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Generic Sinemet
Generic Sinemet for Parkinson’s disease is a prescription medication used for the treatment of the symptoms of idiopathic Parkinson's disease (paralysis agitans), post encephalitic Parkinsonism, and symptomatic Parkinsonism which may follow injury to the nervous system by carbon monoxide intoxication and/or manganese intoxication. Levodopa is used alone or in combination with Carbidopa to treat Parkinson's disease, sometimes referred to as shaking palsy. Generic Sinemet is helpful in improving slow movement and muscle stiffness and treats shaking, difficulty in swallowing and drooling and allows more normal movements of the body by improving muscle control.

Parkinson’s disease is a brain disorder that occurs when certain nerve cells (neurons) in a part of the brain called the substantia nigra die or become impaired. Normally, these cells produce a vital chemical known as dopamine. Dopamine allows smooth, coordinated function of the body's muscles and movement. When approximately 80% of the dopamine-producing cells are damaged, the symptoms of Parkinson disease appear. The key signs of Parkinson disease are Tremor (shaking), Slowness of movement, Rigidity (stiffness), and difficulty with balance.
Prescription Drug Sinemet works by stimulating the production of dopamine. The symptoms of Parkinson's disease are believed to be caused by a lack of dopamine, a naturally occurring chemical produced by certain brain cells that relays messages to the part of brain that controls muscle movement. Administration of dopamine is ineffective in the treatment of Parkinson's disease because it does not cross the blood-brain barrier.

Sinemet Side Effects
The decision to Buy Generic Sinemet for Parkinson’s disease should be taken after due consultation with the doctor regarding probable Sinemet Side Effects. Though Generic Sinemet Side Effects are not so common they are known to occur. It is always advisable to consult a doctor for Drug Information if the symptoms are severe. The most common Sinemet Side Effects include agitation, anxiety, clenching/grinding of teeth, clumsiness, confusion, difficulty swallowing, dizziness, false sense of well being, feeling faint ,general feeling of discomfort or illness, hallucinations ,hand tremor ,nausea numbness, tiredness. Side effects other than those listed here may also occur. It is better to talk to the doctor about any Generic Sinemet side effect that seems unusual or that is especially bothersome.

Safe use of Generic Sinemet during pregnancy has not been established. One should inform the doctor if one is pregnant, or have plans to become pregnant. If one is breast-feeding one should take the doctor into counsel before taking Sinemet Tablet for Parkinson’s disease since most drugs pass into milk.

The Other Side of Generic Sinemet (Carbidopa-levodopa cr)
Side Effects of Generic Sinemet (Carbidopa-levodopa cr)
Like other medicines, Generic Sinemet (Carbidopa-levodopa cr) can cause some side effects. If they occur, the side effects of Generic Sinemet (Carbidopa-levodopa cr) are most likely to be minor and temporary and may go away during treatment as the body adjusts to the prescribed Generic Sinemet (Carbidopa-levodopa cr) . However, some may be serious and need medical attention and may require the individual to inform the doctor or visit the nearest hospital.

It is pertinent to note that side effects of Generic Sinemet (Carbidopa-levodopa cr) cannot be anticipated. If any side effects of Generic Sinemet (Carbidopa-levodopa cr) develop or change in intensity, the doctor should be informed as soon as possible. The individual’s doctor alone can determine if Generic Sinemet (Carbidopa-levodopa cr) is safe to continue and will also determine the decision to buy specific dosages of Generic Sinemet (Carbidopa-levodopa cr) as also counsel treatment in the occurrence of Generic Sinemet (Carbidopa-levodopa cr) dosage side effects.

Dyskinesias are a common side effect of Sinemet treatment. The occurrence of dyskinesias may require dosage reduction.

More common side effects of Generic Sinemet (Carbidopa-levodopa cr) may include:
Abnormal thinking
Agitation
Anxiety
Clenching/grinding of teeth
Clumsiness
Confusion
Difficulty swallowing
Dizziness
Excess salivating
False sense of well being
Feeling faint
General feeling of discomfort or illness
Hallucinations
Hand tremor
Nausea
Numbness
Tiredness
Unsteadiness
Unusual and uncontrolled movements of the body such as the face, tongue, arms, hands, head, and upper body ,
Vomiting
Weakness

Most of the mild side effects may go away during treatment as the body adjusts to the Generic Sinemet (Carbidopa-levodopa cr). However, symptoms or side effects that become severe or do not go away, require medical attention. Generic Sinemet (Carbidopa-levodopa cr) should be stopped and emergency medical intervention sought when an individual experiences any of the following side effects which can turn serious for some.

Some of the more serious/ less common/ rare Generic Sinemet (Carbidopa-levodopa cr) side effects are:
Anaemia
Black sticky bowel motions (stools)
Bleeding from the anus
Blood in the urine
Bloody diarrhoea
Bruising more easily than normal
Changes in mood
Chest pain
Depression
Difficult or painful urination
Difficulty breathing
Fainting
Fast or irregular heartbeats
Feeling very fearful or paranoid
Forgetfulness
Hallucinations
Infections such as fever, severe chills, sore throat or mouth ulcers
Muscle stiffness accompanied by fever
Nose bleeds
Numbness
Shortness of breath
Skin rash, itchiness
Swelling of the face, lips, mouth, throat or tongue which may cause difficulty in swallowing or breathing
Swellings on the skin
Tingling in the hands or feet
Vomiting blood

Side effects other than those listed here may also occur. In event of any unusual reaction to drug, side effect or impact on the individual’s lifestyle should be checked with the doctor at the earliest.

While Generic Sinemet (Carbidopa-levodopa cr) is the most effective medication and has the least short-term side effects, it is associated with high risks of long-term side effects, such as involuntary movements (dyskinesia). Used on a long-term basis, Levodopa may also cause restlessness, confusion, or abnormal movements. Changes in the amount or timing of the dose will usually prevent these side effects.

Only the doctor can determine the decision to buy specific dosages of Generic Sinemet (Carbidopa-levodopa cr) as also counsel treatment in the occurrence of Generic Sinemet (Carbidopa-levodopa cr) dosage side effects.

Action Mechanism of Generic Sinemet (Carbidopa-levodopa cr)
Carbidopa reduces the amount of levodopa required to produce a given response by about 75 percent and, when administered with levodopa, increases both plasma levels and the plasma half-life of levodopa, and decreases plasma and urinary dopamine and homovanillic acid.

Elimination half-life of levodopa in the presence of carbidopa is about 1.5 hours. Following Sinemet CR, the apparent half-life of levodopa may be prolonged because of continuous absorption.

In healthy elderly subjects the mean time-to-peak concentration of levodopa after a single dose of Sinemet CR 50-200 was about 2 hours as compared to 0.5 hours after standard Sinemet. The maximum concentration of levodopa after a single dose of Sinemet CR was about 35% of the standard Sinemet. The extent of availability of levodopa from Sinemet CR was about 70-75% relative to intravenous levodopa or Sinemet in the elderly. The absolute bioavailability of levodopa from Sinemet CR in young subjects was shown to be only about 44%. The extent of availability and the peak concentrations of levodopa were comparable in the elderly after a single dose and at steady state after t.i.d. administration of Sinemet CR 50-200. In elderly subjects, the average trough levels of levodopa at steady state after the CR tablet were about 2 fold higher than after the standard Sinemet.

The extent of availability and peak concentrations of levodopa after a single dose of Sinemet CR 50-200 increased by about 50% and 25%, respectively, when administered with food.

At steady state, the bioavailability of carbidopa from Sinemet Tablets is approximately 99% relative to the concomitant administration of carbidopa and levodopa. Pyridoxine hydrochloride (vitamin B 6 ), in oral doses of 10 mg to 25 mg, may reverse the effects of levodopa by increasing the rate of aromatic amino acid decarboxylation. Carbidopa inhibits this action of pyridoxine.

Drug Information of Generic Sinemet (Carbidopa-levodopa cr)
What is Generic Sinemet (Carbidopa-levodopa cr) ?
Generic Sinemet (Carbidopa-levodopa cr) is used to treat some of the symptoms of Parkinson's disease. Levodopa is used alone or in combination with Carbidopa to treat Parkinson's disease, sometimes referred to as shaking palsy.

Parkinson's disease is a progressive, neuro-degenerative disorder of the nervous system affecting the mobility and control of the skeletal muscular system. It is characterized by tremor, muscle stiffness, slow unsteady movement, rigidity, and/or abrupt movements of one or many parts of the body. If untreated, Parkinson's disease can cause difficulty in performing normal daily activities.

Generic Sinemet (Carbidopa-levodopa cr) is most helpful in improving slow movement and muscle stiffness and treats shaking, difficulty in swallowing and drooling and allows more normal movements of the body by improving muscle control.

Who should use Generic Sinemet (Carbidopa-levodopa cr)?
Generic Sinemet (Carbidopa-levodopa cr) is a prescription drug indicated in the treatment of the symptoms of idiopathic Parkinson's disease (paralysis agitans), postencephalitic parkinsonism, and symptomatic parkinsonism which may follow injury to the nervous system by carbon monoxide intoxication and/or manganese intoxication

Chemical composition of Generic Sinemet (Carbidopa-levodopa cr)
Sinemet is a sustained-release combination of carbidopa and levodopa for the treatment of Parkinson's disease and syndrome.

Carbidopa, an inhibitor of aromatic amino acid decarboxylation, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.3. It is designated chemically as (--)-L-(alpha)-hydrazino-(alpha)-methyl-(beta)-(3,4- dihydroxybenzene) propanoic acid monohydrate.

Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (--)-L-(alpha)-amino-(beta)-(3,4-dihydroxybenzene) propanoic acid.

Sinemet sustained-release combination tablets contain either 50 mg of carbidopa and 200 mg of levodopa, or 25 mg of carbidopa and 100 mg of levodopa.

How does Generic Sinemet (Carbidopa-levodopa cr) work?
The symptoms of Parkinson's disease are believed to be caused by a lack of dopamine which is a naturally occurring chemical produced by certain brain cells that relays messages in the part of the brain that controls muscle movement. Administration of dopamine is ineffective in the treatment of Parkinson's disease because it does not cross the blood-brain barrier.

Levodopa, a metabolic precursor, is a chemical closely related to dopamine and permits the body to make its own dopamine. Carbidopa ensures that enough Levodopa, which crosses the blood-brain barrier reaches to that part of the brain where it is needed. Because the drug reaches those parts of the brain that need it, Generic Sinemet (Carbidopa-levodopa cr) is most helpful in improving slow movement and muscle stiffness and treats shaking, difficulty in swallowing and drooling and allows more normal movements of the body by improving muscle control.

Who should not take Generic Sinemet (Carbidopa-levodopa cr)?
Although Generic Sinemet (Carbidopa-levodopa cr) is prescribed for many individuals to treat the given condition, it is not suitable for everybody.

Generic Sinemet (Carbidopa-levodopa cr) is contraindicated in those patients with a known hypersensitivity to Generic Carbidopa or Generic Levodopa, its combination, medicines that belong to this class of drugs, or any of its ingredients and should take the doctor into confidence regarding use of the medication.

Generic Sinemet (Carbidopa-levodopa cr) is should be avoided by individuals with narrow-angle glaucoma.

Individuals who take MAO inhibitors. These inhibitors must be discontinued at least two weeks prior to initiating therapy with Generic Sinemet (Carbidopa-levodopa cr) tablets or its extended release formulations.

Generic Sinemet (Carbidopa-levodopa cr) should be used with caution in patients with:
Asthma
Blood vessel disease
Bronchitis
Chronic lung disease
Diabetes mellitus
Emphysema
Heart disease
Hormone problems
Kidney disease
Liver disease
Mental illness
Seizure disorders
Suspicious, undiagnosed skin lesions or a history of melanoma.

Medication Levels of Generic Sinemet (Carbidopa-levodopa cr)
Generic Sinemet (Carbidopa-levodopa cr) Intake - How to take?
Generic Sinemet (Carbidopa-levodopa cr) should be taken as directed by the doctor. For Generic Sinemet (Carbidopa-levodopa cr) to be effective one should take the dosage regularly at the specified times as per the doctor’s counsel. The patient should be cautioned not to change the prescribed dosage regimen and not to add any additional Parkinson’s medications, including other Sinemet preparations, without first consulting the physician.

Each dose of Generic Sinemet (Carbidopa-levodopa cr) tablets should be taken with a full glass of water or as indicated by the doctor.

Generic Sinemet (Carbidopa-levodopa cr) can be taken with or without food.
Generic Sinemet (Carbidopa-levodopa cr) extended release tablets should be swallowed whole, not chewed, split or crushed. The patient should be informed that Sinemet CR is a sustained-release formulation of Generic Sinemet (Carbidopa-levodopa cr) which releases these ingredients over a 4- to 6-hour period. It is important that the Generic Sinemet (Carbidopa-levodopa cr) extended release tablets be taken at regular intervals according to the schedule outlined by the physician.

Generic Sinemet (Carbidopa-levodopa cr) Dosage - How much to take?
The dose of Generic Sinemet (Carbidopa-levodopa cr) varies for different patients. The doctor prescribes certain drug and dosage to best suit the patient's unique requirement. The dose of Levodopa or Carbidopa and Levodopa combination will be different for different patients. Therefore, it is important to follow the doctor's instructions regarding the use and dose of the prescribed Generic Sinemet (Carbidopa-levodopa cr) . It is also important to follow the instructions given on the medication package.

Standard drugs for Parkinson's disease, other than Levodopa without a decarboxylase inhibitor, may be used concomitantly while Generic Sinemet (Carbidopa-levodopa cr) is being administered, although their dosage may have to be adjusted.

The usual starting dose of Generic Sinemet (Carbidopa-levodopa cr) is one 25/100 mg tablet taken three times a day. The dose adjustment depends on the severity of the condition, individual’s response to treatment and whether one is taking other medicines.

Generic Sinemet (Carbidopa-levodopa cr) Course - How long to take?
The duration of the use of the drug is determined by the doctor alone. Depending on one’s condition, one may have to take Generic Sinemet (Carbidopa-levodopa cr) for the prescribed time period. Generic Sinemet (Carbidopa-levodopa cr) should not be stopped before its intended course/ duration as indicated by the doctor. The doctor alone determines how long one should take Generic Sinemet (Carbidopa-levodopa cr) since abrupt stopping of medication than a gradual withdrawal will do more harm than good.

It is important to give Generic Sinemet (Carbidopa-levodopa cr) time to work and show results. It is also important that the drug should not be stopped when its intended benefits are visible or experienced

Precautions with Generic Sinemet (Carbidopa-levodopa cr)
Generic Sinemet (Carbidopa-levodopa cr) is prescribed by the doctor to best treat the individual’s condition but certain precautions should necessarily be exercised before, after and during the use of the drug. Precautionary care taken with the use of Generic Sinemet (Carbidopa-levodopa cr) will ensure that the individual derives the maximum intended benefit and lessen situations that may necessitate medical intervention.

One should not use Generic Sinemet (Carbidopa-levodopa cr) if one is allergic to Generic Sinemet (Carbidopa-levodopa cr) , its ingredients or similar medications of its drug class. It is important to take the doctor’s counsel in all aspects before going for Generic Sinemet (Carbidopa-levodopa cr) medication.

Some medical conditions of the patient require administration of Generic Sinemet (Carbidopa-levodopa cr) with caution. The doctor should be aware of the following medical conditions that may recommend a change in dosage or might stop Generic Sinemet (Carbidopa-levodopa cr) medication:
Asthma
Blood vessel disease
Bronchitis
Chronic lung disease
Diabetes mellitus
Emphysema
Glaucoma
Heart Disease
Hormone problems
Kidney disease
Liver disease
Melanoma
Mental illness
Seizure disorders

When patients are receiving Levodopa without a decarboxylase inhibitor, Levodopa must be discontinued at least twelve hours before Generic Sinemet (Carbidopa-levodopa cr) is started.

Generic Sinemet (Carbidopa-levodopa cr) extended release formulations, in some individuals, may cause mental disturbances. These reactions are thought to be due to increased brain dopamine following administration of Levodopa. All patients should be observed carefully for the development of depression with concomitant suicidal tendencies. Patients with past or current psychoses should be treated with caution.

Excessive acidity also delays stomach emptying, thus delaying the absorption of Levodopa. Iron salts (such as in multi-vitamin tablets) may also reduce the amount of Levodopa available to the body.

The dosage of Generic Sinemet (Carbidopa-levodopa cr) should not be decreased or increased without doctor’s approval.

It is important that the doctor checks progress of the treatment with Generic Sinemet (Carbidopa-levodopa cr) at regular visits. This is particularly helpful in ascertaining the patient’s level of comfort with prescribed Generic Sinemet (Carbidopa-levodopa cr) , to allow any Generic Sinemet (Carbidopa-levodopa cr) dosage adjustments, helping to reduce Generic Sinemet (Carbidopa-levodopa cr) side effects, and assist in maintaining the normal lifestyle to the extent possible.

Generic Sinemet (Carbidopa-levodopa cr) and Lifestyle
Some drugs such as Generic Sinemet (Carbidopa-levodopa cr) can influence changes in individual’s lifestyle.

Healthy diet and physical activity programs always benefit the individuals’ drug therapy. The patient should be informed that a change in diet to foods that are high in protein may delay the absorption of Levodopa and may reduce the amount taken up in the circulation. Since protein may interfere with the body's response to Levodopa, high protein diets should be avoided. Intake of normal amounts of protein should be spaced equally throughout the day, or taken as directed by your doctor.

Problems like dizziness or drowsiness are more likely to occur if one drinks alcoholic beverages while being treated with Generic Sinemet (Carbidopa-levodopa cr) medication. Thus alcohol used be used with caution or better stopped permanently unless otherwise directed by the doctor.

Generic Sinemet (Carbidopa-levodopa cr) can make one drowsy and mask one’s judgment. It is safer to not undertake any activity that requires mental alertness, such as driving or operating machinery until one is sure of the medication affects of Generic Sinemet (Carbidopa-levodopa cr).

Missed dose of Generic Sinemet (Carbidopa-levodopa cr)
In the event of a missed dose of Generic Sinemet (Carbidopa-levodopa cr) it is always best to skip it and get back to the regular schedule the next day or when its time for the next dose than trying to make up for the missed dose the same day. Double dosing of Generic Sinemet (Carbidopa-levodopa cr) does more harm than good.

Over dose of Generic Sinemet (Carbidopa-levodopa cr)
Any medication taken in excess can have serious consequences. It is important that one does not take more Generic Sinemet (Carbidopa-levodopa cr) than prescribed and should be careful regarding the use and administration of the medication. Medical help should be summoned in the case of an overdose of Generic Sinemet (Carbidopa-levodopa cr) , even if there are no signs of discomfort or poisoning.

Generic Sinemet (Carbidopa-levodopa cr) interaction with other drugs
Some medicines may interfere with Generic Sinemet (Carbidopa-levodopa cr) or Carbidopa or Levodopa may interfere with these medicines. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, the doctor would want to change the dose, or other precautions may be necessary.

Taking Levodopa while taking or within 2 weeks of taking monoamine oxidase (MAO) inhibitors may cause sudden extremely high blood pressure; at least 14 days should be allowed between stopping treatment with one medicine and starting treatment with the other medicine

When one is taking Generic Sinemet (Carbidopa-levodopa cr) , it is especially important that the doctor should be informed if the following medicines have been taken in recent past or are being taken concurrently:
Monoamine Oxidase (MAO) Inhibitors such as Isocarboxazid, Phenelzine, Procarbazine, Selegiline, Tranylcypromine
Chlorpromazine
Cocaine
Fluphenazine
Haloperidol
Mesoridazine
Perphenazine
Phenothiazines
Prochlorperazine
Promazine
Promethazine
Pyridoxine
Selegiline
Thioridazine
Thiothixene
Thioxanthenes
Trifluoperazine
Triflupromazine
Trimeprazine

Standard drugs for Parkinson's disease, other than Levodopa without a decarboxylase inhibitor, may be used concomitantly while Generic Sinemet (Carbidopa-levodopa cr) extended release tablets are being administered, although their dosage may have to be adjusted.

Drugs other than those listed here may also interact with Generic Sinemet (Carbidopa-levodopa cr). It is advisable to talk to the doctor before taking any prescription or over-the-counter medicines, including herbal products.

Storage of Generic Sinemet (Carbidopa-levodopa cr)
Generic Sinemet (Carbidopa-levodopa cr) should not be stored above the temperature of 30°C (86°F). Excess heat and moisture may break down the medicine. Care should be taken to see that it is kept away from the reach of children. The doctor’s advice has to be taken regarding proper disposal of Generic Sinemet (Carbidopa-levodopa cr) medication

Effect of Generic Sinemet (Carbidopa-levodopa cr) on Special Population
Generic Sinemet (Carbidopa-levodopa cr) and Pediatric Population
Safety and effectiveness of Sinemet in pediatric patients have not been established. Use of the drug in patients below the age of 18 is not recommended. The doctor is the best person to advice on the use and administration to Generic Sinemet (Carbidopa-levodopa cr) to children taking into consideration the risks involved vis-à-vis not taking the medication.

Generic Sinemet (Carbidopa-levodopa cr) and Geriatric Population
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range of Generic Sinemet (Carbidopa-levodopa cr) , reflecting the greater frequency of the decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. Elderly people are especially sensitive to the effects of Levodopa and this may increase the chance of side effects during treatment

Since, elderly patients are more likely to be susceptible to various conditions, care should be taken in Generic Sinemet (Carbidopa-levodopa cr) dose selection, and it may be useful to monitor their progress.

Generic Sinemet (Carbidopa-levodopa cr) and Pregnant Women
There are no adequate or well-controlled studies of Sinemet in pregnant women. It has been reported from individual cases that Levodopa crosses the human placental barrier, enters the fetus, and is metabolized. Carbidopa concentrations in fetal tissue appeared to be minimal. Use of Generic Sinemet (Carbidopa-levodopa cr) in women of childbearing potential requires that the anticipated benefits of the drug be weighed against possible hazards to mother and child and the doctor should be consulted

Generic Sinemet (Carbidopa-levodopa cr) and Nursing Mothers
Many drugs are excreted in human milk and therefore caution should be exercised when Generic Sinemet (Carbidopa-levodopa cr) is administered to a nursing woman. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Generic Sinemet (Carbidopa-levodopa cr) is administered to a nursing woman.
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