Sinemet 25 mg. 250 mg. 98 tablets

What is Sinemet and what is it used for?
Sinemet is a medicine that combines the aromatic amino acid carbidopa (a decarboxylase inhibitor) with levodopa (a metabolic precursor of dopamine). It is used to treat the symptoms of Parkinson's disease.
Why did my doctor prescribe Cinemet?
Your doctor has prescribed Cinemet to treat the symptoms of Parkinson's disease.
Parkinson's disease is a chronic disease characterized by slow and unstable movements, muscle stiffness and tremor. If left untreated, Parkinson's disease can make daily activities difficult.
How does Cinemet work in the treatment of Parkinson's disease?

Sinemet tablets contain two active ingredients, levodopa and carbidopa.
The symptoms of Parkinson's disease are thought to be due to a deficiency of dopamine, a chemical normally produced by a class of nerve cells. Dopamine transmits signals to those parts of the brain that control muscle movement. Thus, the reduced production of dopamine leads to difficulty in movement.
Levodopa restores the normal amount of dopamine in the brain, while carbidopa ensures the delivery of the required amount of levodopa where needed. In many patients, this leads to a reduction in the symptoms of Parkinson's disease.

2. What you need to know before you take Sinemet

Do not take Sinemet:
• if you are allergic to the active substances or to any of the other ingredients of this medicine (listed in section 6).
• if you have suspicious skin changes (moles) that have not been seen by a doctor or if you have had skin cancer
• if you have been treated for depression with MAO inhibitors
• if you have narrow-angle glaucoma

Warnings and precautions
Tell your doctor if you or your family / carer notice that you develop an urge or overwhelming desire to behave in ways that are unusual for you or that you cannot resist the impulse, desire or temptation to perform any activities that could You or others hurt you. These behaviors are called impulse control disorders and may include gambling addiction, overeating, or excessive shopping, unusually strong sexual urges, or increased sexual thoughts or feelings. Your doctor may need to review your treatment.
Tell your doctor if you have or have had any health problems: allergies, depression or mental disorders, lung, kidney, liver, heart or hormonal diseases, ulcers, seizures or glaucoma.
Tell your doctor if you have been treated with levodopa.

Children and adolescents
The safety and efficacy of Sinemet in infants and children have not been established. Its use in patients under 18 years of age is not recommended.

Other medicines and Sinemet
Although Cinemet can be given with other medicines, there are exceptions. Your doctor may warn you of incompatibilities with some medicines used to treat mental illness and depression, iron and iron supplements, tuberculosis, high blood pressure, muscle spasms and seizures.
Your doctor or pharmacist has more detailed information about the medicines you should avoid during treatment with Cinemet. Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription.

Pregnancy, lactation and fertility
Pregnancy
It is not clear exactly what effect Cinemet can have on pregnancy. If you are pregnant or planning to become pregnant, tell your doctor before starting treatment with Cinemet. He will evaluate the benefit of the medicine against the possible risk.
Breastfeeding
Levodopa, one of the ingredients in Cinemet, passes into breast milk. If you are breast-feeding, tell your doctor to start treatment with Cinemet. He will evaluate the benefit of the medicinal product against the possible risk.

Driving and using machines
Be especially careful when driving or using machines during treatment with Cinemet. If you experience increased drowsiness or even sudden episodes of falling asleep, refrain from driving or using machines and contact your doctor. The individual response to the medicinal product may vary. Some side effects that have been reported with Sinemet may affect the ability of some patients to drive or use machines. (See Possible side effects)
Cinnamon can cause drowsiness and sudden episodes of falling asleep. Therefore, avoid driving or engaging in activities in which reduced attention may expose you or others to risk of injury or death (such as working with machines) until such recurring episodes and drowsiness are controlled.

3. How to take Sinemet?
Always take this medicine exactly as your doctor has told you. If you are not sure, talk to your doctor or pharmacist.
The dosage
The dosage of Cinemet may be different and the doctor will determine it depending on the stage of the disease and your tolerance to treatment.
For best results, take Cinemet every day. It is very important that you follow your doctor's recommendations about when and how much to take.
Tell your doctor in good time about any changes in your condition, especially if you have nausea or unusual movements, as this may require changes in your treatment.
Do not stop taking this medicine suddenly unless your doctor tells you to.

If you take more Cinemet than you should
If you take too many tablets, contact your doctor immediately to get qualified medical attention in a timely manner.

If you forget to take Cinemet
Try to take Cinemet as prescribed by your doctor. However, if you miss a tablet, take it as soon as you remember. Do not take a double dose to make up for a forgotten dose. If it is almost time to take the next tablet, do not take the missed one, but continue on the normal schedule as usual.

If you stop taking Cinemet
Do not stop treatment with Cinemet and do not reduce the dose without consulting your doctor. This can lead to muscle stiffness, fever and mental changes.

4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

Serious side effects
Common side effects (may affect more than 1 in 10 people)
• Depression, in severe cases with suicidal thoughts.
Rare side effects (may affect up to 1 in 1,000 people)
• Illness due to a lack of white blood cells (leukopenia and agranulocytosis), which can cause general weakness, a tendency to inflammation or infection, especially sore throat and fever.
• Uneven pulse.
• Severe illness due to low red blood cell count (anemia), which can cause fatigue, headaches, shortness of breath, dizziness, paleness and sometimes yellowing of the skin and eyes. Contact your doctor immediately.
• Bleeding from the skin and mucous membranes and bruising due to changes in the blood (too few platelets).
• Fever, muscle stiffness, heavy sweating (neuroleptic malignant syndrome).
• Vomiting with blood and / or black stools due to bleeding in the stomach or intestines.
• Ulcer in the upper stomach with pain.
• Swelling of the face, lips and tongue, which may cause airway obstruction.
• Spontaneous bleeding from the skin and / or mucous membranes, joint pain and swelling, often with severe stomach pain and bleeding (Enoch-Schonlein purpura),
• Psychotic disorders with delusions (crazy thoughts) and paranoia (obsession).
Not known (cannot be estimated from the available data)
•    Skin cancer. Contact your doctor immediately if new scars appear or birthmarks increase or change in any way.
• Eye muscle spasms with staring upward gaze.
• Prolonged, painful erection.
Minor side effects
Very common side effects (may affect more than 1 in 10 people)
• Involuntary and unintentional movements, manifesting as throwing, throwing and sudden twitching movements.
Common to very common side effects (may affect up to 1 in 10 people or more than 1 in 10 people)
• Heartbeat.
Common side effects (may affect up to 1 in 10 people)
• Unusual fatigue and drowsiness. Very rarely extreme drowsiness during the day and sudden falling asleep during daily duties. They can be or become serious. Consult your doctor.
• Hallucinations. They can be serious.
• Difficulty breathing. In some people, it can become a serious side effect. Consult your doctor.
• Dizziness. If your blood pressure is too low, you may experience dizziness and possible loss of consciousness when changing body position from lying to sitting or from sitting to standing.
• Alternating periods of over-expressed movements with complete stiffness.
• Feeling of burning, tingling or numbness of the skin.
• Vomiting, diarrhea, nausea, loss of appetite.
• Chest pain.
• Unusual dreams.
• Confusion.
Uncommon side effects (may affect up to 1 in 100 people)
•    Muscle spasms. Contact your doctor. Your doctor may change the dose.
• Fainting.
• Hives.
• Anxiety and excitement.
Rare side effects (may affect up to 1 in 1,000 people)
• Inflammation of a vein with pain and swelling along the vein. In some people, it can become a serious side effect.
•    High blood pressure. Talk to your doctor. High blood pressure requires treatment. Too high blood pressure is a serious condition.
• Weakening of memory.
• Dark saliva, dark urine.
Anxiety, disorientation, euphoria.
• Insomnia.
• Gritting teeth.
You may experience the following side effects:
• inability to resist the impulse to perform an action that could be harmful and may include:
- a strong impulse to over-gamble, despite serious personal or family consequences
- altered or increased sexual interest and behavior that is troubling to you or others, such as increased sexual desire, uncontrollable excessive shopping or spending, overeating (eating large amounts of food for a short period of time) or an irresistible tendency to eat (consuming more than the normal amount of food and more than necessary to satisfy hunger)
If you notice any of these behaviors, tell your doctor; he will consider ways to reduce or deal with the symptoms.
In addition, Cinnamet may cause side effects that you would not normally experience. These are changes in some laboratory results, e.g. indicators of liver function, kidney function, elevated blood glucose.
Your doctor or pharmacist has a complete list of side effects. Some of them can be serious. If you experience unusual symptoms, tell your doctor or seek medical help immediately.
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet.

5. How to store Cinemet?
Keep out of reach of children.
Do not use this medicine after the expiry date which is stated on the carton after EXP. The first two digits indicate the month and the last two digits indicate the year.
This medicinal product does not require any special storage conditions. Store Cinemet in the original package and keep the package tightly closed.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. Contents of the package and additional information

What does Cinemet contain?
- The active substances are: carbidopa and levodopa
- The other ingredients are: hydroxypropylcellulose, microcrystalline cellulose, magnesium stearate, crospovidone, pregelatinised starch and the colorant indigo carmine AL (E 132).
1 Cinemet 25 mg / 250 mg tablet contains 25 mg carbidopa and 250 mg levodopa

What Cinemet looks like and contents of the pack

Cinnamet is supplied as 25 mg / 250 mg tablets in a pack of 98 tablets.

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