Crexont
Crexont (carbidopa / levodopa) is an extended-release capsule that treats symptoms of Parkinson's disease (PD) in adults. It works to raise dopamine levels in the brain to manage PD symptoms. In general, this medication is taken by mouth, usually 2 to 4 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 PD symptoms, 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 it 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 helps relieve PD symptoms.
Drug facts
| Common Brands | Crexont |
|---|---|
| Drug Class | Dopa decarboxylase inhibitor / Dopamine replacement |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Crexont (carbidopa / levodopa)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
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%)
Crexont (carbidopa / levodopa) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Falling asleep suddenly or feeling very sleepy
- Hallucinations: seeing things that aren't there, hearing sounds that aren't real, feeling unreal sensations
- Abnormal thinking or behavior: confusion; trouble sleeping; paranoia; delusions; aggression; agitation; strong urges to gamble, shop, or eat
- Heart problems: chest pain that travels to the arm, neck, or jaw; shortness of breath; cold sweat
- Low vitamin B6: depression, confusion, swollen or sore tongue, cracked corners of your mouth, skin irritation, numbness or tingling in the hands or feet, seizure
- Suicidal thoughts or behavior
- Withdrawal symptoms after stopping suddenly: confusion, very high fevers, sweating, muscle stiffness, changes in breathing, irregular pulse, changes in blood pressure
The following Crexont (carbidopa / levodopa) 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
- Low vitamin B6 level—swollen or sore tongue, cracks at the corners of the mouth, rash, pain, tingling, or numbness in the hands or feet, irritability, confusion, feelings of depression, unusual weakness or fatigue, seizures
- 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
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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)
- 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.
- 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.
- It's recommended to 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.
- 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.
- 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.
- You might have more difficulty controlling your body's movements after you start taking Crexont (carbidopa / levodopa). This is called dyskinesia. If it becomes uncomfortable or annoying, let your prescriber know. They might decide to lower your dose to help.
- Tell your care team if your tongue gets sore and red, or if you notice cracks at the corners of your mouth. Also let them know if you feel any strange numbness or tingling. These can be signs of low vitamin B6, which is possible with Crexont (carbidopa / levodopa). Your care team can check your levels with a blood test and suggest a vitamin B6 supplement if you need one.
- Don't take iron-containing products at the same time as Crexont (carbidopa / levodopa). This includes iron vitamins and multivitamins with iron in them. Iron can make the body absorb less Crexont (carbidopa / levodopa). This can affect how well the medication works for your Parkinson's symptoms.
- Talk to your prescriber before you stop taking Crexont (carbidopa / levodopa). Stopping it 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, call the National Suicide Prevention Lifeline at 1-800-273-8255 or local emergency services.
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.
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 like sedatives. They can make you feel even sleepier.
Tell your prescriber if you feel very sleepy during the daytime while taking Crexont (carbidopa / levodopa). Also tell them if you suddenly doze off while doing things that need your focus. Your prescriber can help decide if it's safe for you to keep taking the medication.
High fevers and confusion with treatment changes
Although rare, stopping Crexont (carbidopa / levodopa) or lowering the dose suddenly can cause withdrawal symptoms. They can 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 tell you 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.
Low vitamin B6 levels and seizures
- Risk factors: Taking a high dose of Crexont (carbidopa / levodopa)
Taking Crexont (carbidopa / levodopa) can lower your vitamin B6 levels. The risk of vitamin B6 deficiency is greater if you're taking a higher dose of the medication.
Low vitamin B6 can cause a rash, a swollen tongue, or numbness and tingling in your hands and feet. In serious cases, it can lead to depression, confusion, or even seizures. These seizures might not get better with usual anti-seizure medications. And they might only improve when given extra vitamin B6.
Your care team will check your vitamin levels with blood tests before you start Crexont (carbidopa / levodopa). They'll also check again periodically during treatment. Tell your care team if you notice symptoms of low vitamin B6. These include a sore tongue, cracked corners of your mouth, or numbness and tingling. Your care team might suggest a vitamin B6 supplement to keep your levels up.
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
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 35mg/140mg | 60 capsules | $269.08 | $4.48 |
| 52.5mg/210mg | 120 capsules | $531.91 | $4.43 |
| 70mg/280mg | 120 capsules | $535.06 | $4.46 |
| 87.5mg/350mg | 120 capsules | $531.91 | $4.43 |
Typical dosage for Crexont (carbidopa / levodopa)
Your Crexont (carbidopa / levodopa) dose will depend on whether you've taken certain Parkinson's medications 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 a 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 carbidopa / levodopa (Sinemet) 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 for you.
-
People switching from Rytary (carbidopa / levodopa) to Crexont (carbidopa / levodopa): The dose depends on your previous Rytary 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?
$269.08
Crexont (carbidopa / levodopa) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Crexont (carbidopa / levodopa) will not be safe for you to take.
- Currently take or have taken nonselective monoamine oxidase inhibitors (MAOIs) in the past 2 weeks
What are alternatives to Crexont (carbidopa / levodopa)?
Crexont (carbidopa / levodopa) images
