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Caution should be exercised when the following drugs are administered concomitantly with SINEMET.

If you suspect an a poison control center or emergency room immediately.

For patients receiving MAO inhibitors (Type A or B).see CONTRAINDICATIONS. Concomitant therapy with selegiline and carbidopa levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa levodopa alone (see CONTRAINDICATIONS).

Patients should be alerted to the possibility of sudden onset of sleep during daily some cases without awareness or warning signs.when they are taking dopaminergic agents.including levodopa. Patients should be advised to exercise caution while driving or operating machinery and that if they have experienced somnolence and/or sudden sleep onset.they must refrain from these activities. (See WARNINGS .Falling Asleep During Activities of Daily Living and Somnolence .)

Current evidence indicates that symptoms of Parkinson’s disease are related to depletion of dopamine in the corpus striatum. Administration of dopamine is ineffective in the treatment of Parkinson’s disease apparently because it does not cross the blood-brain barrier. However.levodopa.the metabolic precursor of dopamine.does cross the blood-brain barrier.and presumably is converted to dopamine in the brain. This is thought to be the mechanism whereby levodopa relieves symptoms of Parkinson’s disease.

All patients should be observed carefully for the development of depression with concomitant suicidal tendencies.

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