Compare carbidopa / levodopa vs. tolcapone

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

Sinemet
(carbidopa / levodopa)

Tasmar
(tolcapone)

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.
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Best available price for 90 (25mg/100mg) tablets of carbidopa-levodopa
Coupons for tolcapone
Best available price for 60 (100mg) tablets of tolcapone
Reviews & ratings
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Have you used Sinemet (carbidopa / levodopa)?
Worth itNot sureNot worth it

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Have you used Tasmar (tolcapone)?
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Side effects
carbidopa / levodopatolcapone

The carbidopa / levodopa FDA package insert doesn’t have numbers about how common side effects are.

More about carbidopa / levodopa side effects »
  • Difficulty controlling movement 22%
  • Nausea 12%
  • Sleeping problems 6%
  • Excessive dreaming 4%
  • Muscle cramps 2%
  • Loss of appetite 6%
  • Sleepiness 5%
  • Lightheadedness from standing 3%
  • Diarrhea 8%
More tolcapone side effects »
How it works
carbidopa / levodopatolcapone
Sinemet (carbidopa / levodopa) is a combination of carbidopa and levodopa. Carbidopa prevents breakdown of levodopa allowing it to enter the brain and relieve symptoms of Parkinson's disease.Tasmar (tolcapone) is an enzyme inhibitor that stops levodopa from being broken down. It causes higher levodopa in the brain, which relieves the symptoms of Parkinson's disease.
Type of medication
carbidopa / levodopatolcapone
Prescription onlyPrescription only
Available as
carbidopa / levodopatolcapone
  • Pill
  • Dissolving tablet
  • Pill
Used for
carbidopa / levodopatolcapone
Risk factors for serious side effects
carbidopa / levodopatolcapone
  • Taking other medicines for Parkinson's
  • Stopping Sinemet (carbidopa / levodopa) suddenly
  • Taking other medicines for Parkinson's disease
Detailed Sinemet (carbidopa / levodopa) risks & warnings »
  • Liver damage
  • Taking other medicines for Parkinson's disease
  • Taking antipsychotic medicines
Detailed Tasmar (tolcapone) risks & warnings »
Pregnancy

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Food
carbidopa / levodopatolcapone
No food related info.
  • Tasmar (tolcapone) can be taken with or without food.
Sleep
carbidopa / levodopatolcapone
  • Can make you very sleepy. Don't drive or do anything that requires concentration until you know how your body reacts to it.
  • Can make you very sleepy.
No sleep related info.
Upsides and benefits
carbidopa / levodopatolcapone
  • 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 and risks
carbidopa / levodopatolcapone
  • 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.
Tips from our pharmacists for people taking the medication
carbidopa / levodopatolcapone
  • Can make you very sleepy. Don't drive or do anything that requires concentration until you know how your body reacts to it.
  • Can stain your saliva, sweat and urine a dark color.
  • Take Sinemet (carbidopa / levodopa) 30-60 minutes before a meal so that your body can properly absorb it. Don't eat too much high protein foods (meat, milk, cheese or nuts) because doing so can prevent it from getting absorbed into your body.
  • If you notice Sinemet (carbidopa / levodopa) wearing off sooner than you'd like, talk to your doctor. How much and how often you take it may need to be adjusted.
  • Sinemet (carbidopa / levodopa) may cause unusual cravings in some people.
  • Tasmar (tolcapone) can make you dizzy if you've been sitting or lying down for a while. Be very careful when getting up.
  • Don't drive or do anything requiring concentration until you know how Tasmar (tolcapone) affects you.
  • Your urine might be colored dark orange or brown while taking Tasmar (tolcapone). This is normal.
  • You have to keep taking carbidopa/levodopa with Tasmar (tolcapone). Tasmar (tolcapone) won't work by itself to control your Parkinson's disease.
  • Talk to your doctor if you want to stop taking Tasmar (tolcapone). Stopping it suddenly can be very dangerous.
Learn more
More about carbidopa / levodopaSide effectsAlternativesFDA package insert
Have you used Sinemet (carbidopa / levodopa)?
Worth itNot sureNot worth it
More about tolcaponeSide effectsAlternativesFDA package insert
Have you used Tasmar (tolcapone)?
Worth itNot sureNot worth it