U.S. Brand Names: Sinemet®; Sinemet CR®

Use: Sustained-release combination of carbidopa and levodopa used in the treatment of Parkinson's disease.

Pregnancy Risk Factor and Implications: C; use only if benefits outweigh the risks, unknown if enters breast milk, use with caution.

Contraindications: Do not use if you have suspicious, undiagnosed skin lesions or a history of melanoma. Do not use if you are on a MAO inhibitor. Do not use if you are allergic to any component in this drugs or if you have narrow-angle glaucoma.

Warnings/Precautions: Patients on levodopa without a decarboxylase inhibitor should discontinue use of the levodopa for at least eight hours before starting carbidopa-levodopa. Carbidopa-levodopa may cause involuntary movements and mental disturbances (depression with suicidal tendencies, etc.) so patients should be monitored. Patients with current psychoses, severe cardiovascular or pulmonary disease, bronchial asthma, renal, hepatic, or endocrine disease should be treated with caution. Patients with a history of myocardial infarction who have residual atrial, nodal, or ventricular arrhythmias should be monitored as well as patients with a history of peptic ulcer. Patients whose dosage has been reduced abruptly or discontinued should also be monitored for withdrawal effects. Periodic evaluations of hepatic, hematopoietic, cardiovascular, and renal function are recommended during extended therapy. In order to reduce adverse reactions, it is necessary to individualize therapy.

Adverse Reactions:

Most common serious reactions: Choreiform, dystonic, and other involuntary movements, nausea

Other serious reactions: Mental changes (paranoid ideation and psychotic episodes), depression with or without development of suicidal tendencies, dementia

Less frequent serious reactions: Cardiac irregularities, palpitation, orthostatic hyoptensive episodes, bradykinetic episodes, anorexia, vomiting, dizziness

Rare serious reactions: Gastrointestinal bleeding, development of duodenal ulcer, hypertension, phlebitis, hemolytic and non-hemolytic anemia, thrombocytopenia, leuklopenia, agranulocytosis

Other less serious side effects: Ataxia, numbness, increased hand tremor, muscle twitching, muscle cramps, blepharospasm, trismus, activation of latent Horner's syndrome, confusion, sleepiness, insomnia, nightmares, hallucinations, delusions, agitation, anxiety, euphoria, dry mouth, bitter taste, sialorrhea, dysphagia, bruxism, hiccups, abdominal pain and distress, constipation, diarrhea, flatulence, burning sensation of tongue, weight gain or loss, edema, malignant melanoma, flushing, increased sweating, dark sweat, skin rash, loss of hair, urinary retention, urinary incontinence, dark urine, priapism, diplopia, blurred vision, dilated pupils, oculogyric crises, weakness, faintness, fatigue, headache, hoarseness, malaise, hot flashes, sense of stimulation, bizarre breathing patterns, neuroleptic malignant syndrome.

U.S. Brand Names: Symmetrel®

Use: Used to treat idiopathic Parkinson's disease, postencephalitic parkinsonism, and symptomatic parkinsonism which may follow injury to the nervous system by carbon monoxide intoxication.

Pregnancy Risk Factor and Implications: C; use only if benefits outweigh the risks, is excreted in breast milk, not recommended when nursing.

Contraindications: Do not use if you are allergic to amantadine hydrochloride or to any of the other ingredients in Symmetrel.

Warnings/Precautions: A Symmetryl® overdose may result in death. Some patients on Symmetrel® have attempted suicide. Patients with a history of epilepsy or other "seizures" should be monitored. Patients with a history of congestive heart failure or peripheral edema should be monitored closely. Symmetrel® should not be discontinued abruptly. Patients whose dosage is reduced abruptly or discontinued should be monitored for neuroleptic malignant syndrome, dosage should be reduced in patients with renal impairment and in patients who are 65 or older, use with care in patients with liver disease, use with care in patients with congestive heart failure, peripheral edema, orthostatic hypotension, recurrent eczematoid rash, or psychosis or severe psychoneurosis not controlled by chemotherapeutic agents. Avoid excessive alcohol consumption since it may increase the potential for CNS effects such as dizziness, confusion, lightheadedness and orthostatic hypotension.

Adverse Reactions:

5-10% experience: Nausea, dizziness, insomnia

1-5% experienced: Depression, anxiety and irritability, hallucinations, confusion, anorexia, dry mouth, constipation, ataxia, livedo reticularis, peripheral edema, orthostatic hypotension, headache, somnolence, nervousness, dream abnormality, agitation, dry nose, diarrhea and fatigue

0.1-1% experienced: Congestive heart failure, psychosis, urinary retention, dyspnea, skin rash, vomiting, weakness, slurred speech, euphoria, thinking abnormality, amnesia, hyperkinesia, hypertension, decreased libido, and visual disturbance, including punctate subepithelial or other corneal opacity, corneal edema, decreased visual acuity, sensitivity to light, and optic nerve palsy

Less than 0.1% experienced: Instances of convulsion, leukopenia, neutropenia, eczematoid dermatitis, oculogyric episodes, suicidal attempt, suicide, and suicidal ideation

Other Side Effects Included: coma, stupor, delirium, hypokinesia, hypertonia, delusions, aggressive behavior, paranoid reaction, manic reaction, involuntary muscle contractions, gait abnormalities, paresthesia, EEG changes, and tremor, cardiac arrest, arrhythmias including malignant arrhythmias, hypotension, and tachycardia, acute respiratory failure, pulmonary edema, and tachypnea, dysphagia, leukocytosis, keratitis and mydriasis, pruritus and diaphoresis, neuroleptic malignant syndrome, allergic reactions including anaphylactic reactions, edema, and fever.

Overdose/Toxicology: Seek medical attention immediately. Deaths have been reported from Symmetrel® overdose

U.S. Brand Names: Carbex®; Eldepryl®; Deprenil®; Deprenyl®

Use: Used in conjunction with levodopa or levodopa and carbidopa to treat Parkinson's disease. Increases and extends the effects of levodopa, may help slow the progress of Parkinson's.

Pregnancy Risk Factor and Implications: Use with caution if you are pregnant; unknown if this drug enters breast milk, use with caution.

Warnings/Precautions: Consult your doctor if you have a history of stomach ulcer. In doses of 10 mg or more per day this drug may cause a dangerous reaction if foods that have a high tyramine content are eaten, when alcoholic beverages are consumed, when large amounts of caffeine-containing foods are consumed, and when certain over-the-counter and prescription medicines are used with it.

Adverse Reactions:

Serious side effects: Severe headache, stiff neck, chest pains, fast heartbeat, nausea, vomiting, unusually high blood pressure, severe chest pain, enlarged pupils, fast or slow heartbeat, severe headache, increased sensitivity of eyes to light, increased sweating, nausea and severe vomiting, stiff or sore neck.

More common side effects: An increase in unusual movements of body, mood or other mental changes, abdominal or stomach pain; dizziness or feeling faint; dryness of mouth; nausea; trouble in sleeping; vomiting

Less common/rare side effects: Bloody or black, tarry stools; difficult or frequent urination; difficulty in breathing; difficulty in speaking; dizziness or lightheadedness, especially when getting up from a lying or sitting position; hallucinations; irregular heartbeat; lip smacking or puckering; loss of balance control; puffing of cheeks; rapid or worm-like movements of tongue; restlessness or desire to keep moving; severe stomach pain; swelling of feet or lower legs; tightness in chest; twisting movements of body; uncontrolled chewing movements; uncontrolled movements of face, neck, back, arms or legs; vomiting of blood or material that looks like coffee grounds; wheezing, anxiety; back or leg pain; blurred or double vision; body ache; burning of lips, mouth, or throat; chills; constipation; diarrhea; drowsiness; headache; heartburn; high or low blood pressure; inability to move; frequent urge to urinate; increased sensitivity of skin to light; increased sweating; irritability (temporary); loss of appetite; memory problems; muscle cramps; nervousness; numbness of fingers or toes; pounding or fast heartbeat; red, raised, or itchy skin; restlessness; ringing or buzzing in ears; slow or difficult urination; slowed movements; taste changes; uncontrolled closing of eyelids; unusual feeling of well-being; unusual tiredness or weakness; unusual weight loss

Side Effects with doses higher than 10 mg a day: Clenching, gnashing, or grinding teeth; sudden jerky movements of body

Overdose/Toxicology: Symptoms of an overdose include agitation or irritability; chest pain; convulsions (seizures); difficulty opening mouth or lockjaw; dizziness (severe) or fainting; fast or irregular pulse (continuing); high fever; high or low blood pressure; increased sweating (possibly with fever or cold, clammy skin); severe spasm where the head and heels are bent backward and the body arched forward; troubled breathing. Seek emergency medical attention immediately.

U.S. Brand Names: Parlodel®; Parlodel Snap Tabs®

Use: Stimulates parts of the brain and nervous system that are involved with Parkinson's disease.

Pregnancy Risk Factor and Implications: Not recommended for use during pregnancy, consult doctor; this medicine stops milk from being produced

Contraindications: Do not use if you have had an allergic reaction to this drug or to any of its components.

Warnings/Precautions: Consult with your doctor if you have a history of high blood pressure, pregnancy-induce high blood pressure, liver disease, and mental problems. This medicine may cause drowsiness so use caution when driving, using machines, or doing other dangerous activities. Avoid alcohol until you have consulted your doctor as this drug may cause a reaction when used with alcohol.

Adverse Reactions:

Rare: Abdominal or stomach pain (continuing or severe); increased frequency of urination; loss of appetite (continuing); lower back pain; runny nose (continuing); weakness

More common: Dizziness or lightheadedness, especially when getting up from a lying or sitting position; nausea

Less common: Constipation; diarrhea; drowsiness or tiredness; dry mouth; leg cramps at night; loss of appetite; mental depression; stomach pain; stuffy nose; tingling or pain in fingers and toes when exposed to cold; vomiting

U.S. Brand Names: Permax®

Use: Used in conjunction with levodopa/carbidopa in the management of the signs and symptoms of Parkinson's disease

Pregnancy Risk Factor and Implications: B; only use if clearly needed as uncertain of effects of this drug on the developing fetus, unknown if excreted in human milk, consult doctor.

Contraindications: Do not use if you are allergic to this drug or to any of its components.

Warnings/Precautions: Patients should be aware of the risk of developing symptomatic orthostatic and/or sustained hypotension with the use of this drug. Patients should also be monitored for the developed of hallucinosis. Some patients have died while on this drug, but it is unclear what effect the drug had on these deaths and most of the patients who died were elderly and in bad health to begin with. Patients with a history of pleuritis, pleural effusion, pleural fibrosis, pericarditis, pericardial effusion or retroperitoneal fibrosis should be monitored while on this drug. Use caution in patients prone to cardiac dysrhythmias. Patients on this drug are more prone to episodes of premature contractions and sinus tachycardia; concurrent use of this drug with I-dopa may cause or worsen confusion and hallucinations and dyskinesia. If if the drug is suddenly stopped withdrawal symptoms may occur; if dosage is rapidly reduced or halted patients may experience symptoms resembling neuroleptic malignant syndrome (elevated temperature, muscular rigidity, altered consciousness, autonomic instability).

Adverse Reactions:

More than 1% experienced: Pain, abdominal pain, injury, accident, headache, asthenia, chest pain, flu syndrome, neck pain, back pain, surgical procedure, chills, face edema, infection, postural hypotension, vasodilatation, palpitation, hypotension, syncope, hypertension, arrhythmia, myocardial infarction, nausea, constipation, diarrhea, dyspepsia, anorexia, dry mouth, vomiting, anemia, peripheral edema, edema, weight gain, arthralgia, bursitis, myalgia, twitching, dyskinesia, dizziness, hallucinations, dystonia, confusion, somnolence, insomnia, anxiety, tremor, depression, abnormal dreams, personality disorder, psychosis, abnormal gait, akathisia, axtrapyramidal syndrome, incoordination, paresthesia, akinesia, hypertonia, neuralgia, speech disorder, rhinitis, dyspnea, epistaxis, hiccup, rash, sweating, abnormal vision, diplopia, taste perversion, eye disorder, urinary frequency, urinary tract infection, hematuria,

Frequent Side Effects: Headache asthenia, accidental injury, pain, abdominal pain, chest pain, back pain, flu syndrome, neck pain, fever; postural hypotension, syncope, hypertension, palpitations, vasodilatations, congestive heart failure; nausea, vomiting, dyspepsia, diarrhea, constipation, dry mouth, dysphagia; anemia; peripheral edema, weight loss, weight gain; twitching, myalgia, arthralgia; bone pain, tenosynovitis, myositis, bone sarcoma, arthritis; osteoporosis, muscle atrophy, osteomyelitis, dyskinesia, dizziness, hallucinations, confusion, somnolence, insomnia, dystonia, paresthesia, depression, anxiety, tremor, akinesia, extrapyramidal syndrome, abnormal gait, abnormal dreams, incoordination, psychosis, personality disorder, nervousness, choreoathetosis, amnesia, paranoid reaction, abnormal thinking; akathisia, neuropathy, neuralgia, hypertonia, delusions, convulsion, libido increased, euphoria, emotional liability, libido decreased, vertigo, myoclonus, coma, apathy, paralysis, neurosis, hyperkinesia, ataxia, acute brain syndrome, torticollis, meningitis, manic reaction, hypokinesia, hostility, agitation, hypotonia; Rare: stupor, neuritis, intracranial hypertension, hemiplegia, facial paralysis, brain edema, myelitis, hallucinations and confusion after abrupt discontinuation, rhinitis, dyspnea, pneumonia, pharyngitis, cough increased; sweating, abnormal vision, diplopia; urinary tract infection, urinary frequency, urinary incontinence, hematuria, dysmenorrhea;

Infrequent Side Effects: Facial edema, chills, enlarged abdomen, malaise, neoplasm, hernia, pelvic pain, sepsis, cellulitis, moniliasis, abscess, jaw pain, hypothermia; Rare: acute abdominal syndrome, LE syndrome, myocardial infarction, tachycardia, heart arrest, abnormal electrocardiogram, angina pectoris, thrombophlebitis, bradycardia, ventricular extrasystoles, cerebrovascular accident, ventricular tachycardia, cerebral ischemia, atrial fibrillation, varicose vein, pulmonary embolus, AV block, shock; Rare: vasculitis, pulmonary hypertension, pericarditis, migraine, heart block, cerebral hemorrhage, flatulence, abnormal liver function tests, increased appetite, salivary gland enlargement, thirst, gastroenteritis, gastritis, periodontal abscess, intestinal obstruction, nausea and vomiting, gingivitis, esophagitis, cholelithiasis, tooth caries, hepatitis, stomach ulcer, melena, hepatomegaly, hematemesis, eructation; Rare: sialadenitis, peptic ulcer, pancreatitis, jaundice, glossitis, fecal incontinence, duodenitis, colitis, cholecystitis, aphthous stomatitis, esophageal ulcer, hypothyroidism, adenoma, diabetes mellitus, ADH inappropriate; endocrine disorder, thyroid adenoma, leukopenia, lymphadenopathy, leukocytosis, thrombocytopenia, petechia, megaloblastic anemia, cyanosis; Rare: purpura, lymphocytosis, eosinophilia, thrombocythemia, acute lymphoplastic leukemia, polycythemia, splenomegaly, dehydration, hypokalemia, hypoglycemia, iron deficiency anemia, hyperglycemia, gout, hyper-cholesteremia; electrolyte imbalance, cachexia, acidosis, hyperuricemia, bone pain, tenosynovitis, myositis, bone sarcoma, arthritis; osteoporosis, muscle atrophy, osteomyelitis, akathisia, neuropathy, neuralgia, hypertonia, delusions, convulsion, libido increased, euphoria, emotional lability, libido decreased, vertigo, myoclonus, coma, apathy, paralysis, neurosis, hyperkinesia, ataxia, acute brain syndrome, torticollis, meningitis, manic reaction, hypokinesia, hostility, agitation, hypotonia; stupor, neuritis, intracranial hypertension, hemiplegia, facial paralysis, brain edema, myelitis, hallucinations and confusion after abrupt discontinuation, epistaxis, hiccup, sinusitis, bronchitis, voice alteration, hemoptysis, asthma, lung edema, pleural effusion, laryngitis, emphysema, apnea, hyperventilation; pneumothorax, lung fibrosis, larynx edema, hypoxia, hyperventilation, hemothorax, carcinoma of lung, skin discoloration, pruritus, acne, skin ulcer, alopecia, dry skin, skin carcinoma, seborrhea, vesiculobullous rash, subcutaneous nodule, skin nodule, skin benign neoplasm, lichenoid dermatitis, otitis media, conjunctivitis, tinnitus, deafness, taste perversion, ear pain, eye pain, glaucoma, eye hemorrhage, photophobia, visual field defect; blindness, cataract, retinal detachment, retinal vascular disorder, dysuria, breast pain, menorrhagia, impotence, cystitis, urinary retention, abortion, vaginal hemorrhage, vaginitis, priapism, kidney calculus, fibrocystic breast, lactation, uterine hemorrhage, urolithiasis, salpingitis, pyuria, metrorrhagia, menopause, kidney failure, breast carcinoma, cervical carcinoma; amenorrhea, bladder carcinoma, breast engorgement, epididymitis, hypogonadism, leukorrhea, nephrosis, pyelonephritis, urethral pain, uricaciduria, withdrawal bleeding.

Overdose/Toxicology: Symptoms of an overdose include nausea, vomiting, convulsions, decreased blood pressure, CNS stimulation, hallucinations, involuntary movements, tingling in arms and legs, ventricular extrasystoles, and agitation. Management of overdosage may require supportive measures to maintain arterial blood pressure. Cardiac function should be monitored; an antiarrhythmic agent may be necessary. If signs of CNS stimulation are present, a phenothiazine or other butvronhenone neuroleptic agent may be indicated; the efficacy of such drugs in reversing the effects of overdose has not been assessed.

U.S. Brand Names: Akineton®; Artane®; Artane Sequels®; Cogentin®; Kemadrin®; Parsidol®; Trihexane, Trihexy, Benzatropine, Profenamine

Use: Used to treat Parkinson's disease, improves muscle control and reduces stiffness, controls severe reactions to certain medicines.

Pregnancy Risk Factor and Implications: Pregnancy: Has not been shown to cause problems in human, unknown if excreted in breast milk, consult doctor, may reduce flow of breast milk.

Contraindications: Do not use if you are allergic to this drug or to any of its components.

Warnings/Precautions: Consult with doctor if you have difficulty urinating, an enlarged prostate, glaucoma, heart or blood vessel disease, high blood pressure, intestinal blockage, myasthenia gravis, uncontrolled movements of hands, mouth, or tongue, kidney disease, or liver disease before using this medicine. Consult your doctor before stopping this medicine. The drowsiness effect of this medicine will be increased if used with alcohol or CNS depressants. Do not take this medicine within one hour of taking medicine for diarrhea. This medicine may cause your eyes to become more sensitive to light. This medicine may cause you to sweat less, causing your body temperature to increase, so use caution in hot weather.

Adverse Reactions:

Rare Side Effects: Confusion (more common in the elderly or with high doses); eye pain; skin rash, dizziness or lightheadedness when getting up from a lying or sitting position; false sense of well-being (especially in the elderly or with high doses); headache; loss of memory (especially in the elderly); muscle cramps; nervousness; numbness or weakness in hands or feet; soreness of mouth and tongue; stomach upset or pain; unusual excitement (more common with large doses of trihexyphenidyl).

Common Side Effects:Blurred vision; constipation; decreased sweating; difficult or painful urination (especially in older men); drowsiness; dryness of mouth, nose, or throat; increased sensitivity of eyes to light; nausea or vomiting

Overdose/Toxicology: Taking an overdose of this medicine may lead to unconsciousness. Some signs of an overdose are clumsiness or unsteadiness; seizures; severe drowsiness; severe dryness of mouth, nose and throat; fast heartbeat; hallucinations (seeing, hearing, or feeling things that are not there); mood or mental changes; shortness of breath or troubled breathing; trouble in sleeping; and unusual warmth, dryness, and flushing of skin.

U.S. Brand Names: Mirapex®

Use: Dopamine agonist indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease.

Pregnancy Risk Factors: Category C; use only if the benefits outweigh the risks. It is unknown if this drug enters breast milk so consult a doctor before using while nursing.

Warnings/Precautions: Monitor patients for orthostatic hypotension while they are taking this drug. Older patients are at a greater risk for hallucinations. Use with caution in patients with renal insufficiency. This drug may cause or worsen dyskinesia. Monitor patients for withdrawal symptoms if dosage is suddenly and rapidly reduced or stopped entirely

Contradindications: Do not use this drug if you have had a past allergic reaction to the drug or to any of its components.

Side Effects:

When used in patients with early Parkinson's

Greater than 5% experience: Nausea, dizziness, somnolence, insomnia, constipation, asthenia, hallucinations.

Greater than 1% experience: Asthenia, general edema, malaise, fever, nausea, constipation, anorexia, dysphagia, peripheral edema, decreased weight, insomnia, hallucinations, confusion, amnesia, hypesthesia, dystonia, akathisia, thinking abnormalities, decreased libido, myoclonus, vision abnormalities, impotence.

When used in patients with advanced Parkinson's

Greater than 5% experience: Postural (orthostatic) hypotension, dyskinesia, extrapyramidal syndrome, insomnia, dizziness, hallucinations, accidental injury, dream abnormalities, confusion, constipation, asthenia, somnolence, dystonia, gait abnormality, hypertonia, dry mouth, amnesia, urinary frequency.

Greater than 1% experience: Accidental injury, asthenia, general edema, chest pain, malaise, postural hyoptension, constipation, dry mouth, peripheral edema, increased creatine PK, arthritis, twitching, bursitis, myasthenia, dyskinesia, extrapyramidal syndrome, insomnia, dizziness, hallucinations, dream abnormalities, confusion, somnolence, dystonia, gait abnormalities, hypertonia, amnesia, akathisia, thinking abnormalities, paranoid reaction, delusions, sleep disorders, dyspnea, rhinitis, pneumonia, skin disorders, accommodation abnormalities, vision abnormalities, diplopia, urinary frequency, urinary tract infection, urinary incontinence, enlarged abdomen, death, fever, suicide attempt, peripheral vascular disease, myocardial infarction, angina pectoris, atrial fibrillation, heart failure, arrhythmia, atrial arrhythmia, pulmonary embolism, thirst, joint disorder, myasthenia, agitation, CNS stimulation, hyperkinesia, psychosis, convulsions, pneumonia, cataract, eye disorder, glaucoma, dysuria, abnormal ejaculation, prostate cancer, hematuria, prostate disorder.

Overdose: There is no known antidote for overdosage of a dopamine agonist. If signs of central nervous system stimulation are present, a phenothiazine or other butyrophenone neuroleptic agent may be indicated; the efficacy of such drugs in reversing the effects of overdosage has not been assessed. Management of overdose may require general supportive measures along with gastric lavage, intravenous fluids, and electrocardiogram monitoring.

U.S. Brand Names: Requip®

Use: Used to treat the stiffness, tremors, spasms, and poor muscle control of Parkinson's disease.

Pregnancy Risk Factors: Pregnancy Category C; it is unknown if this drug is harmful to the developing fetus; consult doctor before using. It is unknown if this drug enters breast milk; consult doctor.

Warnings/Precautions: Use caution when driving, operating machinery, or performing other hazardous activities as this drug may cause drowsiness and dizziness. Alcohol, sleep aides, antihistamines, antidepressants, antipsychotics and other medicines may increase the drowsiness caused by this drug so do not take any of the above in conjunction with this drug without first consulting a doctor. Consult with a doctor before using this drug if you have kidney disease. Tell your doctor if you are taking medications to treat mania, schizophrenia, other psychiatric conditions, or nausea and vomiting, an estrogen or the antibiotic ciprofloxacin (Cipro) before beginning treatment with this drug.

Contraindications: Do not take this drug if you are allergic to it or to any of its components.

Side effects: Drowsiness, dizziness, hallucinations, fainting, mild nausea, vomiting, upset stomach, decreased appetite, diarrhea, constipation, dry mouth, sweating, headache, drowsiness, confusion, insomnia, agitation, anxiety.

Overdose: In case of an overdose seek emergency medical attention. Symptoms of an overdose include nausea, vomiting, weakness, dizziness, fainting, agitation, confusion, hallucinations, muscle twitching, uncontrollable movements, a tingling sensation, and chest pain.

U.S. Brand Names: Tasmar®

Use: Used in conjunction with levodopa and carbidopa for the treatment of the signs and symptoms of idiopathic Parkinson's disease. Used primarily in patients who have not responded well to alternate therapies.

Pregnancy Risk Factors: Use this drug while pregnant only if the benefits outweigh the risks. It is unknown if this drug is excreted in human milk, use only if benefits outweighs the risk if nursing.

Contradindications: Patients with liver disease or two SGPT/ALT or SGOT/AST values greater than the upper limit of normal should not use Tasmar. Do not use if you have stopped treatment with Tasmar because of Tasmar-induced hepatocellular injury. Do not use if you are allergic to Tasmar or to any of its ingredients. Do not use if you have a history of non-traumatic rhabdomyolysis or hyperpyrexia and confusion possibly related to medication.

Warnings/Precautions: This drug can cause potentially fatal acute fulminant liver failure and should only be used in patients with Parkinson's disease on levodopa/carbidopa who are experiencing symptom fluctuations and are not responding satisfactorily to or are not appropriate candidates for other adjunctive therapies. A patient who does not show substantial benefit from treatment with this drug within 3 weeks should be withdrawn from Tasmar. Patients on this drug should be frequently tested and monitored for signs of liver damage. Patients with liver disease should not use this drug. Withdrawal symptoms may occur if Tasmar dosage is abruptly reduced or if treatment is suddenly halted. Since MAO inhibitors may interact with Tasmar concurrent treatment is not usually recommended. Tasmar can be taken with a selective MAO-B inhibitor such as selegiline. This drug may increase the risk of orthostatic hypotension. If severe diarrhea occurs while taking Tasmar there may be a risk of anorexia and other problems so consult doctor if diarrhea is severe and persistent. Hallucinations may occur with the use of this drug. Tasmar may cause or worsen dyskinesia. Cases of severe rhabdomyolysis have been reported with Tasmar use. Patients with severe renal impairment should be monitored.

Side Effects:

Greater than 5% experienced: Dyskinesia, nausea, sleep disorder, dystonia, dreaming excessive, anorexia, muscle cramps, orthostatic complaints, somnolence, diarrhea, confusion, dizziness, headache, hallucination, vomiting, constipation, fatigue, upper respiratory tract infection, falling, sweating increased, urinary tract infection, xerostomia, abdominal pain, urine discoloration, depression, hypesthesia, tremor, speech disorder, vertigo, emotional lability; infrequent: neuralgia, amnesia, extrapyramidal syndrome, hostility, libido increased, manic reaction, nervousness, paranoid reaction, cerebral ischemia, cerebrovascular accident, delusions, libido decreased, neuropathy, apathy, choreoathetosis, myoclonus, psychosis, thinking abnormal, twitching, tooth disorder; infrequent: dysphagia, gastrointestinal hemorrhage, gastroenteritis, mouth ulceration, increased salivation, abnormal stools, esophagitis, cholelithiusis, colitis, tongue disorder, rectal disorder, flank pain, accidental injury, abdominal pain, infection, palpitation; infrequent: hypertension, vasodilation, angina pectoris, heart failure, atrial fibrillation, tachycardia, migraine, aortic stenosis, arrhythmia, arteriospasm, bradycardia, cerebral hemorrhage, coronary artery disorder, heart arrest, myocardial infarct, myocardial ischemia, pulmonary embolus, myalgia, urinary incontinence, impotence; infrequent: prostatic disorder, dysuria, nocturia, polyuria, urinary retention, urinary tract disorder, hematuria, kidney calculus, prostatic carcinoma, breast neoplasm, oliguria, uterine atony, uterine disorder, vaginitis, bronchitis, pharyngitis; infrequent: cough increased, rhinitis, asthma, epistaxis, hyperventilation, laryngitis, hiccup, rash; infrequent: herpes zoster, pruritus, seborrhea, skin discoloration, eczema, erythema multiforme, skin disorder, furunculosis, herpes simplex, urticaria, tinnitus; infrequent: diplopia, ear pain, eye hemorrhage, eye pain, lacrimation disorder, otitis media, parosmia

At least 1% experienced: Dyskinesia, nausea, sleep disorder, dystonia, dreaming excessive, anorexia, muscle cramps, orthostatic complaints, somnolence, diarrhea, confusion, dizziness, headache, hallucination, vomiting, constipation, fatigue, upper respiratory tract infection, falling, sweating increased, urinary tract infection, xerostomia, abdominal pain, syncope, urine discoloration, dyspepsia, influenza, dyspnea, balance loss, flatulence, hyperkinesia, chest pain, hypotension, paresthesia, stiffness, arthritis, chest discomfort, hypokinesia, micturition disorder, neck pain, burning, sinus congestion, agitation, bleeding dermal, irritability, mental deficiency, hyperactivity, malaise, panic reaction, tumor skin, cataract, euphoria, fever, alopecia, eye inflamed, hypertonia, tumor uterus, antisocial reaction, delirium, encephalopathy, hemiplegia, meningitis, cholecystitis, duodenal ulcer, gastrointestinal carcinoma, stomach atony, hernia, pain, allergic reaction, cellulitis, infection fungal, viral infection, carcinoma, chills, infection bacterial, neoplasm, abscess, face edema, death, arteriosclerosis, cardiovascular disorder, pericardial effusion, thrombosis, tenosynovitis, arthrosis, joint disorder, bladder calculus, ovarian carcinoma, uterine hemorrhage, apnea, hypoxia, lung edema, apnea, hypoxia, lung edema, glaucoma, edema, hypercholesteremia, thirst, dehydration, anemia; rare: leukemia, thrombocytopenia, diabetes mellitus, surgical procedure.

Overdose: Symptoms may include nausea, vomiting and dizziness. Hospitalization is advised, general supportive care is indicated.