Co-beneldopa should be used with caution in:
- People who have or have had stomach ulcers
- People with severe lung disease
- People with soft bone disease (osteomalacia)
- People with endocrine disorders such as overactive thyroid gland, diabetes or adrenal tumour (phaeochromocytoma)
- People with epilepsy (fits) or history of convulsions
- People with mental health problems (avoid use if severe)
- People with an eye condition due to increased pressure in the eye (open angle glaucoma) or at risk of angle closure glaucoma
- People with kidney or liver problems
- People with heart problems such as heart attack or abnormal heart rhythm
- People taking certain medications including those which lower the blood pressure (see interactions)
It should not be used in:
- People with known hypersensitivity to levodopa or benserazide or any of the other ingredients in the medication
- People with severe mental health problems
- People with severe kidney or liver problems
- People with severe heart problems
- People who have or have had skin cancer (malignant melanoma)
- People with an eye condition due to increased pressure in the eye causing blurred vision and pain (narrow angle or closed angle glaucoma)
- Pregnant women or those trying to become pregnant
- Women breast feeding
- Adults under 25 years old
- People taking or within 2 weeks of stopping treatment with, monoamine oxidase (MAO) non-selective inhibitors used to treat depression such as isocarboxazid or phenelzine
Also see list of precautions and interactions
Do not store above 25°C.
Store in the original package.
Keep bottle tightly closed
What is it used for?
- Co-beneldopa is a dopamine replacement therapy used to treat Parkinson's disease.
- It is a dopaminergic drug.
- It is used to treat Parkinson's disease. Co-beneldopa contains levodopa and benserazide (in a 4 to 1 ratio). People with Parkinson’s disease do not have enough dopamine in certain areas of their brain, which can result in slow movements, stiff muscles and tremor. Levodopa, one of the medicines in co-beneldopa, converts to dopamine, the active substance needed in the brain of people with Parkinson’s disease. Benserazide (a decarboxylase inhibitor) is combined with levodopa to reduce some of the side effects of levodopa in the rest of the body as it allows more of the levodopa to get into the brain.
- In general this drug is used to treat people with Parkinson's disease.
- Benefits of being on this drug can include an improvement in the symptoms of Parkinson's disease: slow movements, stiff muscles and tremor.
Listed below are the typical uses of Co-beneldopa.
- Parkinson's disease (but not drug induced extrapyramidal Parkinsonism-like symptoms)
- Parkinson's disease with on-off phenomenon; sudden stops and starts in your ability to move (controlled release tablets)
On occasion your doctor may prescribe this medicine to treat a condition not on the above list.
HOW TO USE/TAKE
Co-beneldopa is available as oral capsules, controlled release oral capsules and oral dispersible tablets.
How often do I take it?
- Take this medication by mouth usually in divided daily doses, with or after food as directed by your doctor. Controlled release tablets must be swallowed whole, with or without food and must not be crushed or chewed.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- It may take up to a week before the full benefit of this drug takes effect.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- This medication can cause excessive drowsiness or sudden onset of sleep. Do not drive or operate machinery until you are sure that you are not affected. Consult your doctor or pharmacist for more details.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.
- You must not stop taking this medication abruptly as there is a risk of serious side effects if you do so. You may develop a condition known as neuroleptic malignant-like syndrome. Signs include increased shaking, high temperature, stiff muscles, balance problems, rapid heart rate and mental changes.
- Talk to your doctor immediately as this is a life threatening condition.
CO-BENELDOPA SIDE EFFECTS
- Abnormal involuntary body movements (e.g. of face, tongue, hands)
- Dry mouth
- Abnormal dreams
- Sleepiness (including sudden onset of sleep)
- Difficulty sleeping
- Loss of appetite
- Low blood pressure on changing position
- Rapid heart beat
- Irregular heart rhythm (arrhythmia)
- Excited / high or anxious feeling
- Increased sexual desire
- Becoming addicted to gambling
- Change of taste
- Change in the colour of your urine
- Intestinal bleeding
- On-off phenomenon- sudden stops and starts in your ability to move
- Changes in blood cell counts
If any of these persist or you consider them severe then inform doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms:
- Allergic reactions such as rash and itching (see also serious allergic reaction below)
- Changes in your heart beat
- Blood in your faeces (stools) or in your vomit when you are sick (this can look like ground coffee) as this may be due to bleeding in your stomach or intestines.
- An increase in the number of infections you are getting as this may be due to a reduction in the number of white blood cells
- You feel tired and look pale as this may be due to a reduction in the number of red blood cells
- You bruise more easily or get nose bleeds due to a reduction in the number of platelets in your blood.
- High fever alone or in combination with stiff muscles, change in mental state, rapid breathing and rapid heart rate as these may be signs of a serious, but rare condition known as neuroleptic malignant syndrome.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website
Before taking Co-beneldopa, tell your doctor or pharmacist if you are allergic to it; or to other dopaminergic drugs; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:
- Known hypersensitivity to levodopa or benserazide or any of the other ingredients in the medication
- An eye condition due to increased pressure in the eye causing blurred vision and pain (narrow angle or closed angle glaucoma)
- Severe mental health problems
- Severe kidney or liver problems
- Severe heart problems
- Or have had skin cancer (malignant melanoma)
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following Stomach ulcers
- Severe lung disease
- Soft bone disease (osteomalacia)
- Endocrine disorders such as severe overactive thyroid gland, diabetes or adrenal tumour (phaeochromocytoma)
- Epilepsy (fits) or history of convulsions
- Mental health problems (avoid use if severe)
- An eye condition due to increased pressure in the eye (open angle glaucoma) or at risk of angle closure glaucoma
- Kidney or liver problems
- Heart problems such as heart attack or abnormal heart rhythm
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- Alcohol is not known to affect co-beneldopa.
The elderly: co-beneldopa can be used in the elderly.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Co-beneldopa is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Co-beneldopa is not safe to take if you are breastfeeding.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:
- Monoamine oxidase (MAO) non-selective inhibitors used to treat depression such as isocarboxazid or phenelzine. These must not be used within 2 weeks of stopping treatment with co-beneldopa.
If you are currently using any of these medications, tell your doctor or pharmacist before starting co-beneldopa.
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Antacids used to treat indigestion
- Benzodiazepines used to treat sleeping troubles and anxiety, such as diazepam, nitrazepam and temazepam)
- Dexamfetamine and other amphetamines used to treat narcolepsy, a condition where you keep falling asleep
- General anaesthetics such as halothane
- Ferrous sulphate (iron) used to treat anaemia
- Isoniazid used to treat tuberculosis
- Medications used to lower blood pressure and/or treat angina and /or treat heart failure:
- ACE inhibitors such as captopril and enalapril
- Adrenergic neurone blockers such guanethidine
- Alpha blocker s such as doxazosin and prazosin (also used to treat enlarged prostate gland)
- Angiotensin-II receptor antagonists such as candesartan, irbesartan and losartan
- Beta blockers such as atenolol and propranolol for high blood pressure or heart problems (including eye drops)
- Dihydropyridine and calcium-channel blockers such as amlodipine, felodipine and nifedipine
- Diuretics (water tablets)
- Methyl dopa
- Nitrates such as glyceryl trinitrate or isosorbide dinitrate
- Vasodilators such as diazoxide, hydralazine, minoxidil and sodium nitroprusside
- Medications known as antipsychotics used to treat mental illness such as amisulpride, chlorpromazine, haloperidol, flupentixol and risperidone
- Metoclopramide used to treat nausea, vomiting, digestion problems and migraine.
- Moclobemide, a reversible MAO A inhibitor used to treat depression
- Other medications used to treat Parkinson’s disease such as anticholinergics (e.g. orphenadrine, procyclidine), dopamine agonists (e.g. lisuride, pergolide), selegiline (a MAO B inhibitor) and COMT inhibitors ( e.g. entacapone) or if you are already taking levodopa
- Phenytoin used to treat epilepsy
- Tetrabenazine used to treat irregular movements
This information does not contain all possible interactions. Therefore, before using co-beneldopa, tell your doctor or pharmacist of all the products you use.
Taking too much Co-beneldopa, may cause the following: changes in your heart beat, confusion, difficulty sleeping, feeling or being sick and unusual movements of different parts of the body that you cannot control.
People who have taken too much Co-beneldopa, should talk to a doctor or go to a hospital straight away. Take the medicine pack with you.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of Co-beneldopa or intentional overdose is suspected, contact your local hospital, GP or if in England call 111 or NHS Direct. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.