Crexont
Crexont (carbidopa / levodopa) is an extended-release capsule that's used to treat symptoms of Parkinson's disease (PD) in adults. It contains carbidopa (a decarboxylase inhibitor) and levodopa (a dopamine replacement). In general, this medication is usually taken by mouth two to four times a day. Your prescriber will adjust the dose based on how well Crexont (carbidopa / levodopa) is working for you. Side effects include nausea and anxiety.
What is Crexont (carbidopa / levodopa)?
What is Crexont (carbidopa / levodopa) used for?
Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have symptoms of PD, including tremors, slowness, and stiffness)
How Crexont (carbidopa / levodopa) works
Crexont (carbidopa / levodopa) is a combination medication. It has two active ingredients that work together to help bring up the dopamine levels in the brain. This helps relieve symptoms of Parkinson's disease (PD).
Levodopa is a dopamine replacement. After you take levodopa, it travels into the brain where it turns into dopamine. When there's more dopamine in the brain, PD symptoms improve.
Carbidopa is a dopa decarboxylase inhibitor. It stops dopa decarboxylase, a protein in the body that breaks down levodopa before levodopa can reach the brain. By blocking this protein, more levodopa can get to the brain and turn into dopamine. It helps both levodopa and dopamine reach and stay at higher levels in the brain. This enhances levodopa's ability to relieve PD symptoms.
Drug Facts
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What are the side effects of Crexont (carbidopa / levodopa)?
Common Side Effects
- Involuntary movements (dyskinesia, 2-7%)
- Nausea (4-5%)
- Anxiety (2-3%)
- Dizziness (2-3%)
- Constipation (2%)
- Headache (1-2%)
- Vomiting (1-2%)
- Trouble sleeping (1-2%)
Serious Side Effects
- Withdrawal symptoms after stopping suddenly: confusion, very high fevers, sweating, muscle stiffness, changes in breathing, irregular pulse, changes in blood pressure
- Heart problems: chest pain that travels to the arm, neck, or jaw; shortness of breath; cold sweat
- Suicidal thoughts or behavior
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Falling asleep during daily activities
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dark red or black saliva, sweat, or urine
- Dizziness
- Drowsiness
- Headache
- Nausea
Pros and cons of Crexont (carbidopa / levodopa)
Pros
Can provide more "on" time than immediate-release Sinemet (carbidopa / levodopa)
Dose can be adjusted based on how the medication is working for you
Available in 4 different strengths
Cons
Usually need to take multiple times per day
Can make you very sleepy and possibly fall asleep suddenly
Might not be a good option for people who have trouble swallowing pills
Pharmacist tips for Crexont (carbidopa / levodopa)
You can take Crexont (carbidopa / levodopa) with or without food. If you take the medication with food, avoid taking it with a high-fat, high-calorie meal, such as avocados, cheese, and peanut butter. It can make the medication take 2 to 5 hours longer to start working.
Take your first dose of Crexont (carbidopa / levodopa) of the day about 1 to 2 hours before eating. This helps the medication get absorbed faster into your body.
Talk to your prescriber before you make any big diet changes, such as switching to foods that are high in protein. Certain foods can affect how well Crexont (carbidopa / levodopa) gets absorbed into the body and how well it might work for you.
Swallow the Crexont (carbidopa / levodopa) capsules whole. Don't chew, cut, or crush the capsules. Speak with your prescriber about other options if you have trouble swallowing the capsules whole.
Crexont (carbidopa / levodopa) can make you very sleepy. It can also make you fall asleep suddenly. Don't drive or do anything that you need to pay close attention to until you know how the medication makes you feel.
Don't drink alcohol while you're taking Crexont (carbidopa / levodopa). This combination can put you at risk for low blood pressure, which can lead to falls.
You might have more difficulty controlling your body's movements (dyskinesia) after you start taking Crexont (carbidopa / levodopa). If this side effect becomes uncomfortable or annoying, let your prescriber know so they can think about lowering your dose to help.
Don't take iron-containing products at the same time as Crexont (carbidopa / levodopa). Iron and iron-containing medications, vitamins, and supplements can interfere with Crexont (carbidopa / levodopa). They can make the body absorb less Crexont (carbidopa / levodopa), which can affect how well the medication works for your Parkinson's symptoms.
Contact your prescriber before you stop taking Crexont (carbidopa / levodopa). Stopping the medication too suddenly can lead to withdrawal symptoms like fever, muscle problems, and confusion.
Tell your care team if you have suicidal thoughts or behavior. And talk to your loved ones about this risk so they can watch out for any mood changes. For immediate help, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or local emergency services.
Frequently asked questions about Crexont (carbidopa / levodopa)
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What are the risks and warnings for Crexont (carbidopa / levodopa)?
Crexont (carbidopa / levodopa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Sleepiness or falling asleep during activities
Risk factors: History of drowsiness | History of sleep problems | Taking sedatives or medications that make you drowsy
People who've taken medications that contain levodopa, such as Crexont (carbidopa / levodopa), have fallen asleep out of nowhere, even when they didn't feel sleepy beforehand. For example, people might fall asleep in the middle of a meal or a conversation. It's also happened while people were driving, which have sometimes led to accidents.
Because of this risk, avoid driving or doing things that you need to pay attention to until you know how Crexont (carbidopa / levodopa) affects you. This is particularly important if you normally feel sleepy or if you've fallen asleep suddenly in the past. Also avoid taking medications that make you sleepy (e.g., sedatives) while you're taking Crexont (carbidopa / levodopa). They can make you feel even sleepier.
Tell your prescriber if you feel very sleepy during the daytime or if you fall asleep during activities that you need to concentrate for while you're taking Crexont (carbidopa / levodopa).
High fevers and confusion with treatment changes
Although rare, stopping Crexont (carbidopa / levodopa) or lowering the dose suddenly can cause withdrawal symptoms that look similar to those of neuroleptic malignant syndrome (NMS). Symptoms can include very high fevers, confusion, muscle stiffness, irregular pulse, changes in breathing, and changes in blood pressure.
Don't stop taking Crexont (carbidopa / levodopa) or lower your dose without talking to your prescriber. They can instruct you on how to do this safely.
Heart problems
Risk factors: History of heart attack or heart disease | At risk for heart disease
Although rare, some people have had heart problems while they were taking Crexont (carbidopa / levodopa). In studies, these people had a history of heart disease or risk factors for heart disease, such as high blood pressure and high cholesterol.
Before you start taking Crexont (carbidopa / levodopa), be sure your prescriber knows if you've had a heart attack in the past. Your prescriber might monitor your heart when you first start taking this medication.
Call for medical help right away if you have chest pain that might travel to the arm, neck, or jaw; shortness of breath; or a cold sweat. These can be signs of a heart problem.
Hallucinations and changes in behavior and thoughts
Risk factors: History of certain mental health conditions
Crexont (carbidopa / levodopa) can raise the risk of having hallucinations. Sometimes, these hallucinations can happen along with confusion, trouble sleeping, and lots of dreaming. Generally, these symptoms can happen soon after you start taking Crexont (carbidopa / levodopa). And they might go away once your dose is lowered. Contact your prescriber if you or your loved ones think that you're having hallucinations while you're taking Crexont (carbidopa / levodopa).
Crexont (carbidopa / levodopa) can also raise the risk for unusual changes in behavior and thinking (psychosis). They can include paranoia, delusions, confusion, aggressive behavior, uneasiness, and less awareness of your surroundings. Let your prescriber know if you or anyone around you notices that you have unusual behavior or thoughts while you're taking Crexont (carbidopa / levodopa).
Because of the risk for worsening psychosis, you shouldn't take Crexont (carbidopa / levodopa) if you have certain mental health conditions. Certain mental health medications, such as haloperidol (Haldol) or perphenazine, can worsen your Parkinson's symptoms. They also might make Crexont (carbidopa / levodopa) work less well.
Difficulty controlling impulsive behavior
Certain medications for Parkinson's disease, such as Crexont (carbidopa / levodopa), can cause changes in people's behavior. They can include strong sexual or gambling urges, urges to spend a lot money, and binge eating. It can be hard to control these urges.
Contact your prescriber if any urges start to have a negative impact on your life while you're taking Crexont (carbidopa / levodopa). You might not realize that you have these urges, so your prescriber might ask you if you've recently had these behaviors at your next visit.
Stomach bleeding in people who've had a stomach ulcer
Crexont (carbidopa / levodopa) might raise your risk of stomach bleeding if you've had certain kinds of stomach ulcers before. Get medical help right away if you vomit blood or coffee-ground bits; have bloody, black, or tarry stool; or have stomach cramps. These can be signs of stomach bleeding.
Rise in eye pressure in people with glaucoma
Crexont (carbidopa / levodopa) might raise the pressure inside the eye for people who have glaucoma. Tell your eye specialist (optometrist or ophthalmologist) that you're taking Crexont (carbidopa / levodopa). They'll need to check your eye pressure often while you're taking the medication to make sure that your glaucoma doesn't worsen.
Crexont (carbidopa / levodopa) dosage forms
Typical dosing for Crexont (carbidopa / levodopa)
Your Crexont (carbidopa / levodopa) dose will depend on whether you've taken certain medications for Parkinson's disease before.
People who've never taken levodopa before
Days 1 through 3: The typical starting dose is 35 mg/140 mg (carbidopa/levodopa) by mouth twice per day.
Day 4 and onward: Your prescriber might slowly raise your dose up to a maximum daily dose of 525 mg/2,100 mg (carbidopa/levodopa), split up into smaller doses that are taken up to 4 times a day.
People switching from immediate-release Sinemet (carbidopa / levodopa) to Crexont (carbidopa / levodopa): The dose depends on your previous immediate-release carbidopa/levodopa regimen. Your prescriber will work with you to find the right starting dose of Crexont (carbidopa / levodopa) for you.
People switching from Rytary (carbidopa / levodopa) to Crexont (carbidopa / levodopa): The dose depends on your previous Rytary (carbidopa / levodopa) regimen. Your dose for Crexont is typically around the same as your dose for Rytary.
Your prescriber will adjust your Crexont (carbidopa / levodopa) dose depending on how well the medication works for you.
How much does Crexont (carbidopa / levodopa) cost?
Crexont (carbidopa / levodopa) contraindications
Currently take or have taken nonselective monoamine oxidase inhibitors (MAOIs) in the past 2 weeks
What are alternatives to Crexont (carbidopa / levodopa)?
Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have symptoms of PD, including tremors, slowness, and stiffness)
Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have signs and symptoms of PD, including slowness, stiffness, shakiness, and imbalance)
Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have symptoms of PD, including tremors, slowness, and stiffness)
Crexont (carbidopa / levodopa) images
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References
Best studies we foundAmneal Pharmaceuticals LLC. (2024). Crexont- carbidopa and levodopa capsule, extended release [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). Heart disease risk factors.
Fiedorowicz, J. G., et al. (2004). The role of monoamine oxidase inhibitors in current psychiatric practice. Journal of Psychiatric Practice.
Gandhi, K. R., et al. (2023). Levodopa (L-dopa). StatPearls.
Hauser, R. A., et al. (2023). IPX203 vs immediate-release carbidopa-levodopa for the treatment of motor fluctuations in Parkinson disease. Journal of the American Medical Association Neurology.
Hauser, R. A., et al. (2025). Duration of “Good On” time per dose: Immediate-rlease carbidopa-levidopa vs. extended-release carbidopa-levodopa (IPX203, CREXONT®). Parkinsonism & Related Disorders.
LeWitt, P., et al. (2023). Improving levodopa delivery: IPX203, a novel extended-release carbidopa-levodopa formulation. Clinical Parkinsonism & Related Disorders.
Leyden, E., et al. (2023). Carbidopa. StatPearls.
MedlinePlus. (2024). Secondary parkinsonism.
Modi, N. B., et al. (2019). Single-dose pharmacokinetics and pharmacodynamics of IPXX203 in patients with advanced Parkinson disease: A comparison with immediate-release carbidopa-levodopa and with extended-release carbidopa-levodopa capsules. Clinical Neuropharmacology.
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Potentially serious alcohol-medication interactions in older adults (POSAMINO).
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