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Sinemet (carbidopa / levodopa) Disease Interactions

There are 12 disease interactions with Sinemet (carbidopa / levodopa):

Major

Carbidopa (applies to Sinemet) glaucoma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma (Narrow Angle)

Carbidopa-levodopa products are contraindicated in patients with narrow-angle glaucoma.

Major

Dopamine agonists (applies to Sinemet) cardiac disease

Major Potential Hazard, Low plausibility. Applicable conditions: Cardiovascular Disease

Cardiac irregularities occur infrequently in patients on dopamine agonists. The initial administration and titration is recommended to occur under close cardiac monitoring in a facility equipped for intensive cardiac care. Adverse cardiac affects may include palpitation, sinus tachycardia, ventricular tachycardia, extrasystole, atrial flutter or fibrillation, or block of AV conduction.

References

  1. Shah PK, Amin DK, Horn E "Adverse clinical and hemodynamic effects of oral levodopa in chronic congestive heart failure." Am Heart J 110 (1985): 488-9
  2. Chamsi-Pasha H, Horsley M, Barnes PC "Levodopa and congestive cardiomyopathy." Br J Hosp Med 41 (1989): 489
  3. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  4. Broderick G, Rajfer SI "The use of levodopa, an oral dopamine precursor, in congestive heart failure." Basic Res Cardiol 84 (1989): 187-90
  5. Benaim ME "Levodopa and arrhythmias." Br Med J 4 (1972): 50-1
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
View all 6 references
Major

Dopamine agonists (applies to Sinemet) hypotension

Major Potential Hazard, Moderate plausibility.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

References

  1. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  3. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  4. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  5. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  6. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
View all 6 references
Major

Dopamine agonists (applies to Sinemet) neuroleptic malignant syndrome

Major Potential Hazard, Low plausibility.

The use of dopamine agonists is contraindicated in patients with neuroleptic malignant syndrome (NMS). NMS is characterized by hyperthermia, muscle rigidity, altered mental status, irregular pulse or blood pressure, tachycardia, and diaphoresis. The syndrome may rarely be precipitated by abrupt discontinuation of the dopamine agonist.

References

  1. Genis D "Neuroleptic malignant syndrome: impaired dopaminergic systems?" Neurology 35 (1985): 1806
  2. Rainer C, Scheinost NA, Lefeber EJ "Neuroleptic malignant syndrome. When levodopa withdrawal is the cause." Postgrad Med 89 (1991): 175-8,
  3. Gibb WR, Griffith DN "Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome." Postgrad Med J 62 (1986): 59-60
  4. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  5. Friedman JH, Feinberg SS, Feldman RG "A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal." JAMA 254 (1985): 2792-5
View all 5 references
Major

Dopamine agonists (applies to Sinemet) psychoses/depression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

The use of dopamine agonists has been associated with psychiatric effects such as hallucinations, psychosis, confusion, anxiety, mania, hypomania, depression, rapid mood cycling, nightmares, and hypersexuality. Therapy with dopamine agonists should be administered cautiously in psychotic patients and all patients should be carefully observed for development of depression and suicidal tendencies.

References

  1. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  2. Nausieda PA, Glantz R, Weber S, Baum R, Klawans HL "Psychiatric complications of levodopa therapy of Parkinson's disease." Adv Neurol 40 (1984): 271-7
  3. Glantz RH, Bieliauskas L, Paleologos N "Behavioral indicators of hallucinosis in levodopa-treated Parkinson's disease." Adv Neurol 45 (1987): 417-20
  4. Friedman JH "The management of the levodopa psychoses." Clin Neuropharmacol 14 (1991): 283-95
  5. Ko GN, Leckman JF, Heninger GR "Induction of rapid mood cycling during L-dopa treatment in a bipolar patient." Am J Psychiatry 138 (1981): 1624-5
  6. Harsch HH, Miller M, Young LD "Induction of mania by L-dopa in a nonbipolar patient." J Clin Psychopharmacol 5 (1985): 338-9
  7. Banerjee AK, Falkai PG, Savidge M "Visual hallucinations in the elderly associated with the use of levodopa." Postgrad Med J 65 (1989): 358-61
  8. Vazquez A, Jimenez-Jimenez FJ, Garcia-Ruiz P, Garcia-Urra D ""Panic attacks" in Parkinson's disease. A long-term complication of levodopa therapy." Acta Neurol Scand 87 (1993): 14-8
  9. Maricle RA, Nutt JG, Carter JH "Mood and anxiety fluctuation in parkinson's disease associated with levodopa infusion: preliminary findings." Mov Disord 10 (1995): 329-32
  10. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  11. Ryback RS, Schwab RS "Manic response to levodopa therapy. Report of a case." N Engl J Med 285 (1971): 788-9
View all 11 references
Major

Dopaminergic antiparkinson agents (applies to Sinemet) psychosis

Major Potential Hazard, Moderate plausibility.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

Major

Levodopa (applies to Sinemet) glaucoma

Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension

The use of levodopa is contraindicated in patients with acute closed-angle glaucoma. Levodopa (with or without carbidopa) may be used in patients with open-angle glaucoma who are receiving appropriate therapy.

References

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

Levodopa (applies to Sinemet) liver/renal

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease, Renal Dysfunction

The pharmacokinetics of levodopa have not been studied in patients with hepatic or renal impairment. Therapy with levodopa should be administered cautiously in patients with liver or disease. Periodic monitoring of hepatic and renal function is recommended during extended therapy.

References

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

Levodopa (applies to Sinemet) melanoma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Skin Cancer

The use of levodopa is considered by manufacturers to be contraindicated in patients with a history of melanoma or in patients with suspicious, undiagnosed skin lesions. Levodopa reportedly may activate malignant melanoma, although some investigators have found a causal relationship to be tenuous.

References

  1. Abramson DH, Rubenfeld MR "Choroidal melanoma and levodopa" JAMA 252 (1984): 1011-2
  2. Haider SA, Thaller VT "Lid melanoma and parkinsonism." Br J Ophthalmol 76 (1992): 246-7
  3. Fermaglich J, Delaney P "Parkinson's disease, melanoma, and levodopa." J Neurol 215 (1977): 221-4
  4. Fermaglich J, Delaney P "Levodopa and melanoma" JAMA 241 (1979): 883-4
  5. Weiner WJ, Singer C, Sanchez-Ramos JR, Goldenberg JN "Levodopa, melanoma, and Parkinson's disease." Neurology 43 (1993): 674-7
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  7. Robinson E, Wajsbort J, Hirshowitz B "Levodopa and malignant melanoma." Arch Pathol 95 (1973): 213
  8. Rosin MA, Braun M, 3d Braun M "Malignant melanoma and levodopa." Cutis 33 (1984): 572-4
  9. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  10. Gurney H, Coates A, Kefford R "The use of L-dopa and carbidopa in metastatic malignant melanoma." J Invest Dermatol 96 (1991): 85-7
  11. Bernstein JE, Medenica M, Soltani K, Solomon A, Lorincz AL "Levodopa administration and multiple primary cutaneous melanomas." Arch Dermatol 116 (1980): 1041-44
  12. Van Rens GH, De Jong PT, Demols EE, Brihaye-Van Geertruyden MF "Uveal malignant melanoma and levodopa therapy in Parkinson's disease." Ophthalmology 89 (1982): 1464-6
  13. Sober AJ, Wick MM "Levodopa therapy and malignant melanoma." JAMA 240 (1978): 554-5
  14. Kochar AS "Development of malignant melanoma after levodopa therapy for Parkinson's disease. Report of a case and review of the literature." Am J Med 79 (1985): 119-21
View all 14 references
Major

Levodopa (applies to Sinemet) reactive airway disease

Major Potential Hazard, Low plausibility. Applicable conditions: Asthma, Chronic Obstructive Pulmonary Disease

Because of the risk of bronchospasm, use of levodopa in patients with asthma, COPD, or other chronic underlying lung disease is not recommended.

References

  1. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  2. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  3. De Keyser J, Vincken W "L-dopa-induced respiratory disturbance in Parkinson's disease suppressed by tiapride." Neurology 35 (1985): 235-7
  4. Rich MW, Radwany SM "Respiratory dyskinesia. An underrecognized phenomenon." Chest 105 (1994): 1826-32
View all 4 references
Moderate

Carbidopa (applies to Sinemet) depression

Moderate Potential Hazard, Moderate plausibility.

Caution and observation is recommended when treating patients with carbidopa, as depression with concomitant suicidal tendencies may develop or be exacerbated.

Moderate

Levodopa (applies to Sinemet) GI bleeding

Moderate Potential Hazard, Low plausibility. Applicable conditions: Gastrointestinal Hemorrhage

The use of levodopa, especially in combinations with carbidopa, has been associated with an increase in the frequency of gastrointestinal hemorrhage. Therapy with levodopa should be administered cautiously in patients with a history of peptic ulcer disease or gastrointestinal hemorrhage.

References

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

Sinemet (carbidopa / levodopa) drug interactions

There are 320 drug interactions with Sinemet (carbidopa / levodopa)

Sinemet (carbidopa / levodopa) alcohol/food interactions

There is 1 alcohol/food interaction with Sinemet (carbidopa / levodopa)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.