Uses
What is Dhivy used for?
Dhivy is commonly used to treat Parkinson’s disease, a condition that affects the part of your brain that controls your movements. It may also be used to treat conditions with symptoms similar to Parkinson’s disease (called parkinsonism).
Dhivy may also be used for other conditions as determined by your healthcare provider.
How does Dhivy work (mechanism of action)?
In people with Parkinson's disease, the brain does not have enough of a chemical called dopamine, which helps control movement. This makes it hard for people to move their bodies the way they want to.
Carbidopa and levodopa are medicines that work together to help people with Parkinson's disease.
Levodopa is a medicine that turns into dopamine in the brain. When levodopa is used by itself, it gets broken down too quickly, before it can reach the brain. Carbidopa works to block the breakdown of levodopa so that more dopamine can get to the brain. This helps people with Parkinson's disease move more easily.
How is Dhivy supplied (dosage forms)?
Dhivy is available as 25 mg/100 mg oral tablets.
How should I store Dhivy?
Dhivy should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep the container tightly closed. Protect from light and moisture.
Side Effects
What are the most common side effects of Dhivy?
The most common side effects of Dhivy are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Uncontrollable, involuntary movements (see below)
- Nausea
There may be other side effects of Dhivy that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Dhivy?
While less common, the most serious side effects of Dhivy are described below, along with what to do if they happen.
Severe Allergic Reactions. Dhivy may cause allergic reactions, which can be serious. Stop taking Dhivy and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Depression and Suicidal Thoughts. Dhivy may cause depression in a small number of people. If you having thoughts of harming yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
Sleepiness. Dhivy can make you sleepy, sometimes very suddenly and without warning signs (also called a "sleep attack"). Do not drive or do other activities that require alertness or coordination until you know how Dhivy affects you. Tell your healthcare provider if you feel sleepy or drowsy while taking Dhivy.
Uncontrollable, Involuntary Movements (Dyskinesias). Dhivy may cause involuntary movement problems, including shakiness, stiffness, or jerkiness. Call your healthcare provider right away if you develop any unusual or uncontrolled movements or if they get worse.
Hallucinations or Psychotic-like Behaviors. Dhivy may cause hallucinations or psychotic-like behaviors. Talk to your healthcare provider right away if you or someone you know notices that you have any of the following symptoms.
- Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
- Delusional thoughts, such as false beliefs that you are being controlled
- Disorganized thoughts, such as jumping between topics or having a hard time focusing
- Sudden decline in self-care, such as personal hygiene or academic/work performance
- Aggressive behavior
Unusual or Compulsive Behaviors. Dhivy can cause some people to have strong unusual and uncontrolled urges (compulsions), including gambling, sex, shopping, or eating. Talk to your healthcare provider right away if you or someone you know notices that you have new or worsening strong urges or behaviors.
Warnings & Precautions
Who should not use Dhivy?
Allergies to Ingredients. People who are allergic to any of the following should not take Dhivy.
- Levodopa
- Carbidopa
- Dhivy
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Dhivy.
Drug Interactions. Dhivy should not be taken while you are using or if you have recently used certain other medicines. Before taking Dhivy, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about Dhivy before using it?
Do not take Dhivy unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share Dhivy with other people, even if they have the same condition as you. It may harm them.
Keep Dhivy out of the reach of children.
If you have trouble swallowing a whole Dhivy tablet, the tablet can be broken at the score lines to get your dose. Ask your pharmacist or other healthcare provider if you are unsure how to do this.
Do not stop taking Dhivy without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.
- High fever
- Muscle stiffness or rigidity, where it is hard to move
- Changes in your breathing or heart rate
- Increased sweating
- Confusion
You may notice a dark color in your saliva, sputum, urine, or sweat. This is a common side effect of Dhivy and is not believed to be harmful. However, your clothes might get stained.
Dhivy may cause you to feel sleepy, especially if you already have conditions that can make you drowsy. Dhivy may also cause dizziness, especially when you stand up quickly after lying or sitting down. If this occurs, get up slowly after sitting or lying down. Do not drive or do other activities that require alertness or coordination until you know how Dhivy affects you.
Monitor your skin for changes while taking Dhivy. Keep any appointments to have your skin checked.
What should I tell my healthcare provider before using Dhivy?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Dhivy is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Mental health or behavior problems, including depression or any psychotic disorder (such as schizophrenia or delusional disorder)
- Glaucoma
- Heart problems, such as a prior heart attack, heart disease, or an abnormal heart rhythm
- Low blood pressure or feeling faint or dizzy, especially when standing up from a seated or lying position
- Stomach problems, such as a stomach ulcer
- Kidney or liver problems
Pregnancy. It is not known if or how Dhivy could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take Dhivy while you are pregnant or trying to get pregnant.
Breastfeeding. Levodopa, one of the medicines in Dhivy, passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take Dhivy while breastfeeding.
How can I get more information about Dhivy?
For more information about Dhivy, you can visit the drugmaker’s website at www.dhivy.com.
Interactions
Does Dhivy interact with foods or drinks?
High-protein foods may affect how well your body absorbs levodopa (one of the two medicines in Dhivy) and decrease how well Dhivy works. If you change the amount of protein in your diet, tell your healthcare provider.
It is unknown if drinking alcohol will affect Dhivy. However, the risk of drowsiness, sleepiness, and/or dizziness may be increased if you drink alcohol while taking Dhivy.
Does Dhivy interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking Dhivy.
- A nonselective monoamine oxidase inhibitor (MAOI) within the past 2 weeks, such as phenelzine (Nardil), tranylcypromine (Parnate), or isocarboxazid (Marplan), which is a medicine usually used for depression
- A selective monoamine oxidase B (MAO-B) inhibitor, such as rasagiline or selegiline, which is a medicine usually used for depression or Parkinson’s disease
- A medicine for high blood pressure
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- An antipsychotic, such as haloperidol, chlorpromazine, thioridazine, fluphenazine, or risperidone, which is a medicine for certain mental health conditions
- Isoniazid, which is a medicine used to treat an infection called tuberculosis
- Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
- Papaverine, which is a medicine used for various blood flow problems, including chest pain
- Tetrabenazine, which is a medicine used to treat symptoms of Huntington’s disease
- Iron supplements or other products (such as multivitamins) containing iron
- Metoclopramide (Reglan and others), which is a medicine for certain stomach problems
- Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
- Any other medicine that contains carbidopa or levodopa
This may not be a complete list of medicines that can interact with Dhivy. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Dhivy?
If you or someone else has used too much Dhivy, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Dhivy?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
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