When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to carbidopa or levodopa.

How to Use This Medicine:
Suspension

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. Your prescribed dose of Duopa® will be programmed into your pump by your doctor. Your dose should only be changed by your doctor.
• Duopa® is given continuously for 16 hours directly into your stomach. Your doctor will show you how to use Duopa® and the portable pump that delivers the medicine.
• Keep a supply of carbidopa/levodopa immediate-release tablets in case you are not able to get your Duopa® infusion. You will also need these tablets for your prescribed nighttime dose after your Duopa® dose.
• This medicine will take longer to work if you take it with a high-protein meal. Ask your doctor or pharmacist if you should take it 1 or 2 hours before a meal.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: You must use this medicine on a fixed schedule. Call your doctor or pharmacist if you miss a dose.
• Store Duopa® cassette in its original carton and in the refrigerator, away from light. After you remove a cassette from the refrigerator, it should be used within 16 hours. Do not freeze.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you have used an MAO inhibitor (MAOI) within the past 14 days.
• Some foods and medicines can affect how carbidopa/levodopa works. Tell your doctor if you are using any of the following:
  
  • Isoniazid, metoclopramide, papaverine, risperidone
  • A phenothiazine medicine (such as chlorpromazine, perphenazine, prochlorperazine, promethazine, thioridazine)
  • Blood pressure medicines
  • Iron supplements
  • Medicine to treat depression or mental illness
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, glaucoma, heart disease, heart rhythm problems (such as arrhythmia), high blood pressure, a sleep disorder, or a history of heart attack or skin cancer.
• This medicine may cause the following problems:
  
  • Unusual changes in thoughts or behavior, such as the urge to gamble or an increased sex drive
  • Depression or unusual behavior
  • Dyskinesia (trouble controlling movements)
  • An increased risk for skin cancer
• This medicine may make you dizzy, drowsy, or lightheaded, or even cause you to fall asleep without warning. This could happen while you are driving, eating, or talking. Tell your doctor right away if this happens. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, trouble breathing, fast or uneven heartbeat
• Compulsive behavior or intense urges you cannot control
• Constipation that does not go away, nausea, vomiting, fever, dark, tarry stools, stomach pain
• Eye pain, vision changes, seeing halos around lights
• Falling asleep in the middle of an activity
• Lightheadedness, dizziness, or fainting
• New or worse muscle movement you cannot control
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Unusual behavior, mood changes, seeing or hearing things that are not there, or thoughts of hurting yourself

If you notice these less serious side effects, talk with your doctor:

• Cough, runny or stuffy nose, sore throat
• Drowsiness or sleepiness
• Rapid weight gain, swelling in your hands, ankles, or feet

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088