Precautions and Warnings With Carbidopa-Levodopa CR (Cont.)

Specific Precautions and Warnings With Carbidopa-Levodopa CR

Some of the warnings and precautions to be aware of prior to taking carbidopa-levodopa CR include the following:
 
  • Carbidopa-levodopa CR can cause involuntary muscle movements called dyskinesia. Although not typically dangerous, dyskinesia is usually quite disturbing and intolerable. If you develop a severe dyskinesia while taking carbidopa-levodopa CR, your healthcare provider may need to decrease your carbidopa-levodopa CR dosage (or you may need to stop taking carbidopa-levodopa CR altogether).
     
  • If you have heart problems, lung problems, ulcers, or kidney or liver disease, check with your healthcare provider before taking carbidopa-levodopa CR. In some cases, carbidopa-levodopa CR may not be the best choice for you.
     
  • Because carbidopa-levodopa CR can activate a malignant melanoma, it should not be used by anyone with a suspicious, undiagnosed skin lesion or a history of melanoma.
     
  • Carbidopa-levodopa CR can cause or worsen many mental illnesses, due to its effects on dopamine (a brain chemical). Let your healthcare provider know if you have a history of such problems.
     
  • Stopping carbidopa-levodopa CR too quickly can cause a dangerous condition known as neuroleptic malignant syndrome (NMS). Do not stop taking carbidopa-levodopa CR without your healthcare provider's approval and supervision. Let your healthcare provider know if you develop any signs of NMS, such as:

 

    • Irregular pulse or blood pressure
    • Fast heart rate (tachycardia)
    • High fever
    • Stiff muscles
    • Confusion
    • Sweating
    • Irregular heart rhythms (arrhythmias).

 

  • People with glaucoma may not be able to safely take carbidopa-levodopa CR. This medication is not recommended at all for people with narrow-angle glaucoma. People with adequately treated wide-angle glaucoma may take carbidopa-levodopa CR, although careful monitoring of the condition may be necessary.
     
  • The medication may cause you to fall asleep during the day, sometimes without warning. This can be especially dangerous if you are driving a car or operating heavy machinery. In addition, this can happen long after you start taking carbidopa-levodopa CR. Ask your healthcare provider if you should stop driving a car or operating heavy machinery while taking carbidopa-levodopa CR.
     
  • Carbidopa-levodopa CR can cause dark (red, brown, or black) saliva, sweat, or urine. Although this is not dangerous, it can be quite bothersome.
     
  • Carbidopa-levodopa CR can potentially interact with several medications (see Drug Interactions With Carbidopa-Levodopa CR).
     
  • Carbidopa-levodopa CR is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Sinemet CR and Pregnancy).
     
  • Carbidopa-levodopa CR passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Sinemet CR and Breastfeeding).
     
(Precautions and Warnings With Carbidopa-Levodopa CR Continued: Page 3)

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;