Sinemet CR

How does it work?

Sinemet CR and Half Sinemet CR tablets contain the active ingredients levodopa and carbidopa. This combination of medicines is also sometimes known as co-careldopa. It is used in Parkinson’s disease to increase the levels of dopamine in the brain.

Dopamine is a substance known as a neurotransmitter. Neurotransmitters are found the brain and nervous system and are involved in transmitting messages between nerves. These messages allow the normal functioning of the body. The neurotransmitter dopamine is known to be reduced or absent in the brains of people with Parkinson's disease, and this is thought to be the cause of the disease symptoms.

When you take levodopa, it is converted into dopamine in the brain. This replaces the lost dopamine and therefore reduces some of the symptoms of the disease.

Levodopa is also converted into dopamine in the rest of the body, which can cause unwanted side effects such as nausea and palpitations. Carbidopa is used in combination with the levodopa to prevent this happening. Carbidopa is a type of medicine called a dopa-decarboxylase inhibitor. It blocks the conversion of levodopa to dopamine in the body and so prevents these side effects. (Carbidopa cannot pass into the brain and so does not affect the conversion of levodopa to dopamine in the brain.)

The combination of levodopa and carbidopa is therefore effective in the treatment of Parkinson's disease, while minimising the side effects caused by levodopa on the rest of the body.

Sinemet CR and Half Sinemet CR tablets are modified release tablets. They are designed to release the medicine slowly and continuously over several hours to help provide steady blood levels of the medicine throughout the day. These tablets must be swallowed whole and not broken chewed or crushed, to avoid damaging the modified release action.

What is it used for?

Parkinson's disease.

Warning!

Sinemet CR and Half Sinemet CR tablets should be swallowed whole with liquid and not be broken, crushed or chewed, as this would impair the modified release action of the tablets.

This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing, especially when you first start taking the medicine. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass.

This medicine can cause sleepiness and on rare occasions people have experienced a sudden onset of sleep during their daily activities. In some cases this occured without any warning signs. Although this is rare, you should exercise caution when driving or performing other potentially hazardous activities. People who have experienced sleepiness or an episode of sudden onset of sleep while taking this medicine should not drive or operate machinary. Caution should be observed when drinking alcohol or taking other medicines that cause drowsiness, as this may increase the risk of drowsiness.

As this medicine increases the level of dopamine in your brain more than levodopa alone it may cause abnormal involuntary movements or muscle twitches (dyskinesia). Consult your doctor if you experience these symptoms, as they may indicate that your dose of this medicine needs reducing.

Consult your doctor if you feel depressed or confused, or have strange or abnormal thoughts while you are taking this medicine.

Pathological gambling, increased sex drive and hypersexuality have been reported in people taking medicines for Parkinson's disease such as this one, that increase dopamine activity in the brain. If you think this medicine is affecting you in this way, you should consult your doctor.

This medicine may cause a reddish discolouration to your urine and other body fluids, such as sweat and saliva. This is normal and not harmful.

If your symptoms start to improve on this medicine, make sure you resume your normal activities gradually. Try not to do too much too quickly as you may risk injury.

You should have regular tests to monitor the function of your liver, blood, kidneys and heart while taking this medicine.

This medicine may affect the results of certain laboratory tests, including those for testing glucose levels in blood or urine. If you have diabetes ask your doctor for further information about this. Tell your doctor that you are taking this medicine if you have any blood or urine tests.

If you have chronic open angle glaucoma you should have regular tests to monitor the pressure within your eye (intraocular pressure) while taking this medicine.

You should not suddenly stop taking this medicine unless your doctor tells you otherwise.

Use with caution in

Liver disease

Kidney disease

Severe lung disease

Asthma

Severe disease involving the heart and blood vessels

People who have an abnormal heart rhythm following a previous heart attack

Disorders involving hormone producing glands (endocrine disorders)

Diabetes

History of convulsions, eg epilepsy

History of peptic ulcers

History of psychiatric illness

Open angle glaucoma.

Not to be used in

Closed angle glaucoma

History of skin cancer (malignant melanoma)

Suspicious skin lesions of unknown cause

Severe psychotic illness

Pregnancy

Breastfeeding

People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days.

This medicine is not recommended for children and adolescents under 18 years of age, as there is no information regarding its safety and efficacy in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established, therefore it should not be used by pregnant women. Seek further medical advice from your doctor.

This medicine may pass into breast milk. Women taking this medicine should therefore not breastfeed. Seek medical advice from your doctor.

Label warnings

This medication should be swallowed whole, not chewed.

This medication may cause your urine to be coloured reddish.

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