Co-careldopa for dystonia

Why is it important for my child to take co-careldopa?

Children with dystonia can get painful and distressing movements and muscle spasms, which may make movement, sitting and standing difficult. Co-careldopa acts in the brain to slow down messages to the muscles and nerves. This reduces muscle stiffness and improves comfort.

What is co-careldopa available as?

• Tablets: 12.5 mg/50 mg, 25 mg/100 mg, 25 mg/250 mg (the first number is the amount of carbidopa; the second is the amount of levodopa)
• Liquid medicine: you may be able to order liquid medicine from your pharmacy

When should I give co-careldopa

Co-careldopa is usually given two or three times each day. Give the last dose around 6 pm – you may find that co-careldopa affects your child’s sleep if you give it any later in the evening.

•  If it is to be given twice each day, give one dose in the morning and one in the afternoon. Ideally, these times are 8–10 hours apart. For example, this could be between 7 and 8 am and between 5 and 6 pm.
•  If it is to be given three times each day, these times should be 4–6 hours apart, depending on what time your child wakes up and goes to bed. For example, this could be between 7 and 8 am, at about midday, and between 5 and 6 pm.
•  Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
•  Your doctor may suggest that you start by giving co-careldopa twice a day for a few days, then three times a day.

How should I give co-careldopa?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
• You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

Liquid medicine

Shake the medicine well. Measure out the right amount using an oral syringe or medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount. Make sure your child takes it all straight away.

When should the medicine start working?

It may take a few days or sometimes weeks for co-careldopa to work properly. This is because the amount of medicine has to be increased slowly. Continue to give the medicine as you have been told to by your doctor. It may take a while to find the dose that works best for your child.

What if my child is sick (vomits)?

• If your child is sick less than 30 minutes after having a dose of co-careldopa, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of co-careldopa, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.

What if I give too much?

If you think you may have given your child too much co-careldopa, contact your doctor or local NHS services (details at end of leaflet) or take your child to hospital. Have the medicine container or packaging with you, even if it is empty. This will be useful to the doctor.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side effects you must do something about

Other side-effects you need to know about

Your child may get these side-effects when they first start taking co-careldopa but they will usually settle down within about 2 weeks as their body gets used to the medicine. Continue to give co-careldopa to your child as your doctor has told you to. If any of these side-effects continue, contact your doctor.

• Your child may feel less hungry (lose their appetite), and feel sick (nausea) or be sick (vomit).

• Your child may feel dizzy or light-headed when they stand up, or may even faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or lightheaded.

• They may have difficulty sleeping (insomnia). You can try giving the medicine earlier in the evening.

• Their urine (wee), sweat or saliva may have a reddish colour. This is normal with this medicine and is not cause for concern.

Your child may sometimes get side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to the UK safety scheme at mhra.gov.uk/yellowcard.

More information on side-effects can be found in a leaflet on our website.

Can other medicines be given at the same time as co-careldopa?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

co-careldopa should not be taken with some medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before giving co-careldopa. This includes herbal and complementary medicines.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

• Do not suddenly stop giving co-careldopa to your child, as they may get withdrawal symptoms.

• If your doctor decides to stop a particular medicine, they will discuss this with you. You will usually reduce the dose bit by bit. Your doctor will explain how to do this. Do not change the dose without talking to your doctor first.

co-careldopa is also used to treat Parkinson’s disease in adults. If you look for information on co-careldopa, make sure it relates to dystonia in children, as different doses may be used for different conditions.

General advice about medicines

• Try to give medicines at about the same times each day, to help you remember.

• If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• If you think someone else may have taken the medicine, contact a doctor straight away.

• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

• Make sure that the medicines you have at home have not reached the ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
• Make sure that children cannot see or reach the medicine.
• Keep the medicine in the container it came in.

Who to contact for more information?

Your doctor, pharmacist or nurse will be able to give you more information about co-careldopa and about other medicines used to treat dystonia.

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by January 2027.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.