Drug interactions
Carbidopa-levodopa + Ferrous sulfate
Severity: Moderate
Carbidopa-levodopa and Ferrous sulfate: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Oral iron salts can bind levodopa in the gut and reduce the amount absorbed. Patients may lose motor control, with more frequent or longer off periods, after iron is started.
What this interaction means in plain words
Carbidopa-levodopa and Ferrous sulfate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbidopa-levodopa belongs to Central Nervous System; Ferrous sulfate belongs to Miscellaneous.
Why it happens
Iron chelates levodopa in the gastrointestinal tract, forming a poorly absorbed complex and lowering bioavailability.
What to do
Give ferrous sulfate at least 2 hours apart from carbidopa-levodopa. Monitor motor symptoms and adjust the levodopa dose if fluctuations appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Carbidopa-levodopa
- Carbidopa-levodopa + Isocarboxazid Contraindicated
- Carbidopa-levodopa + Phenelzine Contraindicated
- Carbidopa-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-levodopa Major
- Asenapine + Carbidopa-levodopa Major
Other interactions of Ferrous sulfate
Frequently asked questions
Can I take Carbidopa-levodopa with Ferrous sulfate?
MediHelp rates the interaction as moderate. Carbidopa-levodopa and Ferrous sulfate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Oral iron salts can bind levodopa in the gut and reduce the amount absorbed. Patients may lose motor control, with more frequent or longer off periods, after iron is started.
How serious is the interaction between Carbidopa-levodopa and Ferrous sulfate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give ferrous sulfate at least 2 hours apart from carbidopa-levodopa. Monitor motor symptoms and adjust the levodopa dose if fluctuations appear.
What other medicines interact with Carbidopa-levodopa?
MediHelp also lists interactions of Carbidopa-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-levodopa page.
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