Carbidopa Levodopa

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Levodopa is required by the brain to produce dopamine, an important neurotransmitter. People with Parkinson’s disease have depleted levels of dopamine, leading to debilitating symptoms. Levodopa is given to increase production of dopamine, which in turn reduces the symptoms of Parkinson’s disease. When taken by mouth, most levodopa is broken down by the body before it reaches the brain. Sinemet® combines levodopa with carbidopa, a drug that prevents the breakdown, allowing levodopa to reach the brain to increase dopamine levels.

Levodopa is broken down in the body by a process requiring vitamin B6. Breakdown may deplete available vitamin B6. Carbidopa blocks levodopa breakdown and prevents vitamin B6 depletion. People taking levodopa/carbidopa (Sinemet®), or levodopa plus carbidopa (Lodosyn®) have no risk for levodopa-induced vitamin B6 deficiency; it is not a problem for people to supplement vitamin B6 while taking Sinemet.

For people taking levodopa alone, small amounts of vitamin B6 (5–10 mg per day) may prevent levodopa-induced vitamin B6 deficiency.1 Amounts of vitamin B6 slightly higher than those required to replace depleted levels, may reduce the effectiveness of levodopa therapy and should not be taken.2