Caramet CR

  • Co-careldopa may make your urine look a dark red colour - this is harmless.
  • As your condition improves and your body movements become easier, be careful not to overdo physical activities.
  • Occasionally, people taking co-careldopa have fallen asleep suddenly without warning. If you experience this, do not drive and see your doctor as soon as possible.

About co-careldopa

Type of medicine Dopaminergic drug
Used for Parkinson's disease
Also called Caramet® CR, Duodopa®, Half Sinemet® CR, Sinemet®, Sinemet® CR, Sinemet® Plus
Also Stalevo® (with entacapone)
Available as Tablets, prolonged-release tablets, and gel for use with a feeding tube

You will have been prescribed co-careldopa to relieve symptoms of Parkinson's disease. In Parkinson's disease, a number of cells in a small part of the brain called the substantia nigra become damaged and die. These brain cells pass messages down nerves in the spinal cord by producing a chemical called dopamine, and it is these messages which control the muscles of the body. As the cells in the substantia nigra are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain, causes nerve messages to the muscles to become slowed and abnormal. This produces the main symptoms of Parkinson's disease which are stiffness, shaking (tremor), and slowness of movement.

Co-careldopa contains two ingredients, levodopa and carbidopa. Once in the body, levodopa is converted into dopamine which helps restore the level of dopamine in the damaged area of the brain. The carbidopa helps to prevent the levodopa from being broken down into dopamine in parts of the body other than the brain. This means more levodopa gets into the brain to be converted into dopamine, and also it helps to reduce side-effects.

Before taking co-careldopa

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking co-careldopa it is important that your doctor or pharmacist knows:

  • If you are under 18 years of age.
  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have lung or breathing problems.
  • If you have ever had a stomach ulcer.
  • If you have heart or blood vessel problems.
  • If you have glaucoma (raised pressure in the eye).
  • If you have ever had convulsions (fits).
  • If you have liver or kidney problems.
  • If you have a mental health problem, such as depression.
  • If you have ever had skin cancer.
  • If you have an overactive thyroid gland, Cushing's syndrome, diabetes, osteomalacia (weakened bones), or phaeochromocytoma (a growth on your adrenal glands).
  • If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
  • If you have ever had an allergic reaction to this or to any other medicine.

How to take co-careldopa

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack and any additional information your doctor has given you. The pack leaflet will give you more information about the specific brand of co-careldopa you have been given and a full list of possible side-effects from taking it.
  • Take co-careldopa exactly as your doctor has told you. Your doctor will prescribe a dose that best suits you, and will tell you how much to take and when to take it. Your dose will also be on the label of the pack. It is not important whether you take the tablets before or after food, although it is preferable not to take co-careldopa after a large meal.
  • When first starting co-careldopa, your doctor will give you a small dose and then gradually increase it. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted symptoms.
  • Try to take co-careldopa at the same times each day to avoid missing any doses. If you do miss a dose, just take the next dose when it is due. Do not take two doses together to make up for a forgotten dose.
  • If you are taking Stalevo® or a prolonged-release brand of co-careldopa (Caramet® CR, Half Sinemet® CR, Sinemet® CR): swallow these tablets whole; do not break them, or chew or crush them.
  • If you are using Duodopa® gel: your nurse will tell you how to use the pump and cassette.

Getting the most from your treatment

  • As your condition improves and your body movements become easier, be careful not to overdo any physical activities. Physical exercise should be increased gradually to allow your body to adjust to changing balance, circulation and co-ordination. This is especially important if you are elderly.
  • Co-careldopa may make your urine look a dark reddish colour. This is completely harmless and is nothing to worry about.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. During the first few weeks of treatment your dose may require adjusting to suit your individual needs.
  • Stopping treatment suddenly can cause problems and your doctor will probably want you to reduce your dose gradually if this is necessary.
  • Occasionally, people taking co-careldopa have fallen asleep suddenly, with little or no warning of tiredness beforehand. Until you know how you react, take extra care if you drive or operate machinery. If you do find yourself falling asleep suddenly, you should see your doctor as soon as possible and avoid driving or using tools and machines in the meantime.
  • If you drink alcohol, ask your doctor for advice about taking co-careldopa and alcohol. Alcohol may increase feelings of drowsiness and may not be recommended.
  • There may be a small increased risk of skin problems developing while you are taking a medicine containing levodopa. If you notice any unusual patches of skin, let your doctor know.
  • If you have diabetes you may need to check your blood glucose more frequently, as co-careldopa may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
  • If you buy any medicines, check with a pharmacist that they are safe to take with co-careldopa. This includes any vitamin preparations you may purchase, as iron (which is in some vitamin tablets) can interfere with co-careldopa.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking co-careldopa. Also, if you need to have any blood or urine tests, you must say that you are taking co-careldopa because it may affect the result of some tests.

Can co-careldopa cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Possible co-careldopa side-effects What can I do if I experience this?
Loss of appetite, feeling or being sick, diarrhoea, changes in how things taste These may occur when you first take co-careldopa. Taking your doses after a light meal may help. If it continues, let your doctor know so that your dose can be adjusted more slowly
Feeling dizzy when you stand up Getting up more slowly should help. If this continues, let your doctor know, as your dose may need adjusting
Feeling sleepy or tired If this happens, do not drive or use tools or machines. If you find yourself falling asleep suddenly without any warning of tiredness, let your doctor know
Changes in the way you feel, such as being anxious, excited, depressed or agitated; or thinking or believing things that are not true Let your doctor know about any of these
Changes in your behaviour, such as an increased desire to gamble or an increased sex drive You should let your doctor know about either of these as soon as possible
Uncontrollable jerky movements, 'on-off' effects (this is where you switch suddenly from being able to move to being immobile) These can happen after taking co-careldopa long-term. You should let your doctor know about these as soon as possible
Difficulties sleeping, dry mouth, being aware of your heartbeat If any of these become troublesome, discuss them with your doctor

If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.

How to store co-careldopa

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • If you are using Duodopa® gel, store the cassettes containing the gel, in a refrigerator, until they are required.