Levodopa + Benserazide - Oral

Levodopa and Benserazide are combined in this medicine.

Levodopa + Benserazide is used to treat Parkinson's disease, a disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking.

This medicine does not cure Parkinson's disease, but it can improve the quality of life for people who have the disease.

Take Levodopa + Benserazide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food. However, it is best taken on an empty stomach, at least 30 minutes before or 1 hour after meals, whenever possible.

Stomach discomfort, such as nausea or vomiting, may occur in the early stages of treatment. If you experience stomach discomfort, take this medicine with low-protein food or a non-alcoholic drink.

Try to take this medicine at the same time each day.

Levodopa + Benserazide is available as a conventional capsule, conventional tablet, dispersible tablet and modified-release capsule.

If you are taking the conventional capsule or tablet, swallow the capsule or tablet whole with a glass of water.

If you are taking a dispersible tablet, disperse the tablet in 25 mL of water or diluted orange squash. Do not use orange juice. Drink the mixture within 30 minutes of dispersion and stir well immediately before drinking.

If you are taking the modified-release type of capsule (usually labelled as "HBS" or "CR"), swallow it whole. Do not open or crush the capsule.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your response to the medication.

Levodopa + Benserazide must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• serious problems in the hormones, lungs, blood, or bone marrow
• serious heart problems e.g. severely rapid or irregular heartbeat
• angle-closure glaucoma (increased pressure in the eye)
• unusual or unexplained skin spots, or if you have a history of skin cancer
• serious liver problems
• serious kidney problems

as Levodopa + Benserazide may not be suitable for you.

Do not take this medicine if you are less than 25 years of age.

Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while on Levodopa + Benserazide therapy, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods during Levodopa + Benserazide therapy.

Do not take Levodopa + Benserazide if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor if you have the following conditions:

• heart disease e.g. recent heart attack
• history of orthostatic hypotension (a sudden fall in blood pressure when standing up from a sitting or lying down position)
• peptic ulcer (open sores in the lining of the stomach, small intestine, or lower food pipe)
• fits or seizures
• history of mental illness e.g. depression
• osteomalacia (softening of the bones)
• diabetes
• kidney disease
• liver disease

Let your doctor know if you are breastfeeding.

Be sure to check with your doctor or pharmacist before giving Levodopa + Benserazide to the elderly. Elderly people may be more sensitive to the side effects.

If you are going to have an operation, including minor surgery and dental work, tell your doctor that you are taking this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver and kidney function, blood sugar levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
• Regular monitoring for changes in mood, thinking, or behaviour may also be needed.

Levodopa + Benserazide may cause you to suddenly fall asleep during your daily activities such as eating and watching television. Do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Your urine may look slightly darker in colour. This is normal while you are being treated with Levodopa + Benserazide. It may also cause your teeth, tongue, saliva and sweat to change to darker in colour. This is harmless, do not be alarmed.

Other side effects include any of the following: headache, dry mouth, loss of appetite, changes in taste, nausea, vomiting, diarrhoea and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes or mouth
• irregular or abnormal heartbeat
• very high fever, muscle cramps or stiffness, severe headache, excessive sweating
• unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
• strong or uncontrollable urges e.g. excessive eating, gambling, abnormally high sex drive
• new or worsening difficulty in controlling movements, twitching and jerking
• changes in eyesight, eye pain or severe irritation

This medicine may cause the level of your red blood cells, white blood cells, and platelets to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Levodopa + Benserazide if you are currently taking or have taken medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for Parkinson's disease e.g. amantadine, selegiline, ropinirole
• medicines for nausea and vomiting e.g. metoclopramide, domperidone
• strong painkillers e.g. morphine
• medicines for high blood pressure e.g. reserpine
• medicines for mood disorder e.g. chlorpromazine, haloperidol
• vitamins or supplements containing iron

This list does not include all medicines that may interact with Levodopa + Benserazide.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Avoid taking Levodopa + Benserazide together with protein-rich foods.

Ask your doctor or dietitian about the type of foods you need to avoid.

Store in a cool, dry place away from the reach of children.

Protect from light.

Medicines must not be used past the expiry date.