Compare carbidopa / levodopa vs. tolcapone

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Sinemet (carbidopa / levodopa)

Prescription only

Tasmar (tolcapone)

Prescription only
Treats Parkinson's disease.

Sinemet (carbidopa / levodopa) is the first choice treatment for Parkinson's disease.

Treats Parkinson's disease.

Taking Tasmar (tolcapone) is the next step to control Parkinson's disease when carbidopa/levodopa don't work as well, however you might be more likely to have liver damage.

Upsides
  • Sinemet (carbidopa / levodopa) is widely available as a regular pill, a quick dissolving pill or a liquid taken through a feeding tube.
  • Sinemet (carbidopa / levodopa) is available in generic.
  • Tasmar (tolcapone) is part of the medicines used as the most common next step to control Parkinson's disease when carbidopa/levodopa doesn't work as well.
  • Tasmar (tolcapone) is available as a generic.
  • Tasmar (tolcapone) can be taken with or without food.
Downsides
  • Can make you very sleepy.
  • Can stain your saliva, sweat and urine a dark color.
  • Will lose its effect over time as your disease progresses.
  • May need to be taken several times during day to control symptoms of Parkinson's disease
  • May cause unusual cravings in some people.
  • When you first start taking Tasmar (tolcapone), your doctor might have to change the dose a lot because of all the side effects.
  • Tasmar (tolcapone) will only slow the disease down; it is not a cure for Parkinson's disease.
  • Unlike Comtan, Tasmar (tolcapone) is more likely to damage your liver, so you might need regular blood tests for the first few months.
  • Tasmar (tolcapone) is not available as a combination pill with carbidopa/levodopa, unlike Comtan.
  • Tasmar (tolcapone) can cause dry mouth and changes in blood pressure. Changes in blood pressure can make you feel faint and more likely to fall.
Used for
Dosage forms
  • Pill
  • Dissolving tablet
  • Pill
Price
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$18.44
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$1769.68
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Side effects
The Sinemet (carbidopa / levodopa) FDA package insert doesn’t have numbers about how common side effects are.
10possible side effects
  • Difficulty controlling movement
    42%
  • Nausea
    30%
  • Sleeping problems
    24%
  • Excessive dreaming
    21%
  • Muscle cramps
    19%
  • Loss of appetite
    19%
  • Sleepiness
    18%
  • Uncontrolled muscle spasms
    17%
  • Lightheadedness from standing
    17%
  • Diarrhea
    16%
See more detailed side effects
Risks and warnings
  • Falling asleep during the day

    Taking other medicines for Parkinson's

  • High fever and confusion

    Stopping Sinemet (carbidopa / levodopa) suddenly

  • Lack of impulse control

    Taking other medicines for Parkinson's disease

See more detailed risks and warnings
  • Liver damage

    Liver damage

  • Falling asleep during the day

    Taking other medicines for Parkinson's disease

  • Abnormal thinking and mood changes

    Taking antipsychotic medicines

  • Lack of impulse control

    Taking other medicines for Parkinson's disease

See more detailed risks and warnings