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Carbidopa keeps levodopa from breaking down in the body so more reaches the brain; it is sold only in combination tablets for Parkinson's disease, 10/100mg to 50/200mg, plus one entacapone option.
Carbidopa, Levodopa
10/100/25/100/25/250/50/200mg
Carbidopa and levodopa tablets for Parkinson's disease, taken three or four times a day, in 10/100mg, 25/100mg, 25/250mg and 50/200mg strengths with packs of 30 to 360 tablets.
Carbidopa does nothing for tremor, stiffness or slow movement on its own; its whole job is to protect the levodopa beside it. The brain turns levodopa into dopamine, the messenger that runs short in Parkinson's disease. Swallowed alone, much of each dose is destroyed in the gut and bloodstream by an enzyme, dopa-decarboxylase, before any of it can cross into the brain. Carbidopa shuts that enzyme down outside the brain, so more levodopa arrives where it is needed, a lower dose will do, and the sickness levodopa brings is usually milder. Symptoms improve; the disease itself is not cured. Improvement comes gradually, and the response may keep building for a few months.
Every carbidopa product here also contains levodopa. Carbidopa + Levodopa tablets come in the widest range: 10/100mg, 25/100mg, 25/250mg and 50/200mg. Sinemet tablets hold the same two ingredients at 10/100mg, 25/100mg and 25/250mg, under a different brand name. Stalevo pairs them with a third ingredient, entacapone, in a single strength of 25/100/200mg. Entacapone blocks a different enzyme, one that clears levodopa from the body, which can stretch out how long a dose keeps working.
Many people notice a calmer stomach within the first few days. Doses are spaced across the day, three or four of them at steady times, and a rich, fatty meal can blunt the one it goes with. The thing to avoid is stopping suddenly: fever, muscle rigidity and confusion arriving together is a reaction that needs urgent treatment. Keep the tablets in their original pack, away from strong heat.
Nausea, a poor appetite and dizziness are common at the start and usually ease off. Sweat and urine can turn a darker colour, which is harmless. Over months of treatment, some people develop dyskinesia — twitching or writhing they cannot control — while others become confused, see or hear things that are not there, or have vivid dreams. Light-headedness when standing up and sudden sleepiness during the day can also occur. Swelling around the mouth or throat that makes breathing difficult needs emergency care.
A non-selective monoamine oxidase inhibitor such as phenelzine or tranylcypromine is one to keep well away from, and the danger lasts a fortnight after it is stopped. Iron supplements, very protein-rich meals and dopamine-blocking medicines — many antipsychotics, and the anti-sickness drug metoclopramide — all work against levodopa. Medicines for high blood pressure can make the drop in pressure on standing more pronounced.
Carbidopa can be ordered online from PockDose with delivery to Hong Kong. The range is Carbidopa + Levodopa tablets in 10/100mg, 25/100mg, 25/250mg and 50/200mg, generic Sinemet in 10/100mg, 25/100mg and 25/250mg, and generic Stalevo in 25/100/200mg, which adds entacapone. You can pay with Visa, Mastercard or American Express on a secure, encrypted page, or use Bitcoin or Ethereum.
Prices vary between the three carbidopa products and between pack sizes. Every product page lists its current prices in HKD or in the currency you choose.
PockDose does not ask you to upload a prescription when you order carbidopa. See the ordering FAQ for details.
The first figure is carbidopa and the second is levodopa, both in milligrams. Sinemet 25/100mg and Carbidopa + Levodopa 50/200mg hold the same one-to-four ratio, while 10/100mg and 25/250mg use one part carbidopa to ten of levodopa. A higher-strength tablet usually means fewer tablets per dose.
Stalevo pairs carbidopa and levodopa with a third ingredient, entacapone, and comes in one strength, 25/100/200mg. Entacapone slows the clearing of levodopa, so each dose can keep working for longer — which is why it is often chosen when symptoms return before the next tablet is due.
Some people notice less stiffness or slowness within the first days, but it can be several months before the improvement is at its fullest. Because it works on the symptoms rather than the disease itself, it is taken continuously rather than as a short course.
All three products sold here — Carbidopa + Levodopa, Sinemet and Stalevo — are standard tablets, with no liquid, dispersible or slow-release version among them. Each one is swallowed whole with water rather than chewed or crushed.
Symptoms tend to return before the next tablet is due, so a missed dose is usually noticeable. Take it as soon as you remember; if the next dose is close, leave that one out and carry on with the usual schedule rather than doubling up.