fever
    • Stiff muscles
    • Confusion
    • Irregular pulse or blood pressure
    • A fast heart rate (tachycardia)
    • Sweating
    • Irregular heart rhythms (arrhythmias).
  • People with glaucoma may not be able to take the drug safely. Carbidopa-levodopa is not recommended for people with narrow-angle glaucoma. People with adequately treated wide-angle glaucoma may take the drug, although careful monitoring of the condition may be necessary.
  • The medication may cause you to fall asleep during the day, sometimes without warning. This can be especially dangerous if you are driving a car or operating heavy machinery. In addition, this can happen long after you start taking carbidopa-levodopa. Ask your healthcare provider if you should stop driving a car or operating heavy machinery while taking it.
  • Carbidopa-levodopa can cause dark (red, brown, or black) saliva, sweat, or urine. Although this is not dangerous, it can be bothersome.
  • Carbidopa-levodopa can potentially interact with several medications (see Drug Interactions With Carbidopa-Levodopa).
  • Carbidopa-levodopa is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Sinemet and Pregnancy).
  • The medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the carbidopa-levodopa (see Sinemet and Breastfeeding).
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Information on Carbidopa-Levodopa

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