Carbidopa, Levodopa Enteral suspension

What is this medicine?

CARBIDOPA;LEVODOPA (kar bi DOE pa; lee voe DOE pa) enteral suspension is used to treat certain symptoms of advanced Parkinson's disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• diabetes

• drink alcohol

• feel sleepy or have fallen asleep suddenly during the day

• glaucoma

• heart disease

• high blood pressure

• history of irregular heartbeat

• kidney disease

• liver disease

• low blood pressure

• lung or breathing disease, like asthma

• melanoma, skin cancer, or suspicious skin lesions

• mental illness

• nerve problems

• problems with fainting

• stomach or intestine problems or surgery

• an unusual or allergic reaction to levodopa, carbidopa, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Your prescribed dose will be programmed into your pump by a healthcare provider. Your healthcare provider will show you how to use this medication cassette with the pump before you use it for the first time. See the "Instructions for Use" for complete instructions. Your dose will only be changed by your healthcare provider or while you are with your healthcare provider. Do not stop using this medicine or change your dose without the approval of your healthcare provider.

This medicine should be used at room temperature. Take one medication cassette out of the refrigerator and out of the carton 20 minutes prior to use. Use the product at room temperature or you may not get the right dose. The medicine is given continuously over 16 hours. A small pump (CADD-Legacy 1400) is used to move the medicine from the medication cassette into your PEG-J tube. Each cassette can only be used one time. An opened cassette should not be reused. The cassette should not be used for longer than 16 hours.

Disconnect the pump from your PEG-J tube after the 16 hour dosing time is finished. Use a syringe filled with room temperature water to flush your PEG-J tube. After your daily infusion, you should take your usual night time dose of oral carbidopa-levodopa tablets as prescribed. Keep a supply of oral regular-release carbidopa-levodopa tablets with you in case you are unable to receive your infusion.

This medication is not used in children.

Overdosage: If you think you've taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you stop your infusion for more than 2 hours during your 16 hour dosing time for any reason, call your healthcare provider and take oral carbidopa-levodopa tablets as prescribed until you are able to restart your infusion. If you stop your infusion for less than 2 hours, you do not need to take the carbidopa-levodopa tablets, but your healthcare provider may tell you to take an extra dose of your infusion.

Keep a supply of oral immediate-release carbidopa-levodopa tablets with you in case you are unable to receive your infusion.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• MAOIs like Marplan, Nardil, and Parnate

• reserpine

• tetrabenazine

This medicine may also interact with the following medications:

• alcohol

• droperidol

• entacapone

• iron supplements or multivitamins with iron

• isoniazid, INH

• linezolid

• medicines for depression, anxiety, or psychotic disturbances

• medicines for high blood pressure

• medicines for sleep

• metoclopramide

• papaverine

• procarbazine

• tedizolid

• rasagiline

• selegiline

• tolcapone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or healthcare professional if your symptoms do not start to get better or if they get worse. Do not stop taking except on your doctor's advice. You may develop a severe reaction. Your doctor will tell you how much medicine is needed.

Talk to your healthcare provider about what you need to do to care for your PEG-J tube site. Watch for signs of infection. Complications in the stomach or intestines can occur from the PEG-J tube procedure. Contact your healthcare provider immediately if you experience stomach pain, constipation that does not go away, nausea, vomiting, fever, or black stools.

If your PEG-J tube becomes kinked, knotted, or blocked this may cause your Parkinson’s symptoms to worsen or cause recurring movement problems (motor fluctuations). Call your healthcare provider if your Parkinson’s symptoms get worse or you have slow movement while you are treated with this medicine.

Eating high protein foods may affect how this medicine works. Tell your healthcare provider if you change your diet.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

If you find that you have sudden feelings of wanting to sleep during normal activities, like cooking, watching television, or while driving or riding in a car, you should contact your health care professional. Sleepiness and falling asleep suddenly can happen as late as 1 year after you start your treatment.

There have been reports of increased sexual urges or other strong urges such as gambling while taking this medicine. If you experience any of these while taking this medicine, you should report this to your health care provider as soon as possible.

Patients and their families should watch out for new or worsening depression or thoughts of suicide. Call your healthcare provider right away if you feel depressed or have thoughts of suicide.

You may experience a 'wearing off' effect prior to the time for your next dose of this medicine. You may also experience an 'on-off' effect where the medicine apparently stops working for any time from a minute to several hours, then suddenly starts working again. Tell your doctor or health care professional if any of these symptoms happen to you. Your dose may need adjustment.

You should often check your skin for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

If you have diabetes, you may get a false-positive result for sugar in your urine. Check with your doctor or health care professional.

This medicine may discolor the urine or sweat, making it look darker or red in color. This is of no cause for concern. However, this may stain clothing or fabrics.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxiety, confusion, or nervousness

• blood in your stool or a dark tarry stool

• chest pain

• constipation that does not go away

• falling asleep during normal activities like driving

• fast, irregular heartbeat

• hallucination, loss of contact with reality

• new or increased gambling urges, sexual urges, uncontrolled spending, binge or compulsive eating, or other urges

• severe nausea and vomiting

• signs and symptoms of infection like fever or chills; cough; sore throat; pain or trouble passing urine

• signs and symptoms of low blood pressure like dizziness; feeling faint or lightheaded, falls; unusually weak or tired

• stomach pain

• suicidal thoughts or other mood changes

• uncontrolled movements of the mouth, head, hands, feet, shoulders, eyelids or other unusual muscle movements

• weakness or numbness or loss of sensation in the fingers or feet

Side effects that usually do not require medical attention (Report these to your doctor or health care professional if they continue or are bothersome.):

• headache

• loss of appetite

• muscle twitches

• swelling of legs and feet

• trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store unopened cassettes in the refrigerator between 2 degrees C and 8 degrees C (36 degrees F to 46 degrees F). Do not freeze. Protect the cassette from light and keep it in the carton before using. Use before the expiration date printed on the cassette. Throw away any expired medicine.

Once a carton is removed from the refrigerator, opened, or in use, discard after 16 hours, even if it contains medication. Use before the expiration date printed on the cassette.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Carbidopa, Levodopa Oral capsule, extended-release

What is this medicine?

CARBIDOPA;LEVODOPA (kar bi DOE pa; lee voe DOE pa) is used to treat the symptoms of Parkinson's disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• depression or other mental illness

• diabetes

• glaucoma

• heart disease, including recent heart attack

• history of irregular heart beat

• kidney disease

• liver disease

• lung or breathing disease, like asthma

• melanoma or suspicious skin lesions

• stomach or intestine problems

• an unusual or allergic reaction to levodopa, carbidopa, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Swallow whole. Do not crush, chew, or divide the capsules. If you have trouble swallowing, you may open the capsule and sprinkle the entire contents on 1 to 2 tablespoons of applesauce. Take the medicine/food mixture immediately, and do not store for future use. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

A high fat, high calorie meal may slow the absorption of the medicine into your system and delay the onset of action by 2 to 3 hours. Consider taking the first dose of the day 1 to 2 hours before eating. If you develop nausea, the medicine may be taken with food.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you've taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• MAOIs like Marplan, Nardil, and Parnate

• reserpine

• tetrabenazine

This medicine may also interact with the following medications:

• alcohol

• droperidol

• entacapone

• iron supplements or multivitamins with iron

• isoniazid, INH

• linezolid

• medicines for depression, anxiety, or psychotic disturbances

• medicines for high blood pressure

• medicines for sleep

• metoclopramide

• papaverine

• procarbazine

• tedizolid

• rasagiline

• selegiline

• tolcapone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It may be several weeks or months before you feel the full benefits of this medicine. Continue to take your medicine on a regular schedule. Do not take any additional medicines for Parkinson's disease without first consulting with your health care provider.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

If you find that you have sudden feelings of wanting to sleep during normal activities, like cooking, watching television, or while driving or riding in a car, you should contact your health care professional.

You may experience a 'wearing off' effect prior to the time for your next dose of this medicine. You may also experience an 'on-off' effect where the medicine apparently stops working for any time from a minute to several hours, then suddenly starts working again. Tell your doctor or health care professional if any of these symptoms happen to you. Your dose may need adjustment.

A high protein meal can slow or prevent absorption of this medicine. Avoid high protein foods near the time of taking this medicine to help prevent these problems. Take this medicine at least 30 minutes before eating or one hour after meals. You may want to eat higher protein foods later in the day or in small amounts.

If you have diabetes, you may get a false-positive result for sugar in your urine. Check with your doctor or health care professional.

This medicine may discolor the urine or sweat, making it look darker or red in color. This is of no cause for concern. However, this may stain clothing or fabrics.

There have been reports of increased sexual urges or other strong urges such as gambling while taking some medicines for Parkinson's disease. If you experience any of these urges while taking this medicine, you should report it to your health care provider as soon as possible.

You should check your skin often for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxiety, confusion, or nervousness

• falling asleep during normal activities like driving

• fast, irregular heartbeat

• hallucination, loss of contact with reality

• mood changes like aggressive behavior, depression

• stomach pain

• trouble passing urine

• uncontrolled movements of the mouth, head, hands, feet, shoulders, eyelids or other unusual muscle movements

Side effects that usually do not require medical attention (Report these to your doctor or health care professional if they continue or are bothersome.):

• headache

• loss of appetite

• muscle twitches

• nausea/vomiting

• nightmares, trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light and moisture. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Carbidopa, Levodopa Oral disintegrating tablet

What is this medicine?

CARBIDOPA;LEVODOPA (kar bi DOE pa; lee voe DOE pa) is used to treat the symptoms of Parkinson's disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• asthma or lung disease

• depression or other mental illness

• diabetes

• glaucoma

• heart disease, including history of a heart attack

• irregular heart beat

• kidney disease

• liver disease

• melanoma or suspicious skin lesions

• stomach or intestine ulcers

• an unusual or allergic reaction to levodopa, carbidopa, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Take this medicine by mouth. Follow the directions on the prescription label. Remove your medicine from the bottle with dry hands. Place tablet on the tip of the tongue and allow it to melt before swallowing. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• MAOIs like Marplan, Nardil, and Parnate

• reserpine

• tetrabenazine

This medicine may also interact with the following medications:

• alcohol

• droperidol

• entacapone

• iron supplements or multivitamins with iron

• isoniazid, INH

• linezolid

• medicines for depression, anxiety, or psychotic disturbances

• medicines for high blood pressure

• medicines for sleep

• metoclopramide

• papaverine

• procarbazine

• tedizolid

• rasagiline

• selegiline

• tolcapone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It may be several weeks or months before you feel the full benefits of this medicine. Continue to take your medicine on a regular schedule. Do not take any additional medicines for Parkinson's disease without first consulting with your health care provider.

You may experience a wearing of effect prior to the time for your next dose of this medicine. You may also experience an on-off effect where the medicine apparently stops working for anything from a minute to several hours, then suddenly starts working again. Tell your doctor or health care professional if any of these symptoms happen to you. Your dose may need to be changed.

A high protein diet can slow or prevent absorption of this medicine. Avoid high protein foods near the time of taking this medicine to help to prevent these problems. Take this medicine at least 30 minutes before eating or one hour after meals. You may want to eat higher protein foods later in the day or in small amounts. Discuss your diet with your doctor or health care professional or nutritionist.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

If you find that you have sudden feelings of wanting to sleep during normal activities, like cooking, watching television, or while driving or riding in a car, you should contact your health care professional.

If you are diabetic, this medicine may interfere with the accuracy of some tests for sugar or ketones in the urine (does not interfere with blood tests). Check with your doctor or health care professional before changing the dose of your diabetic medicine.

This medicine may discolor the urine or sweat, making it look darker or red in color. This is of no cause for concern. However, this may stain clothing or fabrics.

There have been reports of increased sexual urges or other strong urges such as gambling while taking some medicines for Parkinson's disease. If you experience any of these urges while taking this medicine, you should report it to your health care provider as soon as possible.

You should check your skin often for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxiety, confusion, or nervousness

• falling asleep during normal activities like driving

• fast, irregular heartbeat

• hallucination, loss of contact with reality

• mood changes like aggressive behavior, depression

• stomach pain

• trouble passing urine

• uncontrolled movements of the mouth, head, hands, feet, shoulders, eyelids or other unusual muscle movements

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache

• loss of appetite

• muscle twitches

• nausea, vomiting

• nightmares, trouble sleeping

• unusually weak or tired

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light and moisture. Throw away any unused medicine after the expiration date.

Carbidopa, Levodopa Oral tablet

What is this medicine?

CARBIDOPA;LEVODOPA (kar bi DOE pa; lee voe DOE pa) is used to treat the symptoms of Parkinson's disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• asthma or lung disease

• depression or other mental illness

• diabetes

• glaucoma

• heart disease, including history of a heart attack

• irregular heart beat

• kidney or liver disease

• melanoma or suspicious skin lesions

• stomach or intestine ulcers

• an unusual or allergic reaction to levodopa, carbidopa, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• MAOIs like Marplan, Nardil, and Parnate

• reserpine

• tetrabenazine

This medicine may also interact with the following medications:

• alcohol

• droperidol

• entacapone

• iron supplements or multivitamins with iron

• isoniazid, INH

• linezolid

• medicines for depression, anxiety, or psychotic disturbances

• medicines for high blood pressure

• medicines for sleep

• metoclopramide

• papaverine

• procarbazine

• tedizolid

• rasagiline

• selegiline

• tolcapone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It may be several weeks or months before you feel the full benefits of this medicine. Continue to take your medicine on a regular schedule. Do not take any additional medicines for Parkinson's disease without first consulting with your health care provider.

You may experience a wearing of effect prior to the time for your next dose of this medicine. You may also experience an on-off effect where the medicine apparently stops working for anything from a minute to several hours, then suddenly starts working again. Tell your doctor or health care professional if any of these symptoms happen to you. Your dose may need to be changed.

A high protein diet can slow or prevent absorption of this medicine. Avoid high protein foods near the time of taking this medicine to help to prevent these problems. Take this medicine at least 30 minutes before eating or one hour after meals. You may want to eat higher protein foods later in the day or in small amounts. Discuss your diet with your doctor or health care professional or nutritionist.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

If you find that you have sudden feelings of wanting to sleep during normal activities, like cooking, watching television, or while driving or riding in a car, you should contact your health care professional.

If you are diabetic, this medicine may interfere with the accuracy of some tests for sugar or ketones in the urine (does not interfere with blood tests). Check with your doctor or health care professional before changing the dose of your diabetic medicine.

This medicine may discolor the urine or sweat, making it look darker or red in color. This is of no cause for concern. However, this may stain clothing or fabrics.

There have been reports of increased sexual urges or other strong urges such as gambling while taking some medicines for Parkinson's disease. If you experience any of these urges while taking this medicine, you should report it to your health care provider as soon as possible.

You should check your skin often for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxiety, confusion, or nervousness

• falling asleep during normal activities like driving

• fast, irregular heartbeat

• hallucination, loss of contact with reality

• mood changes like aggressive behavior, depression

• stomach pain

• trouble passing urine

• uncontrolled movements of the mouth, head, hands, feet, shoulders, eyelids or other unusual muscle movements

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache

• loss of appetite

• muscle twitches

• nausea, vomiting

• nightmares, trouble sleeping

• unusually weak or tired

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Throw away any unused medicine after the expiration date.

Carbidopa, Levodopa Oral tablet, extended-release

What is this medicine?

CARBIDOPA; LEVODOPA (kar bi DOE pa; lee voe DOE pa) is used to treat the symptoms of Parkinson's disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• depression or other mental illness

• diabetes

• glaucoma

• heart disease, including history of a heart attack

• irregular heart beat

• kidney disease

• liver disease

• lung or breathing disease, like asthma

• melanoma or suspicious skin lesions

• stomach or intestine ulcers

• an unusual or allergic reaction to levodopa, carbidopa, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Swallow whole. Do not crush or chew. You may cut the tablets in half. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• MAOIs like Marplan, Nardil, and Parnate

• reserpine

• tetrabenazine

This medicine may also interact with the following medications:

• alcohol

• droperidol

• entacapone

• iron supplements or multivitamins with iron

• isoniazid, INH

• linezolid

• medicines for depression, anxiety, or psychotic disturbances

• medicines for high blood pressure

• medicines for sleep

• metoclopramide

• papaverine

• procarbazine

• tedizolid

• rasagiline

• selegiline

• tolcapone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It may be several weeks or months before you feel the full benefits of this medicine. Continue to take your medicine on a regular schedule. Do not take any additional medicines for Parkinson's disease without first consulting with your health care provider.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

If you find that you have sudden feelings of wanting to sleep during normal activities, like cooking, watching television, or while driving or riding in a car, you should contact your health care professional.

You may experience a "wearing off" effect prior to the time for your next dose of this medicine. You may also experience an "on-off" effect where the medicine apparently stops working for anything from a minute to several hours, then suddenly starts working again. Tell your doctor or health care professional if any of these symptoms happen to you. Your dose may need adjustment.

A high protein diet can slow or prevent absorption of this medicine. Avoid high protein foods near the time of taking this medicine to help to prevent these problems. Take this medicine at least 30 minutes before eating or one hour after meals. You may want to eat higher protein foods later in the day or in small amounts. Discuss your diet with your doctor or health care professional or nutritionist.

If you have diabetes, you may get a false-positive result for sugar in your urine. Check with your doctor or health care professional.

This medicine may discolor the urine or sweat, making it look darker or red in color. This is of no cause for concern. However, this may stain clothing or fabrics.

There have been reports of increased sexual urges or other strong urges such as gambling while taking some medicines for Parkinson's disease. If you experience any of these urges while taking this medicine, you should report it to your health care provider as soon as possible.

You should check your skin often for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxiety, confusion, or nervousness

• falling asleep during normal activities like driving

• fast, irregular heartbeat

• hallucination, loss of contact with reality

• mood changes like aggressive behavior, depression

• stomach pain

• trouble passing urine

• uncontrolled movements of the mouth, head, hands, feet, shoulders, eyelids or other unusual muscle movements

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache

• loss of appetite

• muscle twitches

• nausea/vomiting

• nightmares, trouble sleeping

• unusually weak ot tired

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store below 30 degrees C (86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.