Sinemet CR

Sinemet CR is a prescription medication used to treat symptoms of Parkinson's disease. It can also treat Parkinson's-like symptoms caused by certain conditions and injuries to the central nervous system. Parkinson's symptoms, including tremors (shaking), stiffness, and slowness of movement, are caused by a lack of dopamine, a natural substance usually found in the brain.

It is a single product containing 2 medications: levodopa and carbidopa. Levodopa is in a class of medications called central nervous system agents. It is converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain.

This combination medication is an extended-release (long-acting) tablet to be taken by mouth. It is usually taken 2 to 3 times a day.

Common side effects include nausea and abnormal movements.

Sinemet CR can cause drowsiness, dizziness, and blurred vision. Do not drive or operate heavy machinery until you know how Sinemet CR affects you.

Sinemet CR is a prescription medication used to treat symptoms of Parkinson's disease.

It is also used to treat Parkinson's-like symptoms that may develop after encephalitis (swelling of the brain) or injury to the nervous system caused by carbon monoxide poisoning or manganese poisoning.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Merck Sharp & Dohme Corp.

Serious side effects have been reported with Sinemet CR. See the "Sinemet CR Precautions" section.

Common side effects include:

• dizziness
• nausea
• vomiting
• loss of appetite
• diarrhea
• dry mouth
• constipation
• changes in sense of taste
• forgetfulness or confusion
• nervousness
• nightmares
• difficulty sleeping
• headaches
• weakness
• increased sweating
• drowsiness
• abnormal or impaired movement

This is not a complete list of Sinemet CR side effects. Ask your doctor or pharmacist for more information. Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medications you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

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

This is not a complete list of Sinemet CR drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Sinemet CR.

• unusual or uncontrolled movements of the mouth, tongue, face, head, neck, arms, and legs
• fast, irregular, or pounding heartbeat
• depression
• thoughts of death or suicide
• hallucinations
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty swallowing or breathing
• hives
• black, tarry stools
• red blood in stools
• blood in vomit
• vomit that looks like coffee grounds

Sinemet CR can cause drowsiness, dizziness, and blurred vision. Do not drive or operate heavy machinery until you know how Sinemet CR affects you.

Do not take Sinemet CR if you:

• are allergic to Sinemet CR or any of its ingredients
• are taking or have recently stopped taking a monoamine oxidase inhibitor (MAOI)

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Sinemet CR, there are no specific foods that you must exclude from your diet when receiving this medication.

However, tell your doctor if you plan on changing your diet to include foods that are high in protein, such as meat, poultry, and dairy products, since these foods can affect the way your body uses the medication.

Before taking Sinemet CR, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Sinemet or to any of its ingredients
• have or have had glaucoma
• have or have had melanoma (skin cancer) or a skin growth that has not been diagnosed
• have or have had hormone problems
• have asthma or emphysema
• have mental illess
• have diabetes
• have or have had ulcers
• have had a heart attack
• have an irregular heart beat
• have blood vessel, heart, kidney, liver, or lung disease
• are pregnant or breastfeeding
• have phenylketonuria

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when medication is taken during pregnancy.

Sinemet CR falls into category C. In animal stidues, pregnancy animals were given this medication and had some babies born with problems. No well-controlled studies have bene done in humans. Therefore, this medication may be used if the potential benefits to the mother outweight the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Levodopa, one of the components of Sinemet CR, has been detected in human breast milk. Caution should be exercised when Sinemet CR is given to a nursing woman.

Take Sinemet CR exactly as prescribed.

This combination medication is an extended-release (long-acting) tablet to be taken by mouth. It is usually taken 2 to 3 times a day.

Do not chew, divide, or break Sinemet CR extended-release tablets. Swallow these tablets whole.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Sinemet CR at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended starting dose of Sinemet CR will depend on other medications that you are taking.

If you take too much Sinemet CR, call your healthcare provider or local Poison Control Center or seek emergency medical attention right away.

If Sinemet CR is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if an overdose is suspected, seek emergency medical attention.

• Store Sinemet CR at room temperature.
• Keep this and all medications out of the reach of children.