Parcopa Side Effects Center

Last updated on RxList: 5/21/2021
Parcopa Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

What Is Parcopa?

Parcopa (carbidopa and levodopa) extended release tablet is a combination of an inhibitor of aromatic amino acid decarboxylation and an aromatic amino acid indicated in the treatment of Parkinson's disease, postencephalitic parkinsonism, and symptomatic parkinsonism that may follow carbon monoxide intoxication or manganese intoxication. The brand name Parcopa is discontinued, but generic versions may be available.

What Are Side Effects of Parcopa?

Common side effects of Parcopa (carbidopa and levodopa) include

Dosage for Parcopa

Parcopa extended-release tablets contain carbidopa and levodopa in a 1:4 ratio as either the 50 mg/200 mg tablet or the 25 mg/100 mg tablet. The daily dosage of must be determined by careful titration.

What Drugs, Substances, or Supplements Interact with Parcopa?

Parcopa may interact with antihypertensives, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, phenothiazines, butyrophenones, risperidone, isoniazid, phenytoin, papaverine, reserpine, tetrabenazine, iron salts or multivitamins containing iron salts, and metoclopramide. Tell your doctor all medications and supplements you use.

Parcopa During Pregnancy and Breastfeeding

During pregnancy, Parcopa should be used only if prescribed; it is unknown how it might affect a fetus. Parcopa passes into breast milk. Consult your doctor before breastfeeding.

Additional Information

Our Parcopa (carbidopa and levodopa) extended release tablet Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Parkinson's disease is only seen in people of advanced age. See Answer
Parcopa Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
  • worsening of tremors (uncontrolled shaking);
  • severe or ongoing vomiting or diarrhea;
  • confusion, hallucinations, unusual changes in mood or behavior;
  • depression or suicidal thoughts; or
  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Some people taking carbidopa and levodopa have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

You may notice that your sweat, urine, or saliva appears dark in color, such as red, brown, or black. This is not a harmful side effect, but it may cause staining of your clothes or bed sheets.

Common side effects may include:

  • jerky or twisting muscle movements;
  • headache, dizziness;
  • low blood pressure (feeling light-headed);
  • sleep problems, strange dreams;
  • dry mouth;
  • muscle contractions; or
  • nausea, vomiting, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Dementia, Alzheimer's Disease, and Aging Brains See Slideshow
Parcopa Professional Information


In controlled clinical trials, patients predominantly with moderate to severe motor fluctuations while on carbidopa and levodopa immediate-release were randomized to therapy with either carbidopa and levodopa immediate-release or carbidopa and levodopa extended-release. The adverse experience frequency profile of carbidopa and levodopa extended-release did not differ substantially from that of carbidopa and levodopa immediate-release, as shown in Table 1.

Table 1: Clinical Adverse Experiences Occurring In 1% or Greater of Patients

Adverse Experience Carbidopa and Levodopa Extended-release
n = 491 %
Carbidopa and Levodopa Immediate-release
n = 524 %
Dyskinesia 16.5 12.2
Nausea 5.5 5.7
Hallucinations 3.9 3.2
Confusion 3.7 2.3
Dizziness 2.9 2.3
Depression 2.2 1.3
Urinary tract infection 2.2 2.3
Headache 2 1.9
Dream abnormalities 1.8 0.8
Dystonia 1.8 0.8
Vomiting 1.8 1.9
Upper respiratory infection 1.8 1
Dyspnea 1.6 0.4
‘On-Off’ phenomena 1.6 1.1
Back pain 1.6 0.6
Dry mouth 1.4 1.1
Anorexia 1.2 1.1
Diarrhea 1.2 0.6
Insomnia 1.2 1
Orthostatic hypotension 1 1.1
Shoulder pain 1 0.6
Chest pain 1 0.8
Muscle cramps 0.8 1
Paresthesia 0.8 1.1
Urinary frequency 0.8 1.1
Dyspepsia 0.6 1.1
Constipation 0.2 1.5

Abnormal laboratory findings occurring at a frequency of 1% or greater in approximately 443 patients who received carbidopa and levodopa extended-release and 475 who received carbidopa and levodopa immediate-release during controlled clinical trials included: decreased hemoglobin and hematocrit; elevated serum glucose; white blood cells, bacteria and blood in the urine.

The adverse experiences observed in patients in uncontrolled studies were similar to those seen in controlled clinical studies.

Other adverse experiences reported overall in clinical trials in 748 patients treated with carbidopa and levodopa extended-release, listed by body system in order of decreasing frequency, include:

Body as a Whole: Asthenia, fatigue, abdominal pain, orthostatic effects.

Cardiovascular: Palpitation, hypertension, hypotension, myocardial infarction.

Gastrointestinal: Gastrointestinal pain, dysphagia, heartburn.

Metabolic: Weight loss.

Musculoskeletal: Leg pain.

Nervous System/Psychiatric: Chorea, somnolence, falling, anxiety, disorientation, decreased mental acuity, gait abnormalities, extrapyramidal disorder, agitation, nervousness, sleep disorders, memory impairment.

Respiratory: Cough, pharyngeal pain, common cold.

Skin: Rash.

Special Senses : Blurred vision.

Urogenital: Urinary incontinence.

Laboratory Tests : Decreased white blood cell count and serum potassium; increased BUN, serum creatinine and serum LDH; protein and glucose in the urine.

The following adverse experiences have been reported in post-marketing experience with carbidopa and levodopa extended-release:

Cardiovascular: Cardiac irregularities, syncope.

Gastrointestinal: Taste alterations, dark saliva.

Hypersensitivity: Angioedema, urticaria, pruritus, bullous lesions (including pemphigus-like reactions).

Nervous System/Psychiatric: Increased tremor, peripheral neuropathy, psychotic episodes including delusions and paranoid ideation, pathological gambling, increased libido including hypersexuality, impulse control symptoms.

Skin: Alopecia, flushing, dark sweat.

Urogenital: Dark urine.

Other adverse reactions that have been reported with levodopa alone and with various carbidopalevodopa formulations and may occur with carbidopa and levodopa extended-release are:

Cardiovascular: Phlebitis.

Gastrointestinal: Gastrointestinal bleeding, development of duodenal ulcer, sialorrhea, bruxism, hiccups, flatulence, burning sensation of tongue.

Hematologic: Hemolytic and nonhemolytic anemia, thrombocytopenia, leukopenia, agranulocytosis.

Hypersensitivity: Henoch-Schonlein purpura.

Metabolic: Weight gain, edema.

Nervous System/Psychiatric: Ataxia, depression with suicidal tendencies, dementia, euphoria, convulsions (however, a causal relationship has not been established); bradykinetic episodes, numbness, muscle twitching, blepharospasm (which may be taken as an early sign of excess dosage; consideration of dosage reduction may be made at this time), trismus, activation of latent Horner's syndrome, nightmares.

Skin: Malignant melanoma (see also CONTRAINDICATIONS), increased sweating.

Special Senses : Oculogyric crisis, mydriasis, diplopia.

Urogenital: Urinary retention, priapism.

Miscellaneous : Faintness, hoarseness, malaise, hot flashes, sense of stimulation, bizarre breathing patterns.

Laboratory Tests : Abnormalities in alkaline phosphatase, SGOT (AST), SGPT (ALT), bilirubin, Coombs test, uric acid.

Read the entire FDA prescribing information for Parcopa (Carbidopa and Levodopa Extended-release Tablets)

© Parcopa Patient Information is supplied by Cerner Multum, Inc. and Parcopa Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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