Precautions and Warnings With Orally Disintegrating Carbidopa-Levodopa (Cont.)

Specific Precautions and Warnings With Orally Disintegrating Carbidopa-Levodopa

Some of the warnings and precautions to be aware of prior to taking this drug include the following:
 
  • Orally disintegrating carbidopa-levodopa tablets contain phenylalanine (an amino acid). This is important for people with phenylketonuria, who must limit their intake of phenylalanine.
     
  • Stopping orally disintegrating carbidopa-levodopa too quickly can cause a dangerous condition known as neuroleptic malignant syndrome (NMS). Do not stop taking your prescription without your healthcare provider's approval and supervision. Let your healthcare provider know if you develop any signs of NMS, such as:

 

    • High fever
    • Stiff muscles
    • Confusion
    • Irregular pulse or blood pressure
    • Fast heart rate (tachycardia)
    • Sweating
    • Irregular heart rhythms (arrhythmias). 

 

  • People with glaucoma may not be able to take this medicine safely. Orally disintegrating carbidopa-levodopa is not recommended at all for people with narrow-angle glaucoma. People with adequately treated wide-angle glaucoma may take orally disintegrating carbidopa-levodopa, although careful monitoring of the condition may be necessary.
     
  • Because orally disintegrating carbidopa-levodopa can activate a malignant melanoma, it should not be used by anyone with a suspicious, undiagnosed skin lesion or a history of melanoma.
     
  • Orally disintegrating carbidopa-levodopa can cause involuntary muscle movements called dyskinesia. Although not typically dangerous, dyskinesia is usually quite disturbing and intolerable. If you develop dyskinesia while taking orally disintegrating carbidopa-levodopa, your healthcare provider may need to decrease your dosage (or you may need to stop taking the medication altogether).
     
  • Orally disintegrating 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.
     
  • If you have heart problems, lung problems, ulcers, or kidney or liver disease, check with your healthcare provider before taking orally disintegrating carbidopa-levodopa. In some cases, this medication may not be the best choice for you.
     
  • Orally disintegrating carbidopa-levodopa can potentially interact with several medications (see Drug Interactions With Orally Disintegrating Carbidopa-Levodopa).
     
  • This 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 orally disintegrating carbidopa-levodopa. Ask your healthcare provider if you should stop driving a car or operating heavy machinery while taking this medication.
     
  • Orally disintegrating carbidopa-levodopa can cause dark (red, brown, or black) saliva, sweat, or urine. Although this is not dangerous, it can be quite bothersome.
     
  • Orally disintegrating 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 Parcopa and Pregnancy).
     
  • Orally disintegrating carbidopa-levodopa passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Parcopa and Breastfeeding).
     
(Precautions and Warnings With Orally Disintegrating Carbidopa-Levodopa Continued: Page 3)

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;