Drug Information
Levodopa is required by the brain to produce dopamine, an important neurotransmitter. People with Parkinson’s disease have depleted levels of dopamine, leading to debilitating symptoms. Levodopa is given to increase production of dopamine, which in turn reduces the symptoms of Parkinson’s disease. When taken by mouth, most levodopa is broken down by the body before it reaches the brain. Sinemet® combines levodopa with carbidopa, a drug that prevents the breakdown, allowing levodopa to reach the brain to increase dopamine levels.
Common brand names:
Parcopa, Sinemet, Sinemet CR
Summary of Interactions with Vitamins, Herbs, & Foods
Types of interactions:
Beneficial
Adverse
Check
Replenish Depleted Nutrients
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Vitamin B6
Test tube, animal, and preliminary human studies suggest that carbidopa may cause depletion of vitamin B6. However, the use of carbidopa with levodopa reduces the vitamin B6-depleting effects of levodopa. More research is needed to determine whether vitamin B6 supplementation is advisable when taking carbidopa.
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Vitamin B3 (Niacin)
A study in animals has found that carbidopa inhibits an enzyme involved in the synthesis of niacin in the body. In addition, there is evidence that niacin synthesis is decreased in people taking carbidopa and other drugs in its class, raising the concern that people taking these drugs could be at risk of niacin deficiency, even if not frankly deficient. Further studies will be required determine if niacin supplementation is appropriate in people taking carbidopa.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Support Medicine
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Vitamin C
A combination of and vitamin C may be useful for people with Parkinson’s disease whose motor complications are not effectively managed with conventional drug treatment. This combination was administered to people with Parkinson’s disease for 16.8 months in an unblinded, uncontrolled study. The researchers reported that participants who completed the study experienced substantial increases in the number of hours with good functional capacity and were able to reduce their intake of other anti-Parkinsonian drugs. However, 62% of the participants withdrew from the study, citing difficulty in performing voluntary movements as the main reason. Until more research is performed, this drug-nutrient combination must be viewed as preliminary.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Reduces Effectiveness
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Iron
Iron supplements taken with carbidopa may interfere with the action of the drug.
Potential Negative Interaction
Explanation Required
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5-HTP
5-HTP and carbidopa have been reported to improve intention myoclonus (a neuromuscular disorder) in some human cases but not others. Several cases of scleroderma-like illness have been reported in patients using carbidopa and 5-HTP for intention myoclonus.
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Vitamin B6
Vitamin B6 supplementation above 5–10 mg per day reduces the effectiveness of levodopa. However, combining levodopa with carbidopa prevents this adverse effect, so vitamin B6 supplements may safely be taken with Sinemet® (carbidopa/levodopa).
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
