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Carbidopa / levodopa Side Effects

Not all side effects for carbidopa / levodopa may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to carbidopa / levodopa: oral capsule extended release, oral tablet, oral tablet disintegrating, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by carbidopa / levodopa. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking carbidopa / levodopa:

More common
  • Twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
Less common
  • Bladder pain
  • bloody or cloudy urine
  • chest pain
  • confusion
  • difficult, burning, or painful urination
  • discouragement
  • feeling sad or empty
  • frequent urge to urinate
  • inability to move the eyes
  • increased blinking or spasms of the eyelid
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • lower back or side pain
  • seeing, hearing, or feeling things that are not there
  • sticking out of tongue
  • tiredness
  • trouble concentrating
  • trouble in breathing, speaking, or swallowing
  • trouble sleeping
  • uncontrolled twisting movements of the neck, trunk, arms, or legs
  • unusual facial expressions
Incidence not known
  • Anxiety
  • black, tarry stools
  • bluish color
  • blurred vision
  • changes in skin color
  • chest discomfort
  • chills
  • convulsions
  • cough or hoarseness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • false beliefs that cannot be changed by facts
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feelings about hurting oneself or others
  • fever with or without chills
  • general feeling of tiredness or weakness
  • high fever
  • hyperventilation
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • increased sweating
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of bladder control
  • lower back or side pain
  • nausea
  • pain
  • pain or discomfort in the arms, jaw, back, or neck
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • severe muscle stiffness
  • shaking
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swelling of the foot or leg
  • swollen glands
  • tenderness
  • tiredness
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusually pale skin
  • vomiting

Some of the side effects that can occur with carbidopa / levodopa may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Acid or sour stomach
  • back or shoulder pain
  • belching
  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • diarrhea
  • difficulty having a bowel movement (stool)
  • ear congestion
  • headache
  • heartburn
  • indigestion
  • loss of voice
  • muscle cramps
  • nasal congestion
  • runny nose
  • sneezing
  • stomach discomfort, upset, or pain
  • unusual dreams
  • weight loss
Incidence not known
  • Abdominal or stomach distress
  • bad, unusual, or unpleasant (after) taste
  • belching
  • change in taste
  • dark sweat
  • double vision
  • enlarged pupils
  • feeling of warmth
  • hair loss or thinning of the hair
  • lack or loss of strength
  • redness of the face, neck, arms, and occasionally, upper chest
  • seeing double
  • skin rash, hives or welts, itching

For Healthcare Professionals

Applies to carbidopa / levodopa: enteral suspension, oral capsule extended release, oral tablet, oral tablet disintegrating, oral tablet extended release

General

The most common adverse reactions reported include nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, and orthostatic hypotension.[Ref]

Nervous system

Very common (10% or more): Headache (up to 17%), dyskinesia (up to 16.5%), dizziness (up to 12%)
Common (1% to 10%): Confusion, dystonia, on-off phenomena, hypoesthesia, polyneuropathy, tremor, dysgeusia, bradykinesia
Uncommon (0.1% to 1%): Paresthesia, ataxia, gait disturbance, convulsion
Rare (less than 0.1%): Malignant, neuroleptic syndrome
Frequency not reported: Chorea, somnolence, memory impairment, sense of stimulation
Postmarketing reports: Polyneuropathy[Ref]

Psychiatric

Very common (10% or more): Anxiety, insomnia, depression (up to 11%)
Common (1% to 10%): Hallucinations, psychosis, abnormal dreams, sleep disorder, agitation, impulsive behavior, sleep attacks
Uncommon (0.1% to 1%): Suicide, dementia, disorientation, euphoric mood, fear
Rare (less than 0.1%): Abnormal thinking[Ref]

Gastrointestinal

Very common (10% or more): Nausea (up to 30%), constipation (up to 22%)
Common (1% to 10%): Dry mouth, constipation, vomiting, hiatal hernia, postoperative ileus, diarrhea, dyspepsia, abdominal distension, dysphagia, flatulence, bitter taste
Uncommon (0.1% to 1%): Salivary hypersecretion
Rare (less than 0.1%): Bruxism, saliva discoloration, glossodynia, hiccups, trismus, burning tongue sensation
Frequency not reported: Heartburn[Ref]

Cardiovascular

Common (1% to 10%): Ischemic events, orthostatic hypotension, peripheral edema, hypertension, syncope, irregular heart rate, hypotension
Uncommon (0.1% to 1%): Palpitations, phlebitis
Frequency not reported: Chest pain, myocardial infarction[Ref]

Cardiovascular ischemic events occurred in 2.4% (7 of 289) patients receiving carbidopa-levodopa extended-release capsules compared to 1.1% (1 of 92) of patients receiving placebo in early Parkinson's disease clinical trials. In advanced Parkinson's disease, 0.7 % (3 of 450) patients experienced cardiovascular ischemic events. These patients had a previous history of ischemic heart disease or risk factors for ischemic heart disease.[Ref]

Dermatologic

Common (1% to 10%): Excessive granulation tissue, rash, contact dermatitis, hyperhidrosis, pruritus
Uncommon (0.1% to 1%): Alopecia, erythema, urticaria
Rare (less than 0.1%): Sweat discoloration, angioedema
Postmarketing reports: Henoch-Schonlein purpura[Ref]

Local

Insertion site complication was reported in 57% of patients who received this drug compared with 44% of patients who received a PEG-J tube without receiving treatment. The most common adverse reactions associated with naso-jejunal (NJ) insertion were oropharyngeal pain, abdominal distention, abdominal pain, abdominal discomfort, pain, throat irritation, gastrointestinal injury, esophageal hemorrhage, anxiety, dysphagia, and vomiting. The most common adverse reactions associated with PEG-J insertion included upper abdominal pain, duodenal ulcer, duodenal ulcer hemorrhage, erosive duodenitis, erosive gastritis, gastrointestinal hemorrhage, peritonitis, post-operative abscess, and small intestine ulcer.[Ref]

Very common (10% or more): Insertion site complication, incision site erythema (19%), post-operative wound infection
Common (1% to 10%): Incision site cellulitis, post procedural infection, device dislocation, device occlusion
Uncommon (0.1% to 1%): Postoperative abscess, bezoar, ischemic colitis
Postmarketing reports: Gastric perforation, gastrointestinal perforation, small intestinal ischemia, small intestinal perforation[Ref]

Hypersensitivity

Postmarketing reports: Anaphylactic reaction, bullous lesions[Ref]

Respiratory

Common (1% to 10%): Upper respiratory tract infection, atelectasis, dyspnea, aspiration pneumonia, oropharyngeal pain
Uncommon (0.1% to 1%): Dysphonia, hoarseness
Rare (less than 0.1%): Abnormal respiration
Frequency not reported: Bizarre breathing pattern[Ref]

Hepatic

Frequency not reported: Elevated alkaline phosphatases, AST, ALT, LDH, and bilirubin[Ref]

Renal

Frequency not reported: Elevated serum urea and creatinine[Ref]

Other

Very common (10% or more): Asthenia, fatigue
Common (1% to 10%): Pyrexia, malaise
Frequency not reported: Hot flashes[Ref]

Genitourinary

Common (1% to 10%): Urinary tract infection, urinary incontinence, urinary retention
Uncommon (0.1% to 1%): Urinary frequency
Rare (less than 0.1%): Priapism[Ref]

Hematologic

Common (1% to 10%): Anemia
Uncommon (0.1% to 1%): Leukopenia, thrombocytopenia
Rare (less than 0.1%): Hemolytic anemia
Very rare (less than 0.01%): Agranulocytosis
Frequency not reported: Positive Coombs test, reduced hemoglobin and hematocrit[Ref]

Metabolic

Very common (10% or more): Decreased weight
Common (1% to 10%): Anorexia, increased weight, vitamin B6 deficiency, vitamin B12 deficiency
Frequency not reported: Elevated blood sugar
Postmarketing reports: Folic acid deficiency[Ref]

Musculoskeletal

Common (1% to 10%): Back pain, shoulder pain
Uncommon (0.1% to 1%): Muscle cramps, neck pain
Frequency not reported: Muscle twitching, leg pain[Ref]

Ocular

Uncommon (0.1% to 1%): Blepharospasm, diplopia, optic ischemic neuropathy, blurred vision
Rare (less than 0.1%): Mydriasis, oculogyric crisis, activation of a latent Horner's syndrome[Ref]

Oncologic

Rare (less than 0.1%): Malignant melanoma[Ref]

References

1. Cerner Multum, Inc. "Australian Product Information." O 0

2. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.

3. "Product Information. Parcopa (carbidopa-levodopa)." Schwarz Pharma, Mequon, WI.

4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

5. "Product Information. Duopa (carbidopa-levodopa)." AbbVie US LLC, North Chicago, IL.

6. "Product Information. Rytary (carbidopa-levodopa)." Impax Pharmaceuticals, Hayward, CA.

7. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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