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Sinemet (levodopa, carbidopa) is a combination antiparkinsonian medication used to treat Parkinson's disease and similar symptoms, such as shakiness and stiffness, when caused by disorders or damage to the central nervous system.

Parkinson's disease is thought to be caused by low dopamine levels in the brain. Most treatments consist of raising dopamine levels in the brain, which Sinemet also does. To better understand how Sinemet works we'll need to look at its two active ingredients:

  • Levodopa, also called L-DOPA, is widely regarded as the best treatment for Parkinson's. In the brain it converts to dopamine, which helps patients with movement issues. However, when used on its own, much of levodopa is converted before it reaches the brain, resulting in higher doses, greater risk of side effects, and reduced benefit.
  • Carbidopa inhibits conversion of levodopa before it reaches the brain. Including this medication with levodopa means patients receive greater benefit with lower doses and reduced risk/severity of side effects.

Levodopa and carbidopa may be taken as separate tablets, but most patients find Sinemet's combination tablet much more convenient.

It's important to note that patients taking Sinemet should not also take levodopa separately; this is far too much levodopa and side effects are likely to be experienced.

Before Taking Sinemet

While Sinemet produces positive benefits faster than levodopa alone, it also causes adverse reactions quicker. Note that not every patient will experience adverse effects, and they can often be resolved by reducing dosage if they are experienced. Any concerning symptom should be brought to the attention of a doctor.

Patients starting treatment, following dosage adjustments, or abruptly ending treatment should be alert for warning signs.

Though Sinemet is meant to help resolve movement issues, ironically it's a little more likely than levodopa alone to cause different versions of them. An early symptom of these movement disorders is often blepharospam---involuntary blinking or closing of eyelids---but this does not always occur.

Other concerning side effects involve changing mood or behaviors; decreased impulse control and increased sex drive are common. If these become powerful enough to be concerning or cause disruption, consult a doctor.

Sinemet can cause urine, saliva, or sweat to become discolored, even dark red or black. While this may appear alarming it is not cause for concern.

Other medications can interact with Sinemet; be sure the prescribing doctor is aware if taking:

  • Blood pressure medications
  • Antidepressants or antipsychotics
  • Any supplement containing iron
  • Risperidone
  • Isoniazid
  • Metoclopramide
  • Reserpine
  • Phenytoin
  • Papaverine
  • Any medication that ends in -azine, such as tetrabenazine, perphaenazine, chlorpromazine, and so forth

Sinemet can cause drowsiness; some patients fall asleep with little warning. Use caution performing dangerous tasks---such as driving or operating machinery---until effects of Sinemet are known.

Dosage & Administration

Sinemet comes in tablets, available in several strengths:

  • 10/100 mg carbidopa/levodopa
  • 25/100 mg carbidopa/levodopa
  • 25/250 mg carbidopa/levodopa

Tablets can be taken with food, but high-fat or high-protein meals will delay effectiveness. If in doubt, take one or two hours before or after a meal. A full glass of fluid is recommended with each dose.

Patients are typically started on lower doses, which is increased only if needed and if no disruptive side effects develop. Treatment is typically:

  • Start with 25/100 mg carbidopa/levodopa, taken three times per day (total dose of 75/300 mg carbidopa/levodopa)
  • If needed, dosage may be gradually increased. Tablets may be split if needed for accurate dosing.
  • Do not exceed 200 mg carbidopa per day; that's 8 25/100 or 25/250 mg tablets per day.

Other medications and other medical conditions can also influence dosage, usually calling for it to be lower; patients with other conditions or taking other medications may be started on 10/100 mg carbidopa/levodopa.

Treatment really is individualized. Ideally patients will work closely with a doctor, who can evaluate results and monitor for side effects.

Treatment with Sinemet should not end abruptly; dosage should be gradually reduced if treatment ends. A doctor can help come up with a discontinuation plan.


100mg/25mg levodopa/carbidopa  Buy Sinemet 60 Tablets - $50.46
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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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