Patient/caregiver was educated on contraindications for using Sinemet as follows:
- Do not take sinemet with alcohol or opioid pain medications, such as, hydrocodone and codeine, as they can further contribute to the dizziness caused by the medication, thus compromising safety. A number of OTC cough medications, antihistamines, and antianxiety medications, also can cause drowsiness upon intake and must be avoided taking along with sinemet.
- Sinemet is a combination drug, a part of which is partially metabolized in the brain and nervous tissues and the other part is metabolized in the peripheral tissues. The unmetabolized portion of sinemet along with the metabolites is mainly excreted in the urine. Individuals with renal disease cannot excrete the drug and metabolites normally, which allows them to stay in blood circulation for longer time, resulting in toxicity and consequent side-effects. So, sinemet must be used with caution in individuals with compromised renal function, with possible multiple dose adjustments, periodical monitoring for renal functions, and close watch for development of any dangerous side-effects and toxicity symptoms.
