Indications & Uses
Syndopa CR 125 is indicated for:
Pharmacology
Levodopa: Levodopa is the metabolic precursor of dopamine. It crosses the blood-brain barrier and is presumably converted to dopamine in the brain. This is thought to be the mechanism by which levodopa relieves the symptoms of Parkinson's disease.
Carbidopa: When levodopa is given by mouth, it is rapidly decarboxylated to dopamine in tissues outside the brain, so only a small portion of a given dose reaches the central nervous system unchanged. Carbidopa inhibits this peripheral decarboxylation of levodopa, making more levodopa available for delivery to the brain.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Starting Dose for Patients Naive to Levodopa Therapy: For patients who have never taken levodopa before, the usual starting dose of RYTARY is 95 mg taken by mouth three times a day (TID) for the first 3 days. On the fourth day of treatment, the dose can be raised to 145 mg taken three times a day. Depending on how each patient responds and tolerates the medicine, the RYTARY dose may be increased further, up to a maximum recommended dose of 390 mg three times a day. If more frequent dosing is needed and tolerated, the schedule can be changed from three times a day to as often as five times a day. Patients should be kept on the lowest dose that controls symptoms while limiting side effects such as dyskinesia and nausea. The maximum recommended daily dose of RYTARY is 2450 mg.
Converting from Immediate Release Carbidopa Levodopa to RYTARY: Doses of other carbidopa and levodopa products are not interchangeable with RYTARY on a 1:1 basis. To convert a patient from immediate release carbidopa-levodopa to RYTARY, first calculate the patient's current total daily dose of levodopa. The starting total daily dose of RYTARY is then chosen using the conversion guide below. After conversion, any combination of the four RYTARY strengths can be used to reach an optimal dose. The dose and dosing frequency should be adjusted as necessary to maintain patient tolerance and sufficient symptom control. Any other Parkinson's disease medicines the patient is taking should be kept stable while the RYTARY dose is being adjusted. In clinical trials, RYTARY was given in divided doses three to five times a day. The maximum recommended total daily dose of RYTARY is 612.5 mg / 2,450 mg. For patients already being treated with carbidopa and levodopa together with a catechol-O-methyl transferase (COMT) inhibitor such as entacapone, the initial total daily levodopa dose shown in the conversion guide may need to be increased. RYTARY has not been studied in combination with other levodopa products.
Conversion Guide from Immediate Release Carbidopa Levodopa to RYTARY:
Total daily levodopa dose with immediate release levodopa-carbidopa of 400 mg to 549 mg corresponds to a total daily levodopa dose with RYTARY of 855 mg, given as 3 capsules of RYTARY95 mg taken TID.
550 mg to 749 mg corresponds to 1140 mg, given as 4 capsules of RYTARY95 mg taken TID.
750 mg to 949 mg corresponds to 1305 mg, given as 3 capsules of RYTARY145 mg taken TID.
950 mg to 1249 mg corresponds to 1755 mg, given as 3 capsules of RYTARY195 mg taken TID.
Equal to or greater than 1250 mg corresponds to 2340 mg or 2205 mg, given as 3 capsules of RYTARY245 mg taken TID.
Side Effects
Early Parkinson's disease: The most common side effects, occurring in 5% or more of patients and more often than with placebo, include nausea, dizziness, headache, trouble sleeping, unusual dreams, dry mouth, involuntary movements (dyskinesia), anxiety, constipation, vomiting, and a drop in blood pressure on standing (orthostatic hypotension). Advanced Parkinson's disease: The most common side effects, occurring in 5% or more of patients and more often than with standard immediate-release carbidopa-levodopa, are nausea and headache.
Cautions & Contraindications
Warnings & Precautions
Falling asleep during daily living activities and somnolence (drowsiness) Withdrawal-emergent hyperpyrexia and confusion (marked by high temperature, muscle rigidity, altered consciousness and autonomic instability) Cardiovascular ischemic events Hallucinations and psychosis Impulse control and compulsive behaviors Dyskinesia Peptic ulcer disease Glaucoma, etc.
Contraindications
This medicine should not be used by people who are taking a non-selective monoamine oxidase (MAO) inhibitor, such as phenelzine or tranylcypromine. It should also be avoided if a non-selective MAO inhibitor was taken within the last 2 weeks. If the two are used together, high blood pressure (hypertension) can develop.
Pregnancy & Breastfeeding
Pregnancy: No adequate data exist on the developmental risks of RYTARY use in pregnant women. Animal studies have shown carbidopa-levodopa to be developmentally toxic, including teratogenic effects, at doses relevant to clinical use.
Breastfeeding (Lactation): Levodopa has been detected in human milk following carbidopa-levodopa use. There is no data on whether carbidopa passes into human milk, on how levodopa or carbidopa might affect a breastfed infant, or on their effects on milk production. Because levodopa lowers prolactin secretion in humans, breastfeeding mothers may experience reduced milk supply. Carbidopa is excreted in the milk of rats.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Use in children: the safety and effectiveness of Levodopa-Carbidopa prolonged-release tablet haven't been established in infants and children. For that reason, it isn't recommended for anyone below the age of 18.
Storage
Store in a cool and dry place, keep away from light and children.
Drug Interactions
Common questions about Syndopa CR 125 25 mg
What is Syndopa CR 125 25 mg Cr Tablet?
Syndopa CR 125 25 mg Cr Tablet is a medicine that contains Carbidopa + Levodopa. It is made by Sun Pharmaceuticals (EZ) Ltd., Narayanganj. It belongs to the Antiparkinson drugs group of medicines.
What is Syndopa CR 125 used for?
Syndopa CR 125 is used for: Parkinson's Disease.
What are the side effects of Syndopa CR 125?
Early Parkinson's disease: The most common side effects, occurring in 5% or more of patients and more often than with placebo, include nausea, dizziness, headache, trouble sleeping, unusual dreams, dry mouth, involuntary movements (dyskinesia), anxiety, constipation, vomiting, and a drop in blood pressure on standing (orthostatic hypotension). Advanced Parkinson's disease: The most common side effects, occurring in 5% or more of patients and more often than with standard immediate-release carbidopa-levodopa, are nausea and headache.
Can I take Syndopa CR 125 during pregnancy or while breastfeeding?
Pregnancy: No adequate data exist on the developmental risks of RYTARY use in pregnant women. Animal studies have shown carbidopa-levodopa to be developmentally toxic, including teratogenic effects, at doses relevant to clinical use. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Syndopa CR 125?
Store in a cool and dry place, keep away from light and children.
Can I take other medicines with Syndopa CR 125?
Some medicines can interact with Carbidopa + Levodopa, for example: Ferrous Gluconate, Isoniazid, Risperidone, Levodopa, Iron, Phenytoin. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Syndopa CR 125?
Syndopa CR 125 is a prescription (Rx) medicine. Take it as your doctor advises.