Question 1

How can I lower the cost of my carbidopa/levodopa

Accepted Answer

You can lower cost of your carbidopa/levodopa using one of the 4 following drug savings programs: Rx Advantage Card for carbidopa/levodopa, Canadian Prescription Savings for carbidopa/levodopa, carbidopa/levodopa Drug Coupons, carbidopa/levodopa Patient Assistance Programs

Question 2

What dosages is carbidopa/levodopa available in?

Accepted Answer

carbidopa/levodopa is available as a 25 mg/100 mg and 50 mg/200 mg sustained release tablet.

Question 3

What is carbidopa/levodopa used for?

Accepted Answer

carbidopa/levodopa is a dopa decarboxylase inhibitor / dopamine replacement and is used to treat the following:  Parkinson’s disease (PD) Parkinsonism (conditions that cause people to have signs and symptoms of PD, including slowness, stiffness, shakiness, and imbalance)

Question 4

How does carbidopa/levodopa work?

Accepted Answer

carbidopa/levodopa is a combination of two medications: carbidopa and levodopa. By working together, these medications help relieve symptoms of Parkinson’s disease (PD), which occur due to low dopamine levels in the brain. Levodopa is a dopamine replacement.

Levodopa travels into your brain, where it’s converted into dopamine. It helps relieve PD symptoms by restoring dopamine in your brain. Carbidopa is a dopa decarboxylase inhibitor.

Dopa decarboxylase is a protein in your body that breaks down levodopa before it can travel into your brain. By blocking this protein, carbidopa prevents levodopa from breaking down.

This raises the level of levodopa in your body and allows more levodopa to travel into your brain to be converted into dopamine. Levodopa and dopamine can then reach and remain at higher levels in your brain, which enhances levodopa’s ability to relieve PD symptoms.

Question 5

How do I take carbidopa/levodopa?

Accepted Answer

carbidopa/levodopa is typically started at 50 mg/200 mg (carbidopa/levodopa) by mouth 2 times per day at least 6 hours apart.

Question 6

Is it safe for me to take carbidopa/levodopa?

Accepted Answer

carbidopa/levodopa is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. Nonselective monoamine oxidase (MAO) inhibitors are contraindicated for use with carbidopa/levodopa. These inhibitors must be discontinued at least two weeks prior to initiating therapy with carbidopa/levodopa.

Question 7

carbidopa/levodopa Common Side Effects

Accepted Answer

Common side effects of carbidopa/levodopa:  Involuntary movements Nausea

Question 8

carbidopa/levodopa Serious Side Effects

Accepted Answer

Serious side effects are rare with carbidopa/levodopa. Contact your healthcare provider immediately if you experience any of the following.  Neuroleptic malignant syndrome (NMS): very high fevers, confusion, irregular pulse, sweating, muscle stiffness, changes in blood pressure

Question 9

Effects of other drugs, drug classes and over-the-counter products on carbidopa/levodopa

Accepted Answer

The following medications may interact with carbidopa/levodopa:  Symptomatic postural hypotension has occurred when carbidopa levodopa preparations were added to the treatment of patients receiving some antihypertensive drugs Concomitant therapy with selegiline and carbidopa levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa levodopa alone There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and carbidopa levodopa preparations Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of levodopa. In addition, the beneficial effects of levodopa in Parkinson’s disease have been reported to be reversed by phenytoin and papaverine. Patients taking these drugs with carbidopa/levodopa should be carefully observed for loss of therapeutic response Use of SINEMET with dopamine-depleting agents (e.g., reserpine and tetrabenazine) or other drugs known to deplete monoamine stores is not recommended carbidopa/levodopa and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with levodopa and carbidopa and consequently reduce the bioavailability of carbidopa and levodopa

Question 10

Who makes carbidopa/levodopa?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is carbidopa/levodopa safe in pregnancy?

Accepted Answer

There are no adequate and well-controlled studies in pregnant women and carbidopa/levodopa should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Question 12

What is the brand name for carbidopa/levodopa?

Accepted Answer

SINEMET CRSINEMETRYTARY

Question 13

How can NowPatient help me to lower the cost of my carbidopa/levodopa prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your carbidopa/levodopa prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient carbidopa/levodopa savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient carbidopa/levodopa savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for carbidopa/levodopa	Canadian Prescription Savings* for carbidopa/levodopa	carbidopa/levodopa Drug Coupon*	carbidopa/levodopa Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of carbidopa/levodopa?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for carbidopa/levodopa	Canadian Prescription Savings* for carbidopa/levodopa	carbidopa/levodopa Drug Coupon*	carbidopa/levodopa Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the carbidopa/levodopa savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the carbidopa/levodopa drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for carbidopa/levodopa, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the carbidopa/levodopa prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, carbidopa/levodopa is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed carbidopa/levodopa for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the carbidopa/levodopa prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the carbidopa/levodopa prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for carbidopa/levodopa

If you are having trouble paying for your carbidopa/levodopa medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for carbidopa/levodopa you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
carbidopa/levodopa is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers carbidopa/levodopa
If carbidopa/levodopa is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for carbidopa/levodopa

If you are having trouble paying for your carbidopa/levodopa medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for carbidopa/levodopa you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers carbidopa/levodopa
If carbidopa/levodopa is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for carbidopa/levodopa

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your carbidopa/levodopa treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for carbidopa/levodopa you will need to meet the following criteria:

You must be currently insured and have coverage for carbidopa/levodopa
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.