SINEMET CR Rx
Generic Name and Formulations:
Carbidopa, levodopa; 25-100, 50-200; sust rel tabs.
Merck & Co., Inc.
Indications for SINEMET CR:
≥18yrs: Do not crush or chew. Patients not receiving levodopa: initially one Sinemet CR 50–200 tab twice daily, at intervals of at least 6 hrs. Others: see literature. Allow 3 days between dosage adjustments. If given at intervals <4 hrs and/or divided doses not equal: give smaller doses at end of day. May add immediate-release Sinemet 25–100 or 10–100 in advanced disease.
<18yrs: not recommended.
During or within 14 days of nonselective MAOIs (eg, phenelzine). Narrow-angle glaucoma. Undiagnosed skin lesions. History of melanoma.
Severe cardiovascular or pulmonary disease. Asthma. Renal, hepatic, or endocrine disorders. History of peptic ulcer or MI with residual arrhythmias. Suicidal tendencies. Psychosis. Orthostatic hypotension. Chronic wide-angle glaucoma. Discontinue levodopa at least 12 hrs before starting Sinemet or Sinemet CR. Sinemet CR not bioequivalent to Sinemet; see literature when switching forms. Monitor renal and liver function, intraocular pressure, blood counts. May stain body fluids. Pregnancy (Cat.C). Nursing mothers.
Dopa-decarboxylase inhibitor + dopamine precursor.
See Contraindications. Orthostatic hypotension with selegiline, antihypertensives. Antagonized by phenothiazines, butyrophenones, risperidone, phenytoin, papaverine. Hypertension, dyskinesia with tricyclic antidepressants. May be antagonized by iron, high protein diets. May cause false (+) urinary ketone test or false (–) urinary glucose (glucose oxidase) test.
Dyskinesia, GI upset, hallucinations, confusion, psychological disturbances, depression, dizziness, headache, dream abnormalities, dystonia, cardiac arrhythmias, hypotension, dyspnea, on-off phenomenon, back pain, blepharospasm (may indicate excess dosage), hypertension, anticholinergic effects, anorexia, insomnia, leukopenia, renal and liver function disorders, seizures, neuroleptic malignant syndrome.
CR—100, 500; Tabs—100
Neurology Advisor Articles
- Rasagiline Plus Riluzole is Safe, May Improve Survival in ALS
- Treatment of New-Onset Epilepsy: AAN, AES Update Practice Guidelines
- Gender Differences in the Epidemiology of Migraine
- Changes in Glucose Regulation in Parkinson Disease
- Apomorphine Infusions Improves Off Time Associated With Parkinson Disease
- Some Statins May Be Associated With Cognition, Memory Deficits
- Neuropathic Pain Treatments
- Cannabis for Multiple Sclerosis: Prescriber's Perspective
- New Monoclonal Antibody BAN2401 Reduces Amyloid Plaques, Improves Cognition in Alzheimer's
- Nonpharmacologic Interventions for Alzheimer's Have Greater Impact on Outcomes Than Currently Available Medications
- Locally Asymptomatic Ischemic Stroke May Present as Migraine Aura
- Associations Identified Between Stroke Severity, Recovery of Visuospatial Neglect
- Action Tremor May Have Central Origin in Motor Neuron Disease
- Characteristics Affecting Health-Related Quality of Life in RRMS, Progressive MS
- Neurodevelopmental Anomalies, Birth Defects Linked to Zika ID'd