Co-beneldopa

Co-beneldopa is not suitable for some people. For example, check with your doctor if you have diabetes or have ever had a mental health condition.

Co-beneldopa comes as standard capsules, slow-release capsules and tablets that dissolve. Follow the instructions that come with your medicine.

Side effects of co-beneldopa include feeling or being sick. More serious side effects can happen in rare cases.

Co-beneldopa is not often taken during pregnancy. Always check with a pharmacist or doctor.

It can cause problems to take co-beneldopa with some other medicines, such as iron supplements or antidepressants. Check with a pharmacist or doctor.

There are things you can do to help cope with these common side effects of co-beneldopa:

If you lose your appetite, eat when you would usually expect to be hungry. It may help to eat smaller meals, more often than usual.

It may help to have a low-protein snack (such as a plain biscuit or cracker) with your medicine if you're feeling or being sick.

It may help to eat smaller meals, more often than usual.

If you're being sick, have frequent small sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee.

If you keep feeling or being sick, talk to your doctor or specialist nurse. They may be able to recommend an extra medicine to help with this.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Talk to your specialist nurse or doctor if this does not go away and is bothering you.

Try getting up very slowly, or stay sitting down until you feel better.

If you still feel dizzy, lie down so you do not faint, then sit up for a while until you feel OK again.

Do not drive, cycle, or operate machinery if you feel dizzy. Do not drink alcohol as it may make you feel worse.

Avoid big meals, smoking, or drinking alcohol in the evening. Reduce tea and coffee and other drinks that contain caffeine.

Try not to watch TV or use your mobile phone before going to bed. Relax for an hour before bedtime.

Do not take any sleep remedies, including herbal remedies, without talking to a pharmacist, specialist nurse or doctor first.

Let your doctor or specialist nurse know as soon as possible. They may need to adjust your dose or medicine.

Dyskinesias are more likely if you've been taking co-beneldopa for a long time or at a high dose. Talk to your doctor about reviewing your medicine if this starts to happen.

You may also notice that your pee, saliva, tongue, teeth or inside of your mouth change colour. This is normal with co-beneldopa and is not dangerous.

Keep taking the medicine but talk to your doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Co-beneldopa comes as:

• standard capsules
• slow-release (also known as controlled-release or prolonged-release) capsules
• tablets that dissolve in water (dispersible tablets)

Some people may need to take a combination of these.

Co-beneldopa capsules and tablets come in different strengths. The information on the medicine packet shows the amount of levodopa followed by the amount of benserazide (both in milligrams) in each capsule or tablet.

The standard capsules and the tablets work fairly quickly. You'll usually take these several times a day, depending on your dose.

Slow-release capsules get the medicine into your body gradually. This means you may not have to take them as often.

Changes to your dose

You'll usually start on a low dose of co-beneldopa. Your doctor or specialist nurse will increase your dose gradually until your symptoms are under control.

It's best to take the lowest dose that controls your symptoms. This helps reduce your chance of side effects.

How to take it

Take your co-beneldopa at the same times each day. This is important to help control your symptoms. If you delay taking it, your symptoms could come back.

It's best to avoid taking co-beneldopa at the same time as meals containing a lot of protein (such as meat, eggs, cheese, beans or lentils). For some people, protein can reduce the amount of levodopa your body takes in, meaning that your medicine may not work properly.

Because of this, you should take co-beneldopa at least 30 minutes before a meal or 60 minutes after a meal.

Most adults aged 25 or over can take co-beneldopa.

Co-beneldopa is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to co-beneldopa, levodopa, benserazide or any other medicine
• have glaucoma
• have ever had a mental health condition, including depression or psychosis
• have ever had skin cancer (melanoma) or have symptoms such as unusual moles or lumps on your skin
• have had a stroke or heart attack, or you have heart problems such as irregular heartbeats (arrhythmia)
• have had a stomach ulcer, or a hole (perforation) or bleeding in your stomach
• have diabetes
• have an overactive thyroid (hyperthyroidism)
• have Cushing's syndrome
• have problems with your liver, kidneys or adrenal glands (including phaeochromocytoma)
• have lung disease or asthma
• are pregnant, trying to get pregnant or are breastfeeding

Co-beneldopa can affect the results of blood tests and urine tests. Tell your doctor that you're taking co-beneldopa if you need to have any tests.

Co-beneldopa is not often used in pregnancy. This is because there's little information about how the medicine may affect your baby. However, your doctor may advise you to take it if they think the benefits of taking the medicine outweigh any risks.

If you become pregnant while taking co-beneldopa, speak to your doctor as soon as possible.

If your baby is healthy, you may be able to take co-beneldopa while breastfeeding, but talk to your doctor or pharmacist first.

There's very little information about taking co-beneldopa while breastfeeding, but it's thought that it only passes into breast milk in very small amounts. It's unlikely to cause any side effects in your baby.

Co-beneldopa can sometimes reduce your milk production, although this is less likely if you've been breastfeeding for a while.

It's important to keep monitoring your baby if you're taking any medicine while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if you notice that your baby:

• is not feeding as well as usual
• has changes in their behaviour, for example jerky movements
• has changes in their normal sleeping pattern
• is being sick or has diarrhoea

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Carry on taking the medicine, and keep breastfeeding as usual until you've got advice about your baby's symptoms.

Some medicines can affect how co-beneldopa works and may increase the chances of side effects.

Tell your doctor, specialist nurse or pharmacist if you're taking any other medicines, including:

• iron medicines or iron supplements
• tranylcypromine, phenelzine or isocarboxazid, for depression – also tell your doctor if you've taken any of these medicines within the last 2 weeks
• anti-sickness medicines, such as domperidone, metoclopramide or prochlorperazine
• antacids (used to treat indigestion)
• medicines for psychosis or schizophrenia, such as amisulpride, aripiprazole, haloperidol or risperidone
• medicines for high blood pressure, such as atenolol, ramipril or amlodipine
• medicines that make you sleepy, give you a dry mouth or make it difficult to pee (called anticholinergic side effects), including antihistamines, antidepressants and medicines for an overactive bladder

Many medicines have these anticholinergic effects, so check with a pharmacist if you're not sure. These medicines can affect how much co-beneldopa your body takes in and stop it from working properly.

These are not all the medicines that may cause problems if you take them with co-beneldopa. For a full list, see the leaflet inside your medicine packet.

Taking painkillers with co-beneldopa

It's usually OK to take mild painkillers, such as paracetamol and ibuprofen, if you need pain relief.

Check with your doctor before taking any stronger prescription painkillers, including opioids such as codeine, morphine or tramadol.