Sinemet

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Difficulty performing voluntary movements, resulting in jerky or involuntary movements or muscle twitches (dyskinesia)
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Mood changes, strange or abnormal thoughts or depression
- Confusion
- Awareness of your heartbeat (palpitations)
- Irregular heart beats
- A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)
- Loss of appetite
- Dry mouth
- Weakness or loss of strength (asthenia)
- Difficulty in sleeping (insomnia)
- Sleepiness (somnolence)
- Suddenly falling asleep
- False perceptions of things that are not really there (hallucinations)
- Bleeding or ulceration in the stomach or intestines
- Disturbances in the normal numbers of blood cells in the blood
- Inability to resist impulses to gambling (pathological gambling)
- Increased sex drive (libido) and excessive interest or involvement in sexual activity (hypersexuality)
- Visual disturbances
- Difficulty in breathing (dyspnoea)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

This medicine should not be taken at the same time as, or within two weeks of taking non-selective monoamine oxidase inhibitors (MAOIs), for example the antidepressants phenelzine, isocarboxazid and tranylcypromine, and the antibiotic linezolid. In addition it should not be taken in combination with BOTH a selective MAO-A inhibitor, eg moclobemide, AND a selective MAO-B inhibitor, eg selegiline or rasagiline, though it can be used with either of these on their own.

There may be an increased risk of dizziness when moving from a lying or sitting position to sitting or standing (postural hypotension) if this medicine is taken with other medicines that can have this effect, for example medicines to treat high blood pressure (antihypertensives). Your doctor may need to adjust the dose of your blood pressure medicine.

Iron reduces the absorption of this medicine from the gut. For this reason, if you are taking iron supplements such as ferrous sulphate, you should take them two to three hours before or after this medicine.

The following medicines may reduce the effect of levodopa:

- antipsychotic medicines, eg chlorpromazine, prochlorperazine, haloperidol, flupentixol (equally levodopa may oppose the effect of these medicines)
- benzodiazepines, eg diazepam
- isoniazid
- papaverine
- phenytoin.

Tricyclic antidepressants, eg amitriptyline, imipramine, may decrease the therapeutic effects of this medicine, and may also rarely increase the risk of a dangerous rise in blood pressure (hypertensive crisis).

Anticholinergic medicines, eg procyclidine, atropine, hyoscine, propantheline, orphenadrine, benzhexol, may decrease the absorption of this medicine from the gut and reduce its therapeutic effect.

This medicine can be used with other medicines for Parkinson’s disease, eg anticholinergics, amantadine, dopamine agonists or COMT inhibitors, however, both the desired effects and side effects of treatment may be intensified. Your doctor may need to adjust the dose of one or more of your medicines to get the correct balance to control your symptoms with minimum side effects.

Other medicines containing the same active ingredients

Caramet CR

Duodopa

Sinemet CR

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