Does someone in your family, perhaps your mother, father, grandmother or grandfather, suffer from Parkinson's disease? It's very sad to see them suffer from symptoms like tremors, stiffness, and slow walking, isn't it? So, today we thought we would talk about Carbidopa and Levodopa, which are very important medications that can help control these symptoms and make life a little easier.
How does this medicine work?
Simply put, our brains contain a special chemical messenger called dopamine. This dopamine is essential for coordinating and controlling our body's movements. What happens to someone with Parkinson's disease is that the cells in the brain that produce this dopamine are gradually destroyed. Then the dopamine level decreases, and the symptoms we talked about, such as tremors and stiffness, appear.
So, this carbidopa; levodopa, a drug that works by increasing the dopamine levels in the brain again. Although this cannot completely cure the disease, it can greatly control the symptoms and help the patient to carry out daily activities more easily.
Things you need to tell your doctor before taking this medicine
Before prescribing this medication, it is very important that your doctor knows your complete health history. Be sure to tell him/her about any of the conditions listed below.
| Your health condition | Why should you inform? |
|---|---|
| Depression or other mental illnesses | This medication may alter some mental states. |
| Diabetes | Sugar in urine can affect test results. |
| Glaucoma condition | Eye pressure may be affected. |
| Heart disease, history of heart attack, or irregular heartbeat | Heart rate and blood pressure may be affected. |
| Kidney or liver disease | The way the medicine is eliminated from the body can have effects. |
| Lung diseases (e.g. asthma) | Breathing difficulties may occur. |
| Stomach or intestinal problems | Medication absorption and side effects may be affected. |
| If you are pregnant, trying to get pregnant, or breastfeeding | You should discuss the possible effects on the child with your doctor. |
| If you have an allergy to any other medicine, food or substance | To assess the risk of developing an allergy to the medicine. |
How should I use this medicine?
This medicine should be taken by mouth with a glass of water . It is very important to take the correct dose, at the correct time, as prescribed by your doctor. Do not increase or decrease the dose of the medicine or stop it suddenly as you feel like it. Doing so may cause serious reactions. If you stop taking the medicine, do so gradually, according to your doctor's instructions.
Important: 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 two doses at once to make up for a forgotten dose.
What to do if you take too much medicine?
If you think you have taken too much medicine, go to the nearest Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other things that may interact with this medicine
Other medications, vitamins, herbal remedies, and alcohol you are taking may interact with this medicine. Therefore, tell your doctor about everything you are taking.
Do not take this medicine with:
- MAOIs, a class of medications used to treat mental illness (e.g. Marplan, Nardil, Parnate)
- Reserpine
- Tetrabenazine
You can also react with these things:
- Alcohol
- Iron supplements or vitamins
- Antibiotics like Linezolid, Isoniazid (INH), Procarbazine, Tedizolid
- Medications for depression, anxiety, or other mental illnesses
- Medication for high blood pressure
- Sleeping pills
- Metoclopramide, Droperidol, Papaverine
- Rasagiline, Selegiline, Entacapone, Tolcapone (these are also other medications used for Parkinson's disease)
Things to be careful about when taking medicine
Will the effect of the medicine wear off? (Wearing-off effect)
Sometimes, as the next dose is due, the effect of the medicine may wear off and symptoms may return. Also, sometimes the medicine may stop working for a minute or an hour and then start working again. This is called the 'on-off effect'. If this happens to you, don't be shy and tell your doctor. He or she may be able to adjust the dose or timing of your medicine to manage this condition.
Be careful about food and drink.
Protein-rich foods (e.g. meat, fish, eggs, milk, nuts) can reduce the absorption of this medicine. Therefore, avoid eating protein-rich foods close to the time you take the medicine. It is best to take the medicine 30 minutes before or one hour after a meal. It is best to talk to your doctor about your diet and get advice.
Drowsiness, dizziness, and sudden sleepiness
This medicine may make you feel drowsy or dizzy. Therefore, avoid activities that require alertness, such as driving or operating machinery, until you know how this medicine affects you. Especially if you are elderly, do not get up from a sitting position suddenly. Wait a few moments before getting up slowly.
Some people may suddenly fall asleep without warning when taking this medicine. This can happen even while driving or talking. If this happens to you, tell your doctor immediately.
Be alert to unusual temptations.
Very rarely, some people may experience unusual urges to gamble, engage in sexual activity, overeat, or spend money unnecessarily while taking this medicine. This is a side effect of the medicine. If you or someone in your family notices any of these changes, you should tell your doctor immediately.
Other points
- Your urine or sweat may turn a dark color (black or red) . This is normal and nothing to worry about. However, it may stain your clothes.
- If you have diabetes, this medicine may affect urine sugar tests (it does not affect blood tests).
- This medication may cause a vitamin B6 deficiency. Therefore, talk to your doctor about consuming foods rich in vitamin B6 (such as kale, spinach, potatoes).
Side effects of the medicine
| Side effects that you should report to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Changes in heart rate | Rapid heartbeat, irregular heartbeat, chest pain, difficulty breathing. |
| Low blood pressure | Dizziness, fainting, blurred vision. |
| Mental and behavioral changes | Anxiety, agitation, hallucinations, suicidal thoughts, increased stress. |
| Uncontrollable movements | New or increasing uncontrollable movements of the face, mouth, or upper body. |
| Stomach bleeding | Black or tarry stools, vomit that looks like coffee grounds. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Darkening of saliva, sweat, and urine | This is usually not harmful. |
| Dizziness and drowsiness | This is common. |
| Headache and nausea | Tell your doctor if these symptoms persist. |
Take-Home Message
- Carbidopa; Levodopa is not a cure for Parkinson's disease, but a medication that controls the symptoms and makes life easier.
- Do not stop taking this medication suddenly for any reason without your doctor's advice.
- Tell your doctor about all other medications you take and any other illnesses you have.
- Be aware of side effects such as sudden sleepiness, mood swings, and unusual urges. If you notice any changes, tell your doctor immediately.
- Foods high in protein may reduce the effectiveness of the medication. Therefore, talk to your doctor about your diet.
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