Let's learn about these long-acting capsules (Carbidopa; Levodopa Extended-Release Capsules) used for Parkinson's disease.

Are you having difficulty performing your daily activities due to Parkinson's disease? Maybe you feel stiff or your limbs are shaking? We know it's not easy to live with these symptoms. So today we're going to talk about a medicine that can help you reduce these discomforts. That is, Extended-Release Capsules, which are a combination of two drugs called Carbidopa and Levodopa.

What really happens with this medicine?

Simply put, this medicine, Carbidopa; Levodopa, is used to control the symptoms of Parkinson's disease. Our brains contain a chemical called dopamine. This is what helps control our body's movements and coordination. When Parkinson's disease develops, the amount of dopamine in the brain decreases. That's when symptoms like stiffness and tremors appear. So this medicine works by increasing the amount of dopamine in the brain and reducing those symptoms. This medicine can sometimes be used for other things as well. You can ask your doctor or pharmacist about it. A popular brand name for this medicine is Rytary.

Things you need to tell your doctor before you start taking this medicine

Before you start this medication, it is very important to inform your medical team (care team) about certain things. Because that information will determine whether this medication is right for you or not, and how it should be given.

If you have any of these situations, be sure to mention them:

• If you have depression or another mental illness.
• If you have diabetes mellitus.
• If you have glaucoma in your eyes.
• Heart disease, meaning having had a heart attack in the past, or having a history of irregular heartbeat.
• If you have kidney disease.
• If you have liver disease.
• If you have a lung disease, for example, asthma.
• Narcolepsy - a condition in which you suddenly fall asleep uncontrollably during the day.
• If you have sleep apnea, a condition in which you stop breathing during sleep.
• If you have stomach or intestinal problems.
• If you have had an allergic reaction or unusual reaction to Levodopa, Carbidopa, other medicines, foods, artificial dyes, or preservatives.
• If you are pregnant or trying to get pregnant.
• If you are a breastfeeding mother.

It's very important for your own safety to tell the doctor these things without hiding them, okay?

How exactly do I use this medicine?

This medicine should be taken with a glass of water. Follow the directions on the prescription label given to you by your doctor exactly as it says. The capsule should be swallowed whole. Do not crush, chew, or break it in half.

Suppose you have a hard time swallowing this capsule. In that case, you can carefully twist the capsule open and pour all the medicine inside on top of one or two tablespoons of applesauce. However, you should use the medicine immediately after mixing it with food. Do not save it for later use. Take your medicine at the same time every day, at regular intervals. Do not take more medicine than your doctor tells you to. Also, do not stop taking the medicine suddenly without your doctor's advice.

Also, if you eat a meal that is high in fat and calories, it may take longer for the medicine to be absorbed into your body. This could delay the start of the medicine by two to three hours. Therefore, consider taking your first dose of the day an hour or two before a meal. However, if you feel nauseous after taking the medicine, you can take it with some food.

Special care should be taken when giving this medicine to children, so talk to your medical team about it.

Important: This medicine has been prescribed for you only. Never share this medicine with others.

What to do if you take too much medicine?

If you think you have taken too much of this medicine, call a poison control center or emergency room immediately.

What if I miss my medication?

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose or an extra dose.

Other things that may interact with this medicine (Interactions)

There are some medications, such as Carbidopa; Levodopa, that can cause problems when taken together. Therefore, if you are taking any other medications, it is essential to tell your doctor .

Never take this medicine with the following medications:

• Medications in the class of drugs called MAOIs, such as Marplan, Nardil, and Parnate.
• Reserpine
• Tetrabenazine

Interactions may also occur with these medications:

• Alcohol
• Droperidol
• Entacapone
• Iron supplements or multivitamins with iron
• Isoniazid (INH)
• Linezolid
• Medications for depression, anxiety, or mental disorders
• Medication for high blood pressure
• Sleeping pills
• Metoclopramide
• Papaverine
• Procarbazine
• Tedizolid
• Rasagiline
• Selegiline
• Tolcapone

This list may not include all interactions. Therefore, tell your doctor about all the medicines you take (prescribed, over-the-counter, herbal products, vitamins). Also tell your doctor if you smoke, drink alcohol, or use illegal drugs. Some of these can interact with your medicine.

Things to keep in mind when taking this medicine

See your doctor regularly to check how you are doing while you are taking this medicine. Tell your doctor if your symptoms do not improve or if they get worse. Do not stop taking this medicine without your doctor's advice. Doing so may cause a serious reaction. Your doctor will tell you how much medicine you need to take.

• Drowsiness and dizziness: You may feel drowsy or dizzy. Do not drive, use machinery, or do anything that requires concentration until you know how this medicine affects you. Do not stand up or get up from a sitting position suddenly, especially if you are elderly. Doing so can reduce the risk of dizziness and falls. Alcohol can interfere with the way this medicine works. So avoid drinking alcohol.

• Sudden sleepiness: When taking this medicine, you may suddenly fall asleep without warning . You may fall asleep while driving, talking, or eating. You may not feel sleepy before this happens. If this happens to you, tell your doctor right away.

• Unusual urges: Some people have reported that they experience unusual sexual desire while taking this medicine, or that they have uncontrollable urges to gamble, overeat, or buy things they don't need. If you experience any of these symptoms, tell your doctor as soon as possible.

• 'Wearing off' and 'On-Off' effects: Sometimes, before it is time to take your next dose, you may feel like the medicine is wearing off (a 'wearing off' effect). Also, sometimes the medicine may suddenly stop working (from a few minutes to a few hours) and then start working again (an 'on-off' effect). It's like turning a switch 'on' or 'off'. If you experience any of these symptoms, tell your doctor . Your dose may need to be adjusted.

• High-protein foods:Eating a high-protein meal can delay or prevent the absorption of this medicine. Therefore, to avoid these problems, avoid eating a high-protein meal (for example, a lot of meat, fish, lentils, etc.) close to the time you take the medicine. Take the medicine at least 30 minutes before or one hour after a meal. You can eat high-protein meals later in the day or in smaller quantities. Talk to your doctor about this.

• For diabetics: If you have diabetes, this medicine may cause a false-positive result for sugar in your urine. So talk to your doctor about this.

• Discoloration of urine or sweat: This medication may cause your urine or sweat to become dark (like black) or red. This is not a cause for concern. However, it may stain clothes.

• Vitamin B6 deficiency: This medication can cause a decrease in vitamin B6 levels in the body. Therefore, you should make sure that you are getting enough vitamin B6 while taking this medication. Talk to your doctor about the foods and vitamins you are taking.

Possible side effects of this medicine

Like all medications, this one can have some side effects. Some are serious, some are not so serious.

Side effects that require immediate medical attention:

If you experience any of the side effects listed below, you should tell your doctor or medical team as soon as possible:

• Allergic reactions: Skin rash, itching, hives, swelling of the face, lips, tongue, or throat.
• Suddenly falling asleep while working during the day.
• Changes in heart rate: fast or irregular heartbeat, dizziness, fainting, chest pain, difficulty breathing.
• Low blood pressure: dizziness, fainting, blurred vision.
• Mood and behavior changes: anxiety, restlessness, confusion, hallucinations, irritability, hostility, suicidal thoughts, worsening of mental status, feelings of depression.
• New or worsening, uncontrollable, repetitive movements of the face, mouth, or upper body.
• Stomach bleeding: bloody or tarry stools, vomiting a brown substance that looks like coffee grounds, or blood.
• Sudden eye pain or vision changes: for example, blurred vision, seeing halos around lights, or loss of vision.
• Unusual temptations:Impulsive behaviors that you can't control, such as gambling, overeating, engaging in sexual activity, or buying things differently than you normally would.

Side effects that usually do not require medical advice (but should be reported to the doctor if they persist or are bothersome):

• Dark red or black color of saliva, sweat, or urine.
• Dizziness.
• Drowsiness.
• Headache (headache).
• Nausea.

This list does not include all possible side effects. Talk to your doctor for medical advice about side effects.

How should you store your medicine?

Keep this medicine out of the reach of children.

Store at room temperature (between 15 and 30 degrees Celsius, between 59 and 86 degrees Fahrenheit). Protect from light and moisture. Throw away any unused medicine that has expired.

Remember (Take-Home Message)

Okay, so let's remind you of some of the most important things we've talked about.

• This Carbidopa; Levodopa medicine helps reduce the symptoms of Parkinson's.
• It is extremely important to tell your doctor about all of your health conditions and other medications you are taking before starting the medication .
• Swallow the medicine whole. Do not crush or chew it. Only if it is difficult to swallow, break it into pieces and take it with applesauce.
• Take the prescribed dose at the prescribed time. Do not stop taking it without your doctor's advice.
• Be careful as it can cause drowsiness and dizziness. You may also fall asleep suddenly.
• Be aware of unusual urges, such as 'wearing off'/'on-off'. If this happens, tell your doctor .
• Do not eat high-protein meals close to the time you take your medication.
• If you experience any unusual side effects, especially those on the list of "side effects that require immediate medical attention" that we discussed, tell your doctor immediately.

Remember, this leaflet is only a summary. It may not cover all the information. If you have any further questions about this medicine, talk to your doctor, pharmacist, or other healthcare provider. They will be able to help you.

` Parkinson's disease, carbidopa, levodopa, dopamine, Parkinson's medication, side effects, drug interactions