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Please carefully review the following safety and warning information related to the use of Sinemet (carbidopa/levodopa). It is crucial to understand the associated risks and consult your healthcare provider if you have any questions or concerns.

• Drowsiness and Sudden Sleep Onset: Sinemet may cause unexpected sleepiness or sudden sleep episodes. Avoid driving or engaging in activities that require full attention until you know how this medication affects you. This risk is heightened if you have a history of drowsiness, sleep issues, or are taking other sedative medications. Contact your healthcare provider if you experience excessive daytime sleepiness or suddenly fall asleep while engaged in activities.

• Neuroleptic Malignant Syndrome (NMS)-like Symptoms: Abrupt discontinuation or reduction of Sinemet can lead to symptoms similar to NMS, a severe condition that includes high fevers, confusion, irregular heartbeat, sweating, muscle stiffness, and blood pressure changes. Do not stop or alter your dosage without consulting your healthcare provider, who can guide you on safely adjusting your medication.

• Hallucinations and Behavioral Changes: This medication may cause hallucinations, paranoia, delusions, confusion, aggression, sleep disturbances, or increased dreaming. These symptoms typically manifest shortly after starting the medication and may resolve with dose adjustment or discontinuation. Avoid using Sinemet if you have certain mental health conditions, as it can interact negatively with some psychiatric medicines. Inform your provider of any mental health history before starting treatment.

• Impulsive Behavior: Sinemet may lead to uncontrollable urges, such as excessive gambling, spending, or eating. If you experience these behaviors, inform your healthcare provider. They may inquire about any recent behavior changes during your consultations.

• Increased Skin Cancer Risk: Individuals with Parkinson's disease have an elevated risk of developing skin cancer. Regularly check for new or unusual skin growths or changes in moles, and report any findings to your healthcare provider. They may recommend periodic skin examinations.

Contraindications:

• Avoid using Sinemet if you are taking nonselective monoamine oxidase inhibitors (MAOIs) or have narrow-angle glaucoma, as these conditions pose significant health risks.

Please ensure you discuss any pre-existing conditions or current medications with your healthcare provider before starting Sinemet to prevent adverse interactions and optimize your treatment plan.

When taking this medication, you may encounter some common side effects such as dizziness, lightheadedness, nausea, vomiting, headache, loss of appetite, trouble sleeping, and unusual dreams. These effects are generally mild and should ease with time, but if they persist or worsen, it is advisable to consult your healthcare provider. Additionally, you might notice a harmless change in the color of your saliva, urine, or sweat, which may stain clothing.

Some individuals may experience more serious effects, such as involuntary movements or spasms, increased eye blinking or twitching, vision changes, and severe stomach pain. Mental and mood changes, including confusion, agitation, and hallucinations, have also been reported. If you notice these symptoms, it is important to contact your doctor promptly.

Rare but severe side effects require immediate medical attention. These include chest pain, fainting, and symptoms of a serious condition known as neuroleptic malignant syndrome (NMS), characterized by high fevers, muscle stiffness, severe confusion, and irregular heartbeat. Abruptly stopping or reducing the dose can also trigger NMS. Allergic reactions are rare but serious, and you should seek emergency help if you experience rash, severe dizziness, or trouble breathing. Always report any new or worsening symptoms to your healthcare provider.