levodopa-carbidopa, Sinemet, Sinemet CR, Parcopa (cont.)
PREGNANCY: Although there are no human studies that have examined the effects of carbidopa-levodopa on the fetus, animal studies have shown adverse effects. Therefore, in prescribing carbidopa-levodopa for a pregnant woman, the treating physician must weigh the potential risks to the fetus against the potential benefits to the mother.
NURSING MOTHERS: Levodopa is distributed into breast milk. It also may inhibit production of milk. It is generally recommended that carbidopa-levodopa should not be given to women who are breast- feeding.
SIDE EFFECTS: Most patients receiving carbidopa-levodopa experience side effects, but these usually are reversible. Occasional involuntary movements are the most common of the serious side effects of carbidopa-levodopa therapy. These may include chewing, gnawing, twisting, tongue or mouth movements, head bobbing, or movements of the feet, hands, or shoulder. These may respond to a reduction in the dose. Muscle twitching, dizziness, muscle jerks during sleep, and hand tremor also may occur.
Various psychiatric disturbances may occur during carbidopa-levodopa therapy. Such disturbances include memory loss, anxiety, nervousness, agitation, restlessness, confusion, inability to sleep, nightmares, daytime tiredness, mental depression or euphoria.
Gastrointestinal side effects are common in patients receiving carbidopa-levodopa. Nausea, vomiting, loss of appetite, and weight loss may occur. Patients may experience dizziness upon standing up, associated with a drop in blood pressure. Fortunately, the body develops tolerance to this side effect within a few months. Infrequently, patients may develop a drop in white blood cell count during carbidopa-levodopa therapy. This is a reason to temporarily, if not permanently, stop treatment.
Reference: FDA Prescribing Information
Last Editorial Review: 2/28/2012
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