5and5 Drug Analysis: Levodopa/Carbydopa (Sinemet), Parkinson’s 5 benefits/5 risks Profile

The combination oral Parkinson’s drug Levodopa(L-dopa)/Carbydopa sold as Sinemet with pills of varying quantities of each drug, enhances L-dopa by blocking its breakdown in the body and lowering dopamine production there. The carbydopa component of the combo blocks the enzyme DDC (dopa-decarboxylase)in the blood which converts the L-dopa to dopamine outside the brain. Dopamine outside the brain causes nausea and vomiting and can even raise blood pressure. (see diagram below)

risks/benefits of the levodopa/carbydopa combo:

This is a summary for learning and is by no means an exhaustive list. Other names for this combo include: Sinemet, Parcopa, and Atamet. The generic British name is Co-careldopa.

5 Benefits/Advantages of Levodopa (L-Dopa)/Carbydopa therapy for Parkinson’s

1. Less nausea and vomiting (explained above)
2. Long safety record over many years
3. Less total levodopa (L-dopa) needed
4. Because of less L-dopa needed to be taken orally for the same effect, less interference with dietary protein than when taking L-dopa alone.
5. Available in many doses and most recently in an extended release tablet.

5 Risks/Disadvantages of Levodopa (L-Dopa)/Carbydopa therapy for Parkinson’s:

(actually the side-effect profile is better than with levodopa alone)

1. When taken as Stalevo ( with 3rd component entacapone, see diagram), there is a real risk of rare but severe cardiac and cardiovascular events like heart attack and stroke.
2. Rare but severe allergic reactions with throat-swelling can occur.
3. Many possible GI effects like appetite loss and constipation.
4. Can cause drowsiness and sleep problems.
5. Can worsen confusion of dementia.

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