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Introduction About TIDOMET PLUS TABLET
TIDOMET PLUS TABLET is a combination of Carbidopa and Levodopa which belongs to the group of medicines called Antiparkinsonian drugs. It is used to improve the signs of Parkinsonism. Parkinsonism is a long-term illness caused due to loss of nerve cells in the part of the brain which is responsible for producing dopamine. Dopamine is a chemical messenger that controls body balance and movements.
Symptoms of parkinsonism include slow and unsteady movements, muscle tightness, shaking or trembling, difficulty in walking, balance and coordination.
TIDOMET PLUS TABLET must be used with caution among patients having any form of glaucoma (increased pressure in the eyes), as it can lead to further damage to the eye. TIDOMET PLUS TABLET is not recommended for use in women who are pregnant or breastfeeding, including children and adolescents (aged below 18 years).
It is important for caregivers to notice and report doctor immediately that if the patient develops any addictive symptoms like craving for large doses of TIDOMET PLUS TABLET, unusual behavior, gambling, excessive eating or spending, an abnormally high sex drive or any other activities that could harm themselves or others.
Try to avoid eating a heavy meal that includes a lot of protein (such as beef, pork, cheese, fish and eggs) while taking TIDOMET PLUS TABLET, as it may interfere with its absorption.
The common side effects of taking TIDOMET PLUS TABLET are nausea, vomiting, abnormal muscle movements, loss of appetite, dry mouth, bitter taste and tiredness. Consult your doctor if any of the side effects worsen.
Uses Of TIDOMET PLUS TABLET
- Used to improve the signs of Parkinsonism
How TIDOMET PLUS TABLET Works
TIDOMET PLUS TABLET effectively controls the signs of parkinsonism, where levodopa acts by converting itself into a substance called dopamine (a chemical messenger that controls body movement) and carbidopa acts by managing the breakdown of levodopa outside the brain, thereby allowing greater proportion of levodopa to enter the brain. Collectively they supplement the brain with sufficient dopamine levels which ultimately results in improving the signs of parkinsonism.
How to use TIDOMET PLUS TABLET
Take TIDOMET PLUS TABLET as advised by your physician. Swallow the medicine as a whole and do not crush or chew the medicine. Continue to take TIDOMET PLUS TABLET unless your doctor tells you to stop because sudden withdrawal of TIDOMET PLUS TABLET can cause symptoms like mental changes, fever and muscle tightness.
Your doctor will decide the correct dose and duration of TIDOMET PLUS TABLET for you depending upon your age, body weight and disease condition.
Side Effects Of TIDOMET PLUS TABLET
Common
- abnormal body movements (dyskinesia, chorea, dystonia)
- nausea, vomiting, dry mouth, bitter taste
- loss of appetite
- low blood pressure while standing up from sitting or lying position (orthostatic hypotension), fainting
- confusion, dizziness, nightmares, drowsiness, tiredness, sleeplessness
- feeling euphoria (an extremely strong feeling of happiness)
Uncommon
- weight loss or weight gain
- difficulty in speaking or making abnormal sounds while speaking
- hoarseness, chest pain
- constipation, diarrhea, bloating
- increased saliva secretion, difficulties in swallowing
- fluid accumulation
- muscle spasms, loss of strength
- dark urine
- weakness
- hot flushes
Rare
- excitement, anxiety, disorientation
- headache
- numbness, tingling or prickling sensation, fits
- blurred vision
- breathlessness, abnormal breathing patterns
- indigestion with fullness in upper abdomen or pain, heartburn
- urinary retention, involuntary passing of urine, persistent erection
Stop taking TIDOMET PLUS TABLET and contact your doctor immediately if you experience any of the following side effects:
- signs of allergic reactions (such as skin rash, itching, swelling
of your face, lips, tongue or throat, which may cause difficulty in breathing or swallowing) - chest pain, uneven heartbeat or palpitations
- signs of bleeding in the stomach which may be shown as blood in faeces or darkened faeces
- signs of low blood counts (such as pale skin, fever, tiredness, sore throat or mild bruising and prolonged bleeding after injury)
- signs of neuroleptic malignant syndrome (muscle stiffness with high fever, sweating, increased salivation, inability to sit still, impaired consciousness)
- mental changes including hallucinations, delusions and depression
- fits (convulsions)
How To Manage Side Effects
Nausea and vomiting:
Try to take TIDOMET PLUS TABLET with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if the symptom does not improve.
Diarrhoea:
Drink lot of fluids such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for managing diarrhoea. Consult your doctor if the symptom does not improve.
Constipation:
Eat fiber rich foods such as fresh fruits, vegetables, cereals and drink plenty of water. Try to exercise more regularly. Consult your doctor if the symptom does not improve on its own.
Dry mouth:
Sip water regularly and other sugar free liquids. Do not use mouthwashes that contain alcohol because they can make your mouth dry, use mouthwash that is used only for dry mouth. Limit your caffeine intake. Avoid smoking or using tobacco products. Consult your doctor if the symptom does not improve.
Warning & Precautions
Pregnancy
TIDOMET PLUS TABLET is not recommended for use in pregnant women and in women who think that they might be pregnant. Consult your doctor before taking it.
Breastfeeding
TIDOMET PLUS TABLET is not recommended for use in breastfeeding women. Consult your doctor before taking it.
Driving and Using Machines
Do not drive or operate any heavy tools or machines, as TIDOMET PLUS TABLET may cause sudden sleep attacks or can make you feel sleepy suddenly.
Alcohol
Avoid consumption of alcohol while taking TIDOMET PLUS TABLET, as it could make you feel dizzier or drowsier.
Kidney
TIDOMET PLUS TABLET should be taken with caution among patients who have or had any kidney diseases in the past. Consult your doctor before taking it.
Liver
TIDOMET PLUS TABLET should be taken with caution among patients who have or had any liver diseases in the past. Consult your doctor before taking it.
Allergy
Talk to your doctor if you are allergic to Levodopa or Carbidopa.
Heart Disease
TIDOMET PLUS TABLET should be taken with caution among patients with heart disease (such as previous history of heart attack, heartbeat problems, circulation or breathing problems). Consult your doctor before taking it.
Others
TIDOMET PLUS TABLET is not recommended for use in patients who:
- have ever had any forms of skin cancer
- have any unusual moles in the skin that has not yet been examined by the doctor
- have narrow-angle glaucoma (increased pressure in the eye)
- have a severe mental disorder (Ex. severe panic disorder, psychosis, severe depression, bipolar disorder)
Before taking TIDOMET PLUS TABLET, inform your physician if you:
- have a history of fits (epilepsy)
- have had an ulcer in the stomach
- have vomited blood
- have any hormonal problems
- have had depression or any other similar mental problems
- have chronic wide-angle glaucoma (a painless eye condition that can affect your vision)
- feel sleepy or having sudden sleep attacks (Ex. Narcolepsy)
- are due to have a surgery
- are due to have a blood/urine test
Use in pediatrics:
TIDOMET PLUS TABLET is generally not recommended for use in children and adolescents (aged below 18 years). However, consult your child’s doctor for advice.
Use in geriatrics:
TIDOMET PLUS TABLET is considered safe for use in elderly patients (aged 65 years or above). However, proper dose adjustment and careful monitoring is required in such patients.
Interactions
A. Drug-Drug interactions:
Before taking TIDOMET PLUS TABLET, inform your doctor, if you are taking any of the following medicines:
- medicines used to manage depression (such as isocarboxazid, phenelzine, selegiline, tranylcypromine)
- medicines used to manage tuberculosis (Ex. rifampicin, isoniazid)
- medicines used to manage high blood pressure (Ex. atenolol, propranolol, captopril, enalapril, olmesartan, telmisartan)
- medicines used to manage epilepsy (Ex. carbamazepine, valproic acid, phenytoin)
- medicines used to manage involuntary movements (such as ataxia, dystonia, myoclonus, tardive dyskinesia) Ex. fluphenazine, haloperidol, chlorpromazine or thioridazine
- medicines used to manage iron deficiency (Ex. ferrous fumarate, iron isomaltoside)
- medicines that can reduce muscle stiffness, strain or spasms (such as trihexyphenidyl, orphenadrine, benzatropine and procyclidine)
- papaverine (a medicine used to manage impotence in men)
B. Drug-Food interaction:
Try to avoid eating a heavy meal that includes a lot of protein (such as beef, pork, fish and eggs) while taking TIDOMET PLUS TABLET, as it may interfere with its absorption.
Overdosage:
If you or anyone else accidentally take too much of TIDOMET PLUS TABLET, contact your doctor immediately or go to a hospital straight away.
Synopsis
| Drug | : | Carbidopa, Levodopa |
| Pharmacological Category | : | Dopamine agonists, Decarboxylase inhibitors |
| Therapeutic Indication | : | Parkinsonism |
| Dosage Forms | : | Tablet |
More Information
- Keep TIDOMET PLUS TABLET out of reach of children
- Store at room temperature
FAQs About TIDOMET PLUS TABLET
What foods need to be avoided while taking TIDOMET PLUS TABLET?
It is better to avoid eating protein rich foods like beef, chicken, pork, fish and eggs while taking TIDOMET PLUS TABLET, as it could interfere with its absorption and alters the effects of this medicine.
Are there any medicines that needs to be avoided while taking TIDOMET PLUS TABLET?
Before taking TIDOMET PLUS TABLET, it is better to inform your doctor about all the medicines that you are taking, to avoid the risk of unwanted side effects. It is known that TIDOMET PLUS TABLET can interact with certain medicines used to manage depression (such as isocarboxazid, phenelzine, selegiline, tranylcypromine). These medicines should be stopped for at least two weeks before taking TIDOMET PLUS TABLET. Also, consult your doctor for more information about the medicines that needs to be avoided.
How long does it take for TIDOMET PLUS TABLET to start working?
TIDOMET PLUS TABLET will start showing its effect after 24 hours. Although, it can have an effect after one day, it may take up to 7 days to show its complete effect and so take this medicine at the same time each day as instructed by your doctor. Avoid eating a heavy meal rich in protein to enhance the risk of antiparkinsonian effects.
Can I stop taking TIDOMET PLUS TABLET when the symptoms subside?
No, do not stop taking TIDOMET PLUS TABLET unless your doctor tells you, because sudden withdrawal of TIDOMET PLUS TABLET can cause excessive muscle tightness, fever and mental changes in patients. Therefore, continue to take TIDOMET PLUS TABLET as informed by your physician.
Can TIDOMET PLUS TABLET make you feel sleepy?
Yes, TIDOMET PLUS TABLET can make you feel drowsy suddenly or can cause sudden sleep attacks (like narcolepsy) while doing your daily activities. You may not be experiencing any drowsiness or notice any warning signs before falling asleep suddenly. Avoid driving or operating any tools or heavy machines while taking TIDOMET PLUS TABLET. If you experience any unusual episodes of sudden sleepiness or excessive sleepiness during the daytime, consult your doctor.
Can TIDOMET PLUS TABLET cause dark urine?
Yes, TIDOMET PLUS TABLET may alter the color of your urine and make it look darker. This is usually harmless. However, if you experience any blood in urine or other unusual symptoms consult your doctor immediately.
Is TIDOMET PLUS TABLET safe to use in pregnant women?
TIDOMET PLUS TABLET is not recommended for use in pregnant women and in women who think that they might be pregnant. Consult your doctor for advice before taking TIDOMET PLUS TABLET if you are pregnant or planning to get pregnant.
References
1. KD. Tripathi. Drugs acting on central nervous system. Antiparkinsonian drugs. Essentials of medical pharmacology. 8th Edition. 2019. Page – 452-457.
2. Gerald G. Briggs and Roger K. Freeman. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 657 & 2455.
3. Dr. Rebecca Gilbert. The many variations of carbidopa/levodopa – the mainstay of Parkinson’s disease treatment. American Parkinson Disease Association. March 2021. [Accessed on 21st March 2022] https://www.apdaparkinson.org/article/carbidopa-levodopa-formulations-and-parkinsons-disease/
4. Masahiro Nomoto, Masahiro Nagai, , Rina Ando, Yoshifumi Kagamiishi, Koji Yano, Shigeto Saito, Atsushi Takeda. Pharmacokinetics and safety/efficacy of levodopa pro-drug ONO-2160/carbidopa for Parkinson's disease. Sciencedirect.com. December 2018. [Accessed on 21st March 2022] https://www.sciencedirect.com/science/article/pii/S2405650218300315
5. Merck Sharp & Dohme B.V. Electronic Medicines Compendium (EMC). [Revised in February 2021] [Accessed on 21st March 2022] https://www.medicines.org.uk/emc/files/pil.7805.pdf
6. Merck Sharp & Dohme B.V. Electronic Medicines Compendium (EMC). [Revised in February 2021] [Accessed on 21st March 2022] https://www.medicines.org.uk/emc/files/pil.1655.pdf
7. Fair-Med Healthcare GmbH. Health Products Regulatory Authority (HPRA). [Revised in October 2018] [Accessed on 21st March 2022] https://www.hpra.ie/img/uploaded/swedocuments/a48b3e79-0aae-4c3d-b727-a4272f22fc16.pdf
8. Torrent Pharmaceuticals Ltd. Tidomet Forte (Carbidopa 25mg and Levodopa 250 mg tablets). [Revised in June 2018]. [Accessed on 21st March 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/542.pdf
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