Proper Use

Drug information provided by: Merative, Micromedex®

Take this medicine exactly as directed, and every time that you are supposed to take it. Do not stop taking your medicine unless ordered by your doctor. It is also important to not start taking other medicines for your Parkinson's disease without first talking with your doctor.

You may experience a “wearing-off” effect towards the end of the dosing interval. You should tell your doctor if you have problems with this that affect your every day life. Your doctor may want to adjust your dose.

Since protein may interfere with the body's response to carbidopa and levodopa, high protein diets should be avoided. Intake of normal amounts of protein should be spaced equally throughout the day, or taken as directed by your doctor.

If you are taking multivitamin tablets or plan to start taking them, discuss this first with your doctor. Iron salts (in vitamins) may keep this medicine from working properly.

Swallow the Dhivy™ tablet whole. If you are unable to swallow it, you may also break the tablet at the score lines. You may take this medicine with or without food.

Sinemet® tablet or Parcopa® disintegrating tablet begins to release its ingredients 30 minutes after you take it.

Swallow the extended-release capsule or sustained release tablet whole. Do not crush, break, or chew it.

If you have trouble swallowing the extended-release capsules: The capsules can be opened and the contents can be sprinkled on 1 to 2 tablespoons of applesauce. This mixture must be swallowed immediately without chewing.

If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not remove the tablet from the bottle until you are ready to take it. Place the tablet on the top of your tongue, where it will melt quickly.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For Parkinson's disease:
    • For oral dosage form (extended-release capsules):
      • Adults—
        • For patients starting on carbidopa and levodopa treatment: At first, one capsule 3 times a day for the first 3 days. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 10 capsules per day.
        • For patients taking carbidopa and levodopa already: At first, 3 or 4 capsules 3 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 10 capsules per day.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (disintegrating tablets):
      • Adults—
        • For patients starting on carbidopa and levodopa treatment: At first, one tablet 3 or 4 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 8 tablets per day.
        • For patients taking levodopa already: Levodopa should be discontinued at least 12 hours before starting Parcopa®. The starting dose is one tablet 3 or 4 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 8 tablets per day.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (sustained release tablets):
      • Adults—
        • For patients switching from Sinemet® to Sinemet® CR: The starting dose is based on the amount of Sinemet® you are currently taking per day. Your doctor may adjust your dose as needed.
        • For patients taking levodopa already: Levodopa should be discontinued at least 12 hours before starting Sinemet® CR. The starting dose is one tablet 2 times a day. Your doctor may adjust your dose as needed.
        • For patients not taking levodopa: At first, one tablet 2 times a day. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults—
        • For patients starting on carbidopa and levodopa treatment: At first, one tablet 3 or 4 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
        • For patients taking levodopa already: Levodopa should be discontinued at least 12 hours before starting Lodosyn® plus levodopa or Sinemet®. The starting dose is one tablet 3 or 4 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
        • For patients taking carbidopa and levodopa already: 25 milligrams (mg) of Lodosyn® per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
      • Children—Use and dose must be determined by your doctor.
  • For Parkinson's disease, parkinsonism caused by encephalitis, or parkinsonism caused by carbon monoxide or manganese poisoning:
    • For oral dosage form (tablets):
      • Adults—At first, 25 milligrams (mg) carbidopa and 100 mg levodopa (1 tablet) 3 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 8 whole tablets per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

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Portions of this document last updated: Feb. 01, 2024

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