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In clinical pharmacologic studiessimultaneous administration of carbidopa and levodopa produced greater urinary excretion of levodopa in proportion to the excretion of dopamine than administration of the two drugs at separate times.

If you plan to have surgery that needs a general anaesthetictell your doctor or dentist that you are taking SINEMET.

Before initiating treatment with SINEMETadvise patients about the potential to develop drowsiness and ask specifically about factors that may increase the risk for somnolence with SINEMET such as the use of concomitant sedating medications and the presence of sleep disordersConsider discontinuing SINEMET in patients who report significant daytime sleepiness or episodes of falling asleep during activities that require active participatione.gconversationseatingetcIf treatment with SINEMET continuespatients should be advised not to drive and to avoid other potentially dangerous activities that might result in harm if the patients become somnolentThere is insufficient information to establish that dose reduction will eliminate episodes of falling asleep while engaged in activities of daily living.

Patients should be alerted to the possibility of sudden onset of sleep during daily activitiesin some cases without awareness or warning signswhen they are taking dopaminergic agentsincluding levodopaPatients should be advised to exercise caution while driving or operating machinery and that if they have experienced somnolence and/or sudden sleep onsetthey must refrain from these activitiesSee WARNINGSFalling Asleep During Activities of Daily Living and Somnolence

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