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Sinemet might lose its effectiveness over time or at certain times during the day. Call your doctor if your symptoms worsen or vary.
Infrequently.patients may develop a drop in white blood cell count during carbidopa-levodopa therapy. This is a significant reason to temporarily.if not permanently.stop treatment.
Maintain patients on the lowest dosage required to achieve symptomatic control and to minimize sinemet treatment reactions such as dyskinesia and nausea.
Reports of patients taking dopaminergic medications (medications that increase central dopaminergic tone).suggest that patients may experience an intense urge to gamble.increased sexual urges.intense urges to spend money.binge eating.and/or other intense urges.and the inability to control these urges. In some cases.although not all.these urges were reported to have stopped when the dose was reduced or the medication was discontinued. Because patients may not recognize these behaviors as abnormal.it is important for prescribers to specifically ask patients or the caregivers about the development of new or increased gambling urges.sexual urges.uncontrolled spending or other urges while being treated with SINEMET. Physicians sinemet treatment consider dose reduction or stopping the medication if a patient develops such urges while taking SINEMET [see PATIENT INFORMATION ].
The early diagnosis of this condition is important for the appropriate management of these patients. Considering NMS as a possible diagnosis and ruling out other acute illnesses (e.g..pneumonia.systemic infection.etc.) is essential. This may be especially complex if the clinical presentation includes both serious medical illness and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). Other important considerations in the differential diagnosis include central anticholinergic toxicity.heat stroke.drug fever.and primary central nervous system (Sinemet treatment) pathology.
If general anesthesia is required.SINEMET may be continued as long as the patient is permitted to take fluids and medication by mouth. If therapy is interrupted temporarily.the patient should be observed for symptoms resembling NMS.and the usual daily dosage may be administered as soon as the patient is able to take oral medication.
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because patients may not recognize these behaviors as abnormal, it is important for prescribers to specifically ask patients or the caregivers about the development of new or increased gambling urges, sexual urges, uncontrolled spending or other urges while being treated with sinemet.