AA-Levocarb CR: Uses, Side Effects and Dosage

What is AA-LEVOCARB CR used for?

AA-LEVOCARB CR is used to treat the symptoms of Parkinson’s disease in adults.

How does AA-LEVOCARB CR work?

AA-LEVOCARB CR contains two ingredients:

• levodopa: this acts to replenish dopamine in the brain.
• carbidopa: ensures that enough levodopa gets to the brain where it is needed.

It is believed that the symptoms of Parkinson’s disease are caused by a lack of dopamine.

Dopamine is a naturally occurring chemical produced by certain brain cells. It has the role of relaying messages in certain regions of the brain that control muscle movement. Difficulty in movement results when too little dopamine is produced. In many patients, this reduces the symptoms of Parkinson’s disease.

Serious Warnings and Precautions

What are the ingredients in AA-LEVOCARB CR?

Medicinal ingredients: Carbidopa and levodopa.

Non-medicinal ingredients: Hydroxypropyl methylcellulose, magnesium stearate, red ferric oxide and yellow ferric oxide (200 mg/50 mg tablets only).

AA-LEVOCARB CR comes in the following dosage forms:

Controlled-release tablets: 100 mg/25 mg and 200 mg/50 mg.

Do not use AA-LEVOCARB CR if:

• you are allergic to levodopa, carbidopa, or to any other ingredients in AA-LEVOCARB CR.
• you have any suspicious skin lesions (moles) which have not been examined by your healthcare professional doctor or if you have ever had skin cancer.
• you are taking certain monoamine oxidase inhibitors (MAOIs) (such as those used to treat depression). Most MAOIs should be stopped at least two weeks before starting therapy with AA-LEVOCARB CR.
• you have a serious eye condition called narrow-angle glaucoma.
• you have untreated heart, liver, kidney, lung, blood or hormonal disease.

• you have been told that you should not take sympathomimetic drugs such as:

  • isoproterenol (used to treat asthma and certain heart conditions),
  • amphetamines (used to treat attention deficit hyperactivity disorder (ADDH) and narcolepsy (uncontrolled urge to sleep)),
  • epinephrine or cough and cold medications containing drugs related to epinephrine.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take AA-LEVOCARB CR. Talk about any health conditions or problems you may have, including if you:

• are taking or have taken levodopa in the past.
• have a history of heart problems (heart attack and arrhythmias). Your healthcare professional should carefully monitor you in an appropriate facility when you first start taking AA-LEVOCARB CR.
• have or have had ulcers in your gut (called “duodenal” or “peptic” ulcers).
• have a history of convulsions/seizures.
• have dyskinesia, which are severe uncontrolled involuntary movements that can look like fidgeting, writhing or swaying.
• have any unusual conditions related to your eyes or eyesight (glaucoma).
• are going to have an operation that requires general anesthesia.
• suffer from a medical condition called psychosis.
• have or had skin cancer (melanoma).

• are pregnant, think you may be pregnant or become pregnant while taking AA-LEVOCARB CR. Your healthcare professional will advise whether you should take AA-LEVOCARB CR while you are pregnant.

• are breastfeeding or wish to breastfeed. Your healthcare professional will decide whether you should take AA-LEVOCARB CR while breastfeeding.
• have allergies.
• have problems with your lungs, kidneys, or liver.
• have hormonal problems.

Other warnings you should know about:

Laboratory tests and monitoring: When you take AA-LEVOCARB CR for a prolonged time, your healthcare professional may:

• monitor your liver, kidney and heart function
• do blood tests

Physical activity: As you improve on AA-LEVOCARB CR you may increase your physical activity slowly depending if you have any other medical conditions.

Uncontrollable movements: AA-LEVOCARB CR may cause uncontrollable movements. This may happen soon after you take AA-LEVOCARB CR.

Mental health changes/disturbances: AA-LEVOCARB CR may cause changes to your mental health.

• Tell your healthcare professional right away if you start to feel depressed or have thoughts of suicide.
• Hallucinations (seeing or hearing things that are not there) can occur when taking AA-LEVOCARB CR.

Neuroleptic malignant syndrome: This is a disorder that causes you to have a high fever, confusion, altered states or consciousness and stiffness in your muscles. Neuroleptic malignant syndrome may happen if you suddenly:

• Reduce your dose
• Stop taking AA-LEVOCARB CR
• Switch medicines

Your healthcare professional should monitor you when your dose is reduced or when you stop taking AA-LEVOCARB CR, especially if you take antipsychotic medicines.

Compulsive behaviours: While taking AA-LEVOCARB CR, you may have unusual urges and/or behaviours such as excessive:

• gambling
• sexual behaviour
• eating
• spending

You or your caregiver should tell your healthcare professional if either of you notice that you have new or changes to your behaviour.

Skin: People with Parkinson’s disease have a higher risk of developing skin cancer (melanoma). Your healthcare professional should monitor you for skin cancer while you are taking AA-LEVOCARB CR. Tell your healthcare professional if you have:

• suspicious, undiagnosed changed patches of pigmented skin
• irritated or irregular moles
• moles in which you have noticed changes

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with AA-LEVOCARB CR:

• antihypertensive drugs (used to treat elevated blood pressure).
• some medications used to treat psychiatric conditions or mental depression (including phenothiazines, butyrophenones, risperidone, selegiline, and tricyclic antidepressants).
• tetrabenazine (used to treat conditions related to involuntary movements such as Huntington’s Disease.
• phenytoin (used to treat and control seizures)
• papaverine (used to treat intestinal spasms).
• isoniazid (used to treat tuberculosis).
• metoclopramide (used to relieve nausea and vomiting).
• iron salts (such as multivitamins).
• anesthetics (drugs used during surgery).
• foods that are high in protein. This includes meat, fish, dairy products, seeds and nuts.

How to take AA-LEVOCARB CR:

• Take AA-LEVOCARB CR exactly as your healthcare professional has told you. Talk to your healthcare professional if you are not sure.
• AA-LEVOCARB CR 200mg/50mg tablets are scored and may be broken in half.
• Swallow the half tablets or whole tablets. DO NOT chew or crush the half tablets or whole tablets.

• DO NOT:

  • stop taking AA-LEVOCARB CR, reduce the amount of AA-LEVOCARB CR you take or change your dose unless your healthcare professional tells you to. If you suddenly stop or reduce your dose, you may experience the following symptoms: stiff muscles, fever and mental changes.
  • take any other medicines used to treat Parkinson’s disease without first consulting your healthcare professional. This includes other medicines containing levodopa and carbidopa.
  • give AA-LEVOCARB CR to other people.
  • use AA-LEVOCARB CR for any other condition.

Usual dose:

Your healthcare professional will tell you how many tablets you will need to take each day and when you should take them.

Tell your healthcare professional right away if you notice any changes in your symptoms during your treatment, such as nausea or abnormal movements. Your healthcare professional may need to change your dose.

The effect of the first morning dose of AA-LEVOCARB CR may be delayed for up to 1 hour compared with the response usually obtained from the first morning dose of levodopa/carbidopa immediate-release tablets. Consult your healthcare professional if such delayed responses pose a problem in treatment.

Overdose:

Missed Dose:

If you have missed a dose, take it as soon as you remember. If it is almost time to take your next dose, do not take the dose you have missed, and take your next dose as scheduled.

What are possible side effects from using AA-LEVOCARB CR?

These are not all the possible side effects you may have when taking AA-LEVOCARB CR. If you experience any side effects not listed here, tell your healthcare professional.

Side effects may include:

• nausea or vomiting
• abnormal or slow movements
• sleepiness, abnormal dreams
• dizziness
• mental changes including confusion
• hair loss
• dark-coloured saliva, urine and sweat
• chest pain
• feeling weak and tired
• changes in blood pressure
• dry mouth, changes in tastes, drooling, burning sensation of the tongue, grinding or clenching of the teeth
• diarrhea, constipation, stomach pain, heartburn, gas
• back, shoulder or leg pain
• muscle cramps
• bladder infection
• hiccups
• changes in weight, eating disorder (anorexia)
• blurred or double vision
• spasms that move the eye(s) into a fixed position (oculogyric crisis)
• falling
• headache
• difficulty falling asleep or staying asleep (insomnia)

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting Side Effects

Storage:

• Store in a tightly closed container at room temperature (15°C to 30°C). Protect from light and moisture.
• Do not use outdated medicine.
• Keep out of reach and sight of children.

If you want more information about AA-LEVOCARB CR:

• Talk to your healthcare professional.
• Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website (https://www.aapharma.ca/en/), or by calling 1-877-998-9097.

Last Revised: JUN 09, 2023