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The striatum of patients with Parkinson€™s disease is deficient in dopamine. Levodopa is a dopamine precursor and Carbidopa is a peripheral decarboxylase inhibitor. The combination of Carbidopa-Levodopa increases the half-life of Levodopa in the periphery and makes more of Levodopa cross blood brain barrier and reaches the site of action.

The common side effects reported with Sinemet are chest pain, asthenia, cardiac irregularities, hypotension, orthostatic hypotension, hypertension, syncope, phlebitis, palpitation, dark saliva, gastrointestinal bleeding, duodenal ulcer, anorexia, vomiting, diarrhea, constipation, dyspepsia, dry mouth, taste alterations, agranulocytosis, anemia, thrombocytopenia, leukopenia, confusion, agitation, dizziness, somnolence, dream abnormalities, insomnia, paresthesia, headache, depression, dementia, pathological gambling and increased libido.

The concomitant administration of Sinemet and antihypertensive drugs or MAO inhibitors can cause orthostatic hypotension. The administration of Dopamine D2receptor antagonists and isoniazid with Levodopa can cause a loss in its efficacy and therapeutic response. Iron salts reduce the bioavailability of Sinemet. Sinemet should be used cautiously in patients with chronic wide-angle glaucoma. It is not advisable to consume Sinemet drug during pregnancy. Carbidopa -Levodopa should not be administered to nursing mothers and patients below age of 18.

Sinemet tablets are available in a 1:4 ratio of carbidopa to levodopa as well as 1:10 ratio. The recommended starting dose of Sinemet is one tablet 25-100 three times a daily.