Nausea with my Sinement

I take carbidopa/levodopa 3x a day I was getting nausea about 25 minutes after taking it. But not all the time so my neurologist wants me to take Tigan it is $185.00 a month I told him I can't afford it he got mad, so he said take carbidopa 1 hrs before I take my carb/lev sometimes I get sick and sometimes I don't, i'am ready to throw it all in the trash, i'am getting so discouraged with it all. Any suggestions?

34 Replies

  • I have a good friend that had this problem with carbidopa-levodopa and her neurologist suggested breaking it in half and taking one half at a time and more often. She did that for about 3 months and the nausea went away and then when she started back on one pill and quit breaking it in half she never had the nausea again. Don't give up yet! I hope this is some help for you.

  • Sleddog

    Might not be relevant to your question but check out the post I wrote on knowledge is power. It's about meds.

    The best anti nausea pill is domperidone but if you are in US don't know if you can get it. Eating something like toast or a biscuit when you take your med can help too.

  • when this starts happening to me, I eat something....a toast, cup of fruit...just something to have in your stomach to offset the meds. This usually happens within 1/2 hr. after taking them.

  • I found eating a little something even crackers helped as well.

  • To avoid nausea and GI pain after taking Sinemet CR, I take Domperidone. However, max daily dosage is 3 tabs, so I take half tab about 20 mins before breakfast AND dinner followed by my Sinemet. At lunch I manage my Sinemet after eating with no problems.

    I have to have a snack before bedtime dose of Sinemet, so I take 1 Domperidone again at least 20 mins before snack and Sinemet. I found the GI problems were most uncomfortable at bedtime.

    Note.....I take my Sinemet after some food.....cannot take on an empty stomach.

    Hope this makes sense and helps.

    I live in BC, Canada.

  • Anything with ginger helps 😃

  • In the UK domperidone is the only drug recommended to take alongside Parkinson's drugs to avoid interactions. Domperidone is the name of the actual drug so presumably any manufacturer can produce it and it should not cost that much

  • I believe that Domperidone should not be taken if you have some heart condition. Which condition I don't know. I suppose one should check. This should be included in the patient information leaflet.

  • See the emc page section entitled

    "4.4 Special warnings and precautions for use

    Cardiovascular effects4.4

    Special warnings and precautions for use

    Cardiovascular effects "

    The link for this page is "" and then scroll down a bit.

  • First off, you need not abide the insensitivity of any neurologist who gets mad when you tell him you can’t afford a drug. He deserves to be fired.

    Secondly, RE Sleddog’s comment, “The best anti nausea pill is domperidone,“ you are obviously in the USA so you should be aware of the caveat posted at the FDA’s website, “Domperidone is not currently a legally marketed human drug and it is not approved for sale in the U.S. “

    Thirdly, Dopaminergic Agents (e.g., Levodopa) are the major class of drugs used to treat the motor symptoms of PD and they can, and do, cause nausea and vomiting, which is why virtually nobody takes straight Levodopa. It’s almost always combined with Carbidopa which reduces the risk of nausea and vomiting. For convenience, Levodopa & Carbidopa, are combined in one pill, such as in the older brand name drug Sinemet® and the newer brand name drug Stalevo®. But, we’re all different and for some people, the amount of Carbidopa in a Stalevo or Sinemet pill is not adequate to combat the nausea, so an additional anti-nausea pill (e.g., Carbidopa or Tigan) is added. You might check prices on Carbidopa vs. Tigan and discuss with a new neurologist.



  • Secondly, RE Sleddog’s comment, “The best anti nausea pill is domperidone,“ you are obviously in the USA so you should be aware of the caveat posted at the FDA’s website, “Domperidone is not currently a legally marketed human drug.......

    Refers to Me or Sleddog ?

  • It's interesting, the differences in our healthcare systems and what you can, and can't get. I'm in the UK and for some of the supplements I use, I have to send to the States to get these. Yet here, until 2014, you could yet Domperidone over the counter, although you now need a prescription. I'm also struck by the fact that Aziclet is, apparently, very expensive for those of you in the USA, yet I was prescribed it as standard.

  • Post was intended to address Sleddog and to reference you. Sorry.

  • Espo

    Just a note, sinemet is carbidopa/levadopa and Stalevo has entacopone as well so it is not equivalent and  it isn't just another brand in fact stelevo has been around quite a long time. 

  • Try taking it 30 minutes after eating,

    Ginger tea is good for nausea.

    Motilium is the recommended ant emetic here in UK , which is available in generic form as Domperidone

    Also what dose are you taking ?

  • I agree that ginger tea can be very helpful.

  • Moon does the same as VT does. Even just a soda cracker or two, this month a girl scout cookie, at 2 am a banana.....just like morning sickness.....something for the pill to land on.

  • My neurologist gives me a separate Rx of extra Carbidopa 25 mg. which does the trick nicely.Maybe that is what Domperidone is I don't insurance covers it all the way.

    I'm a veteran RN (retired) and you have the right to be treated in a professional way, get someone who acts accordingly. Dont be afraid to speak up, they are working for YOU, not the other way around. Good Luck

  • Take sinemet with some food in your stomach, like a cracker or a toast. Don't take it on an empty stomach.

  • ...... but avoid protein rich snacks!

  • Moody I agree with you, well it's certainly what I tell people so how come my sinimet kicked in so quick just now, I took it with lunch - a meat and cheese pie no less! I was on faster than the usual 25mins.

    It doesn't make a lot of sense to me!

  • I can understand why eating something with or just after taking Sinemet might speed up absorbtion, but would have expected a protein rich snack to cancel out the advantage. I wonder ... did that Sinemet dose last as long as usual or did you 'switch off' sooner?

  • I think it lasted as long but will pay more attention next time. I have had a sense, unproven, that taken at the same time works better than an hour later for heavy protein meals. I reason that the ldopa wins in the absorption race but later with my slow gut it's competing. The quicker time I reported above may be a one off.

  • Tablespoon of tablespoon of kefir my pills in it and take no nausea

  • As recommended by my Neurologist , I was titrated initially when begin taking sinemet using the protocol of a one hour fast both prior to, and after taking pill. At this point haven't had nausea. BillDavid

  • Get a new neurologist. I dumped my first one and found one who is very flexible and well aware there are many different and sometimes contradictory approaches to treating PD. Also, try taking your c/l with a little food. I know that isn't what you are told. But a bit of toast and tea won't diminish the effect of c/l very much. Best wishes.

  • Check with different pharmacies for pricing of Tigan. I found it for less than $30. I haven't gotten sick from the carbadopa/Levadopa since starting it.

  • I've found a great help with the stomach discomfort issue is to dissolve the tablet in a small amount of water (2 or 3 tablespoons) and drink that first. After I drink that, I pour a small amount of water into the container two more times and drink that, just to make sure I don't leave any of the dissolved tablet in the bottom of the container. Then, I drink a full glass of water on top of that.

  • Hi Sleddog. My feeling is that if the mediatuon is not doing anythng to relieve any of the symptoms and it does nothing to slow down the progresson of the desease itself, then why take it?

    Surely your doctor can give you some motivation for the medicatuon he/she has prescribed, and if it does not achieve that result then he/she should change the prescription. All Pd medication is designed to relieve some symptoms and if it does not do ths then why take it? If he/she says that it is doing you good, then ask him/her in what way?


  • I take carb/Levi and dopimine for my anxiety. 3 times a day but I eat something first take first pills at 6 am again at 11:30 am and that holds me till 7:30 pm. But if my dr got mad because I couldn't afford any meds I'd change drs for sure. Good luck

  • Simply replace the Sinemet with Mucuna Pruriens ... a ground up bean seed containing Ldopa .. get it over the counter at health store $16 a bottle of capsules. If you want to really get cute then drink green tea as well (does some carbidopa functions). see

  • like I said, I eat something or take it before/with a meal.....I also add Comtan 3x per day with 3 doses of carb/levo; so far doing fine....the only other med I'm on is Amantadine 2x for Parkinson's

    I am looking into a stationary bike saw one I would love but $$$ Theracycle anyone try this?

  • Hi I had the same side effect and a few other nasty side effects, think my doctor over dosed me as i was on 3 mg a day of sinamet er. My daughters are really serious about living a healthy lifestyle excercising often and using natural remedies to control symptoms. I was very hesitant to go off my meds even though they were making me very sick and gain heaps of weight.

    My daughters siad the meds only masking symptoms and giving me more symptoms!! 

    When I did go off meds carefully and slowley I was experiencing a lot of pain aches and joint pain (bursitis). I thought this is so hard I cant stand this, but my daughters said it will get worse before it gets better because your body is full of all the toxic medications you've been taking. It took a long time about a month or more but eventually things got better . I difinitely dont feel doped up on drugs any more and am taking suppliments and magnesium tablets every day. And have just started walking as much as possible and a program with my local palaties and physio studio where I am given excercises to do at home for six weeks. Then go back to them to get next set of excercises to do.

    Im feeling very good , but do still get aches and pains but only a matter of using natural remedy to stop synptoms.

    Every one has their own ideas of what to do and its all good , I'm lucky I have two very determined daughters who pushed me to rid my body of all the toxins.

    I see my neurologist April 11. So will post what he opinion was , he does seem open to alternate treatments, oh well I'll find out I guess.

    I have a long way to go yet before I 'll know how I will go without the meds but so far its good knowing i am coping well with out the meds and have absolutely no side efects !

    Hang in their and talk to as many people about it as you can its a hard one Pd very different for each person. I live in Australia. 

    Good luck to you.

  • Moonel 

    I wish you well and hope you don't feel bad if eventually you do find you need meds.  How long have you been diagnosed and how long since you stopped taking them?  

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