Patient leaflet - Carbidopa/levodopa 25 mg/250 mg tablets
1. What Carbidopa/Levodopa tablets is and what it is used for
Carbidopa/Levodopa tablets improve the signs of Parkinson’s disease. Parkinson’s disease is a long-term illness where:
- you become slow and unsteady
- your muscles feel stiff
- you may develop shaking or trembling (called ‘tremor’).
If not treated, Parkinson’s disease can make it hard for you to continue your normal daily activities.
Carbidopa/Levodopa tablets contains two different medicines called: levodopa and carbidopa.
levodopa turns into a material called ‘dopamine’ in your brain. The dopamine helps to
improve the signs of your Parkinson’s disease.
carbidopa belongs to a group of medicines called ‘aromatic amino acid decarboxylase
inhibitors’. It helps levodopa work more effectively by slowing the speed at which levodopa is broken down in your body.
2. What you need to know before you take Carbidopa/Levodopa tablets
Do not take Carbidopa/Levodopa tablets
if you are allergic to carbidopa or levodopa or any of the other ingredients of this
medicine (listed in section 6)
if you have ever had skin cancer or you have any unusual moles which have not been
examined by your doctor
if you are taking certain medicines called ‘MAOIs’ (Monoamine Oxidase Inhibitors) used
for depression. You need to stop using these medicines at least two weeks before you start Carbidopa/Levodopa tablets (see also under ‘Other medicines and Carbidopa/ Levodopa tablets’ below)
if you have a condition called ‘narrow-angle glaucoma’ that may cause a sudden build up
of pressure in the eye
- if you have a severe mental disorder
- if you are pregnant, might become pregnant, or are breast-feeding.
Do not take Carbidopa/Levodopa tablets if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Carbidopa/Levodopa tablets.
Warning and precautions
Talk to your doctor, pharmacist or nurse before taking Carbidopa/Levodopa tablets: • if you have a history of fits (convulsions)
if you have had an ulcer in your gut (called ‘duodenal’ or ‘peptic ulcer’) or have vomited
blood
- if you have had a heart attack, heart beat problems, circulation or breathing problems • if you have had kidney, liver or hormonal problems
- if you have had depression or other mental problems
if you have a condition called ‘chronic wide-angle glaucoma’ that may cause a build up of
pressure in the eye. You will need to have regular checks on the pressure in your eye • if you sometimes have sudden sleep attacks or sometimes feel very sleepy • if you are due to have surgery.
Treatment with high doses of carbidopa/levodopa may lead to low levels of vitamin B6, which can increase the risk of seizures. If you are receiving high doses of this medicine, your doctor may perform blood tests to check your vitamin B6 levels. Tell your doctor if you experience signs of low levels of vitamin B6, such as pale skin, weakness or breathlessness (anemia), nerve pain or tingling in the hands and feet (polyneuropathy), or seizures.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Carbidopa/Levodopa tablets.
Tell your doctor if you or your family/carer notices you are developing addiction-like symptoms leading to craving for large doses of Carbidopa/Levodopa tablets and other medicines used to treat Parkinson’s disease.
Tell your doctor if you or your family/carer notices you are developing urges or cravings to behave in ways that are unusual for you, or you cannot resist the impulse, drive or temptation to carry out certain activities that could harm yourself or others. These behaviours are called impulse control disorders and can include addictive gambling, excessive eating or spending, an abnormally high sex drive or an increase in sexual thoughts or feelings. Your doctor may need to review your treatments.
Other medicines and Carbidopa/Levodopa tablets
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. This includes herbal medicines. This is because Carbidopa/Levodopa tablets can affect the way some other medicines work. Also, some other medicines can affect the way Carbidopa/Levodopa tablets work.
Package leaflet: Information for the user
Carbidopa/Levodopa 10 mg/100 mg tablets
Carbidopa/Levodopa 12.5 mg/50 mg tablets
Carbidopa/Levodopa 25 mg/100 mg tablets
Carbidopa/Levodopa 25 mg/250 mg tablets
carbidopa/levodopa
In particular tell your doctor or pharmacist if you are taking any of the following medicines: • Medicines for Parkinson’s disease containing levodopa:
- If they are ‘slow release’, you will need to wait 24 hours after your last dose before starting Carbidopa/Levodopa tablets.
- If they are ‘normal release’, you will need to wait 12 hours after your last dose before starting Carbidopa/Levodopa tablets.
- Tell the doctor or pharmacist even if you have only taken them in the past.
Medicines for Parkinson’s disease which do not contain levodopa will usually be continued. However, your dose may be changed.
- Medicines for mental problems (including depression), tuberculosis (TB), high blood pressure, muscle spasms, epilepsy or other diseases related to involuntary movements. Your dose may need to be changed.
- Medicines to treat low iron. Your dose may need to be changed.
- Medicines called ‘MAOIs’ (see also ‘Do not take Carbidopa/Levodopa tablets’). • Anticholinergic medicines (such as orphenadrine, trihexyphenidyl, benzatropine and procyclidine). Your dose may need to be changed.
- Phenytoin which is used to treat fits (convulsions).
- Papaverine which is used to treat impotence in men.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking this medicine. Your doctor or pharmacist has a more complete list of medicines to avoid while taking Carbidopa/Levodopa tablets.
Tests while you are taking Carbidopa/Levodopa tablets
This medication can affect some laboratory tests that your doctor may perform on blood or urine samples. Please remind your doctor if you are taking Carbidopa/Levodopa tablets and are having any tests.
Carbidopa/Levodopa tablets with food and drink
Try to avoid taking your tablets with a heavy meal. If your diet contains too much protein (meat, eggs, milk, cheese) Carbidopa/Levodopa tablets may not work as well as it should.
Pregnancy and breast-feeding
Do not take Carbidopa/Levodopa tablets if you are pregnant, might become pregnant or are breastfeeding.
Levodopa, one of the substances in Carbidopa/Levodopa tablets, is passed into human milk. Ask your doctor or pharmacist for advice before taking any medicine, if you are pregnant or breast-feeding.
Driving and using machines
Carbidopa/Levodopa tablets affects different people in different ways. Some people have side effects which affect their ability to drive or use tools or machines (see section 4 Possible side effects). Do not drive or use tools or machines if you get these effects. • Carbidopa/Levodopa tablets can also make you sleepy or cause ‘sudden sleep attacks’.
If this happens to you, you must not drive or use tools or machines. Your doctor will tell you if you can start driving again if these attacks stop.
3. How to take Carbidopa/Levodopa tablets
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Taking this medicine
- If the tablet breaks when you remove it from the blister pack, make sure you have all of the tablet pieces (the full dose). If you do not have all the pieces of a broken tablet, throw away the pieces and take another tablet from the blister pack.
- Taking only part of a tablet (a partial dose) may cause symptoms to get worse. • Take this medicine by mouth.
- Although your medicine can have an effect after one day, it may take up to seven days to work.
Take them at regular time intervals according to your doctor’s instructions. • Do not change the times at which you take your tablets or take any other medicines for
Parkinson’s disease without first consulting your doctor.
- Try to avoid taking your tablets with a heavy meal.
If you have not had levodopa before
The recommended dose is:
- for Carbidopa/Levodopa 12.5 mg/50 mg Tablets is one tablet three or four times a day. • for Carbidopa/Levodopa 25 mg/100 mg tablets: one tablet three times a day. • for Carbidopa/Levodopa 10 mg/100 mg Tablets: one tablet three or four times a day.
If you have had levodopa before
Your doctor will ask you to stop taking your medicine for Parkinson’s disease before you start taking Carbidopa/Levodopa tablets.
The recommended dose is:
for Carbidopa/Levodopa 25 mg/100 mg Tablets and Carbidopa/Levodopa 25 mg/250 mg
Tablets: one tablet three or four times a day.
- for Carbidopa/Levodopa 10 mg/100 mg and Carbidopa/Levodopa 12.5 mg/50 mg Tablets it will depend on what you were taking before.
More than one Carbidopa/Levodopa tablets product may be prescribed by your doctor. If you have been given different Carbidopa/Levodopa tablets to take, make sure that you are taking the correct one at the right time.
Use in children and adolescents
Carbidopa/Levodopa tablets are not suitable for children under the age of 18 years.
If you take more Carbidopa/Levodopa tablets than you should
If you take too many tablets, see your doctor immediately. If you forget to take Carbidopa/ Levodopa tablets Do not take a double dose to make up for a forgotten dose.
If you stop taking Carbidopa/Levodopa tablets
Do not stop taking Carbidopa/Levodopa tablets or change your dose without talking to your doctor first. When you stop taking Carbidopa/Levodopa tablets the following can occur: stiff muscles, high temperature (fever) and mental changes.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Stop taking Carbidopa/Levodopa tablets and see your doctor straight away, if you notice any of the following side effects:
allergic reaction, the signs may include hives (nettle rash), itching, rash, swelling of your
face, lips, tongue or throat. This may cause difficulty in breathing or swallowing
- chest pain
- uneven (irregular) heartbeat or palpitations
- dizziness on standing-up quickly
bleeding from your gut which may be seen as blood in your faeces or darkened faeces
(gastro-intestinal bleeding)
blood problems, the signs may include pale skin (pallor), tiredness, fever, sore throat or
mild bruising and prolonged bleeding after injury
- stiff muscles, high fever
- mental changes including delusions, hallucinations and depression
- fits (convulsions).
The most common side effects are
abnormal movements such as twitching or spasms (which may or may not be like your
Parkinson’s symptoms)
- nausea
- urinary tract infections (frequency: very common).
- Having too little vitamin B6 (frequency: common).
Other side effects include:
- fainting, anorexia, high blood pressure
inflammation of the veins, being sick (vomiting), diarrhoea, discoloration of urine, sweat
or saliva
on-off phenomenon, characteristic of some people with long-standing Parkinson’s
disease. This is when you can have unpredictable changes from being mobile - “on” - to a sudden inability to move - “off”. “Off” to “on” can occur just as suddenly
dizziness; sleepiness (including excessive drowsiness or sudden sleep onset episodes),
pins and needles
- dream abnormalities, confusion, feeling agitated, shortness of breath, hair loss.
You may experience the following side effects:
Craving for large doses of Carbidopa/Levodopa tablets in excess of that required to
control motor symptoms, known as dopamine dysregulation syndrome. Some patients experience severe abnormal involuntary movements (dyskinesias), mood swings or other side effects after taking large doses of Carbidopa/Levodopa tablets.
inability to resist the impulse to perform an action that could be harmful, which may
include:
o strong impulse to gamble excessively despite serious personal or family
consequences
o altered or increased sexual interest and behaviour of significant concern to you or to
others, for example, an increased sexual drive o uncontrollable excessive shopping or spending
o binge eating (eating large amounts of food in a short time period) or compulsive
eating (eating more food than normal and more than is needed to satisfy your hunger).
Tell your doctor if you experience any of these behaviours; he/she will discuss ways of managing or reducing the symptoms. Side effects that have been reported with medicines containing levodopa.
These may be experienced when taking Carbidopa/Levodopa tablets. Nervous system:
- loss of control over the voluntary movements of everyday life
numbness, increased hand tremor, muscle twitching, muscle cramp, irregular movement
of jaw muscles resulting in difficulty opening the mouth
- difficulty sleeping, feeling anxious or high, falling over and abnormal walking patterns
- headache
Eyes:
- drooping eyelid and dilated pupil
- changes in vision, irregular movement of the eye
Digestive system:
- indigestion, dry mouth, bitter taste
- swelling of the salivary glands, difficulty swallowing, grinding of the teeth
- hiccups, abdominal pain and distress, constipation, wind
- burning sensation of the tongue.
Sexual:
- persistent abnormal erection of the penis
Urinary:
- difficulty passing urine or incontinence (inability to control urine flow)
Skin:
changed patches of pigmented skin, including, irritated or irregular moles, or moles in
which you have noticed changes (melanoma)
General:
- weight gain or loss, swelling in the limbs
- flushing, hot flushes, increased sweating
- feeling weak, faint or tired
- hoarseness, general feeling of being unwell
- increased energy or activity, unusual breathing pattern
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Carbidopa/Levodopa tablets
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. The expiry date refers to the last day of that month.
This medicine does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Carbidopa/Levodopa tablets contains
The active substance is Carbidopa and Levodopa
Each 10 mg/100 mg tablet contains 10.8 mg carbidopa monohydrate (equivalent to
10 mg carbidopa) and 100 mg levodopa.
Each 12.5 mg/50 mg tablet contains 13.5 mg carbidopa monohydrate (equivalent to
12.5 mg carbidopa) and 50 mg levodopa.
Each 25 mg/100 mg tablet contains 27 mg carbidopa monohydrate (equivalent to 25 mg carbidopa) and 100 mg levodopa.
Each 25 mg/250 mg tablet contains 27 mg carbidopa monohydrate (equivalent to 25 mg carbidopa) and 250 mg levodopa.
The other ingredients are: Cellulose, microcrystalline (Grade-101), starch, pregelatinised
(maize starch), crospovidone (type B), FD&C blue No.2 aluminium lake (E 132) (Carbidopa/Levodopa 10mg/100mg tablets & Carbidopa/Levodopa 25mg/250mg tablets), quinoline yellow lake (E 104) (Carbidopa/Levodopa 12.5mg/50mg tablets & Carbidopa/ Levodopa 25mg/100mg tablets), hydroxypropyl cellulose (100 cps), magnesium stearate.
What Carbidopa/Levodopa tablets looks like and contents of the pack
Carbidopa/Levodopa tablets 10 mg/100 mg tablets:
Blue to light blue, round shaped, approximately 8 mm, uncoated scored tablets debossed with ‘CA’ and ‘10’ separated by score line on one side and ‘LT 100’on the other side. The tablet can be divided into equal doses.
Carbidopa/Levodopa tablets 12.5 mg/50 mg tablets
Yellow to light yellow, oval shaped, approximately 9 × 4.5 mm, uncoated scored tablets debossed with ‘CA’ and ‘12.5’ separated by score line on one side and ‘LT 50’ on the other side. The tablet can be divided into equal doses.
Carbidopa/Levodopa tablets 25 mg/100 mg tablets
Yellow to light yellow, round shaped, approximately 8 mm, uncoated scored tablets debossed with ‘CA’ and ‘25’ separated by score line on one side and ‘LT 100’on the other side. The tablet can be divided into equal doses.
Carbidopa/Levodopa tablets 25 mg/250 mg tablets
Blue to light blue, round shaped, approximately 10.35 mm, uncoated scored tablets debossed with ‘CA’ and ‘25’ separated by score line on one side and ‘LT 250’on the other side. The tablet can be divided into equal doses.
Carbidopa/Levodopa tablets are available in blister and HDPE bottle packs.
Pack sizes:
Carbidopa/Levodopa tablets 10 mg/100 mg tablets
Blister packs: 100 tablets.
HDPE packs: 50, 100, 250 and 500 tablets.
Carbidopa/Levodopa tablets 12.5 mg/50 mg tablets
Blister packs: 90 tablets.
HDPE packs: 50, 100, 250 and 500 tablets.
Carbidopa/Levodopa tablets 25 mg/100 mg tablets
Blister packs: 100 tablets.
HDPE packs: 50, 100, 250 and 500 tablets.
Carbidopa/Levodopa tablets 25 mg/250 mg tablets
Blister packs: 100 tablets.
HDPE packs: 50, 100, 250 and 500 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder:
Milpharm Limited
1 Roundwood Avenue
Stockley Park, Uxbridge
UB11 1AF
United Kingdom
Manufacturer:
Milpharm Limited
1 Roundwood Avenue
Stockley Park, Uxbridge
UB11 1AF
United Kingdom
Or
APL Swift Services (Malta) Limited
HF26, Hal Far Industrial Estate, Hal Far,
Birzebbugia, BBG 3000, Malta
Or
Generis Farmaceutica, S.A.,
Rua Joao De Deus, N 19, Venda Nova,
Amadora, 2700-487, Portugal
This leaflet was last revised 10/2026.
Ref Ver: 1.0