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In some patients the onset of effect of the first morning dose may be delayed for up to one hour compared with the response usually obtained from the first morning dose of sinemet .
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pSINEMET is used to treat some of the symptoms of Parkinson’s diseaseThis is a disease of the nervous system that mainly affects body movementThe three main symptoms are shakingtremormuscle stiffness and slow and unsteady movementPeople with Parkinson’s disease often walk with a shuffle as they have difficulty in initiating movementIf untreatedParkinson’s disease can cause difficulty in performing normal daily activities./ppFor patients receiving MAO inhibitorsType A or Bsee CONTRAINDICATIONSConcomitant therapy with selegiline and carbidopa levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa levodopa alonesee CONTRAINDICATIONS/ppCurrent evidence indicates that symptoms of Parkinson’s disease are related to depletion of dopamine in the corpus striatumAdministration of dopamine is ineffective in the treatment of Parkinson’s disease apparently because it does not cross the blood-brain barrierHoweverlevodopathe metabolic precursor of dopaminedoes cross the blood-brain barrierand presumably is converted to dopamine in the brainThis is thought to be the mechanism whereby levodopa relieves symptoms of Parkinson’s disease./ppWhen levodopa is administered orallyit is rapidly decarboxylated to dopamine in extracerebral tissues so that only a small portion of a given dose is transported unchanged to the central nervous systemFor this reasonlarge doses of levodopa are required for adequate therapeutic effectand these may often be accompanied by nausea and other adverse reactionssome of which are attributable to dopamine formed in extracerebral tissues./ppThe most common adverse reactions reported with SINEMET have included dyskinesiassuch as choreiformdystonicand other involuntary movementsand nausea./p

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