Carbidopa and levodopa enteral (Duopa) is a combination medicine used to treat advanced Parkinson's disease.

Carbidopa and levodopa may also be used for purposes not listed in this medication guide.

This medicine can cause serious side effects. Call your doctor right away if you have stomach pain, vomiting, ongoing constipation, fever, bloody or tarry stools, or problems around the tube through which this medicine is given (redness, warmth, swelling, oozing).

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

This medicine is infused directly into the small intestine through a tube inserted into the wall of your stomach through a surgical incision. This tube is attached to an infusion pump.

A healthcare provider will program the pump and show you how to use it. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Duopa comes in a plastic cassette to attach to the infusion pump. Each cassette is to be used only one time and then thrown away.

Duopa is usually infused over a 16-hour period.

Do not stop using this medicine or change your dose without your doctor's advice.

You may need to take a pill form of carbidopa and levodopa at night or whenever your infusion pump is disconnected for longer than 2 hours.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Duopa.

Store cassettes in their original carton in the refrigerator, do not freeze.

Take a cassette out of the refrigerator and let it reach room temperature for 20 minutes, protected from light. Do infuse Duopa from a cold cassette.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.

Tell your doctor if you have ever had:

• a stomach ulcer or stomach surgery;

• low blood pressure, or fainting spells;

• heart disease, high blood pressure, or a heart attack;

• problems falling asleep suddenly during the day;

• problems with muscle movement;

• depression or mental illness;

• glaucoma; or

• nerve problems that cause numbness or tingling in your hands or feet.

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Ask your doctor about skin symptoms to watch for.

It is not known if this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Duopa can slow breast milk production. Tell your doctor if you are breastfeeding.

Not approved for use by anyone younger than 18 years old.

You may need to use extra medicine to make up a missed dose. Call your doctor for instructions if you stop your infusion or disconnect your pump for longer than 2 hours.

Get your prescription refilled before you run out of medicine completely.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid eating a diet high in iron or protein. These things can make it harder for your body to digest and absorb carbidopa and levodopa. Talk with your doctor or dietitian about the best foods to eat or avoid.

Drinking alcohol with this medicine can cause side effects.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Carbidopa and levodopa enteral may cause serious side effects. Call your doctor at once if you have:

• nausea, vomiting, stomach pain, fever;

• ongoing constipation, bloody or tarry stools;

• cough, trouble breathing;

• pain, swelling, redness, warmth, or oozing around the tube in your stomach wall;

• uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

• a light-headed feeling, like you might pass out;

• chest pain, fast or irregular heartbeats;

• daytime sleepiness or if you suddenly fall asleep after being alert;

• numbness or weakness in your hands or feet; or

• hallucinations, depression or suicidal thoughts.

Some people using Duopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges. Talk with your doctor if this occurs.

Common side effects of carbidopa and levodopa enteral may include:

• increased blood pressure;

• swelling in your lower legs;

• nausea;

• depression; or

• mouth or throat pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using Duopa with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• metoclopramide;

• mineral or vitamin supplements that contain iron;

• blood pressure medicine; or

• medicine to treat mood disorders or mental illness such as schizophrenia.

This list is not complete. Other drugs may affect Duopa, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.