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Sinemet (Levodopa/Carbidopa) Levodopa (also called L-dopa) is the most commonly prescribed and most effective drug for controlling the symptoms of Parkinson's disease, particularly bradykinesia and rigidity. Levodopa is transported to the nerve cells in the brain that produce dopamine.
Unfortunately, it can cause side effects, like nausea, vomiting, sleepiness, and low blood pressure. If you take levodopa over a long period of time, you may experience involuntary twisting or writhing movements (dyskinesia), and possibly psychotic delusions or hallucinations
It may also be used for other conditions as determined by your doctor. Sinemet 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.
This combination medication is used to treat symptoms of Parkinson's disease or Parkinson-like symptoms (such as shakiness, stiffness, difficulty moving). Parkinson's disease is thought to be caused by too little of a naturally occurring substance (dopamine) in the brain.
Patients with Lewy Body dementia or Parkinson's disease with dementia can have hallucinations regardless of the medications that they take, but sinemet can make the hallucinations more common and worse. That being said, the other Parkinson's medications are often more likely to cause hallucinations than sinemet.
When carbidopa and levodopa are administered together, the half-life of levodopa is increased to about 1.5 hours. At steady state, the bioavailability of carbidopa from SINEMET tablets is approximately 99% relative to the concomitant administration of carbidopa and levodopa.
Mechanism of action. Levodopa is converted to dopamine via the action of a naturally occurring enzyme called DOPA decarboxylase. This occurs both in the peripheral circulation and in the central nervous system after levodopa has crossed the blood brain barrier.
Essentially, L-DOPA is transported across the blood brain barrier by LAT-1 (L or Large amino acid transporter). This transporter moves amino acids like phenylalanine and tyrosine across the blood brain barrier. Without a transporter, a molecule needs to be lipid soluble to cross the blood brain barrier.
Carbidopa and levodopa can be taken with or without food. Take your doses at regular intervals to keep a steady amount of the drug in your body at all times. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole.
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