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Carbidopa and levodopa suspension

Pronunciation

Generic Name: carbidopa and levodopa (KAR-bi-DOE-pa & LEE-voe-DOE-pa)
Brand Name: Duopa

Carbidopa and levodopa suspension is used for:

Treating symptoms associated with Parkinson disease. It may also be used for other conditions as determined by your doctor.

Carbidopa and levodopa suspension is an antidyskinetic combination. Levodopa is transformed by the body and the brain into a substance that helps to decrease tremors and other symptoms of Parkinson disease. Carbidopa helps levodopa to reach the brain.

Do NOT use carbidopa and levodopa suspension if:

  • you are allergic to any ingredient in carbidopa and levodopa suspension
  • you have narrow-angle glaucoma
  • you are taking reserpine or tetrabenazine
  • you have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using carbidopa and levodopa suspension:

Some medical conditions may interact with carbidopa and levodopa suspension. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of heart attack or other heart problems (eg, irregular heartbeat), blood pressure problems, endocrine problems, fainting, lung or breathing problems (eg, asthma), kidney or liver problems, glaucoma or increased pressure in the eye, skin cancer or skin growths, stomach or bowel problems (eg, ulcers, bleeding), stomach or bowel surgery, sleep problems, nerve problems (eg, burning, numbness, or tingling feeling), or mood or mental problems (eg, depression, suicidal thoughts or actions)
  • if you are taking another product with the same medicine in it

Some MEDICINES MAY INTERACT with carbidopa and levodopa suspension. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • MAOIs (eg, phenelzine) because the risk of severe high blood pressure may be increased
  • Tricyclic antidepressants (eg, amitriptyline) because the risk of high blood pressure or unusual muscle movements may be increased
  • Metoclopramide because side effects may occur
  • Blood pressure medicines, rasagiline, or selegiline because the risk of severe dizziness when standing may be increased
  • Butyrophenones, (eg, haloperidol), isoniazid, papaverine, phenothiazines (eg, chlorpromazine), phenytoin, reserpine, risperidone, or tetrabenazine because they may decrease carbidopa and levodopa suspension's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if carbidopa and levodopa suspension may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use carbidopa and levodopa suspension:

Use carbidopa and levodopa suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Carbidopa and levodopa suspension comes with an extra patient information sheet called a Medication Guide. It also comes with detailed instructions for use. Read them carefully. Read them again each time you get carbidopa and levodopa suspension refilled.
  • Carbidopa and levodopa suspension is given as an infusion through a tube connected to your bowels. A health care provider will teach you how to use it. Be sure you understand how to use carbidopa and levodopa suspension. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Take the oral form of carbidopa and levodopa suspension as you have been told by your doctor.
  • Carbidopa and levodopa suspension needs to be at room temperature before use. Take a cassette out of the carton and out of the refrigerator 20 minutes before using.
  • Do not reuse casettes. Do not use a cassette for longer than 16 hours, even if some medicine remains.
  • If you need to disconnect the pump for a short time (less than 2 hours), follow what your doctor has told you to do or read the package insert. If you need to disconnect the pump for longer than 2 hours, call your doctor to find out what to do.
  • If you take an iron product or a multivitamin that contains iron, ask your doctor or pharmacist how to take it with carbidopa and levodopa suspension. Iron may decrease your body's ability to absorb carbidopa and levodopa suspension.
  • Diets that are high in some contents (eg, protein, fat, calories) may decrease your body's ability to absorb carbidopa and levodopa suspension. Discuss any questions or concerns with your doctor. Tell your doctor if you have a diet that is high in protein, fat, or calories or if you will be changing your diet.
  • Carefully follow the dosing schedule given to you by your health care provider.
  • Take carbidopa and levodopa suspension on a regular schedule to get the most benefit from it. Taking carbidopa and levodopa suspension at the same times each day will help you to remember to take it.
  • Continue to take carbidopa and levodopa suspension even if you feel well. Do not miss any doses.
  • Do not suddenly stop taking carbidopa and levodopa suspension or lower your dose without checking with your doctor. Side effects may occur. Discuss any questions or concerns with your doctor.
  • If you miss a dose of carbidopa and levodopa suspension, call your doctor to find out what to do.

Ask your health care provider any questions you may have about how to use carbidopa and levodopa suspension.

Important safety information:

  • Tell your doctor or dentist that you take carbidopa and levodopa suspension before you receive any medical or dental care, emergency care, or surgery.
  • Carbidopa and levodopa suspension may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use carbidopa and levodopa suspension with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using carbidopa and levodopa suspension; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Carbidopa and levodopa suspension may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that has happened when carbidopa and levodopa suspension was stopped all of a sudden. NMS has also happened when the dose of carbidopa and levodopa suspension was lowered. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
  • Some patients who take carbidopa and levodopa suspension have reported suddenly falling asleep while performing daily activities (eg, driving, eating, talking). Some patients did not experience drowsiness and felt that they were alert immediately before suddenly falling asleep. Some of these events have been reported as late as 1 year after carbidopa and levodopa suspension was started. Use caution when driving, operating machinery, or performing other activities that could be dangerous. Inform your doctor if you experience unusual drowsiness or sleepiness while using carbidopa and levodopa suspension.
  • Patients with Parkinson disease may have an increased risk of developing a certain type of skin cancer (melanoma). It is not known if carbidopa and levodopa suspension also increases the risk of melanoma. You may need to have skin exams while you are using carbidopa and levodopa suspension. Tell your doctor if you notice any unusual skin growths or a change in the appearance of a mole. Discuss any questions or concerns with your doctor.
  • Some people have experienced new, unusual, or increased urges (eg, gambling, sexual urges) while taking carbidopa and levodopa suspension. Tell your doctor right away if you notice such effects.
  • Stomach or bowel problems can happen with carbidopa and levodopa suspension. Some of these problems may lead to the need for surgery or may be fatal. This includes things like stomach or bowel bleeding, blockage, or ulcers; infection or other problems where the tube goes into your body; or pancreatitis. Call your doctor right away if you have dark, tarry, or bloody stools; fever; nausea; persistent constipation; stomach pain; or vomiting.
  • Diabetes patients - Carbidopa and levodopa suspension may cause the results of some tests for urine glucose or urine ketones to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.
  • Gradually increase physical activity as your symptoms improve.
  • A dark color (red, brown, or black) may appear in your saliva, urine, or sweat after taking carbidopa and levodopa suspension. This is not harmful but may discolor clothes.
  • The effects of carbidopa and levodopa suspension might start to wear off between doses. Talk with your doctor if carbidopa and levodopa suspension stops working well or if your condition worsens.
  • Carbidopa and levodopa suspension may affect certain lab test results. Make sure your doctors and lab personnel know you take carbidopa and levodopa suspension.
  • Lab tests may be performed while you use carbidopa and levodopa suspension. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Have your eye pressure checked as you have been told by your doctor. Talk with your doctor.
  • Use carbidopa and levodopa suspension with caution in the ELDERLY; they may be more sensitive to its effects.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking carbidopa and levodopa suspension while you are pregnant. Carbidopa and levodopa suspension is found in breast milk. If you are or will be breast-feeding while you are taking carbidopa and levodopa suspension, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of carbidopa and levodopa suspension:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal dreams; constipation; dizziness; drowsiness; dry mouth; headache; mouth or throat pain; trouble sleeping.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); burning, numbness, or tingling; chest pain; confusion; dark urine; eye pain; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; new or increased involuntary movements; new or worsening mental, mood, or behavior changes (eg, depression, anxiety, restlessness, irritability); problem with the device or problem where the tube goes into your body; severe or persistent dizziness or headache; shortness of breath; suicidal thoughts or actions; swelling of the legs or feet; unusual bruising or bleeding; unusual or painful movements or spasms of the face, eyelids, mouth, tongue, arms, hands, or legs; unusual tiredness or weakness; vision changes; vomiting blood or vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of carbidopa and levodopa suspension:

Store carbidopa and levodopa suspension in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Protect from light. Store cassettes in the carton before using. Keep carbidopa and levodopa suspension out of the reach of children and away from pets.

General information:

  • If you have any questions about carbidopa and levodopa suspension, please talk with your doctor, pharmacist, or other health care provider.
  • Carbidopa and levodopa suspension is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take carbidopa and levodopa suspension or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about carbidopa and levodopa suspension. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to carbidopa and levodopa suspension. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using carbidopa and levodopa suspension.

Review Date: November 3, 2016

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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