Sideeffect of Sinemet CR

Too much Sinemet CR may cause muscle twitches, inability to open the eyes [including sleepiness], or other symptoms of levodopa overdosage. After taking Sinemet CR, if you feel that overdose is suspected, then contact with your doctor immediately."and from InhousePhamacy.com

Warnings and Precautions
When patients are receiving levodopa monotherapy, levodopa must be discontinued at least 8 hours before therapy with Sinemet CR is started (at least 12 hours if slow-release plain levodopa has been administered).
Dyskinesias may occur in patients previously treated with levodopa alone because carbidopa permits more levodopa to reach the brain and, thus, more dopamine to be formed. The occurrence of dyskinesias may require dosage reduction.
As with levodopa, Sinemet CR may cause involuntary movements and mental disturbances. These reactions are thought to be due to increased brain dopamine following administration of levodopa. Dosage reduction may be required. All patients should be observed carefully for the development of depression with concomitant suicidal tendencies. Patients with past or current psychoses should be treated with caution.
Sinemet CR should be administered cautiously to patients with severe cardiovascular or pulmonary disease, bronchial asthma, renal, hepatic or endocrine disease, or a history of peptic ulcer disease or of convulsions.
Care should be exercised in administering Sinemet CR to patients with a history of recent myocardial infarction who have residual atrial, nodal, or ventricular arrhythmia. In such patients, cardiac function should be monitored with particular care during the period of initial dosage administration and titration.
Patients with chronic wide angle glaucoma may be treated cautiously with Sinemet CR, provided the intraocular pressure is well controlled and the patient monitored carefully for changes in intraocular pressure during therapy.
A symptom complex resembling the neuroleptic malignant syndrome including muscular rigidity, elevated body temperature, mental changes, and increased serum creatine phosphokinase has been reported when antiparkinsonian agents were withdrawn abruptly. Therefore, patients should be observed carefully when the dosage of carbidopa-levodopa combinations is reduced abruptly or discontinued, especially if the patient is receiving neuroleptics.
Sinemet CR is not recommended for the treatment of therapy-induced extrapyramidal reactions.
Periodic evaluations of hepatic, haematopoietic, cardiovascular and renal function are recommended during extended therapy.

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