Monograph Details
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Central Nervous System
> Parkinsonism
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SINEMET CR 50-200 |
| Manufacturer |
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Bristol-Myers Squibb |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Dopa-decarboxylase inhibitor + dopamine precursor. |
| Generic Name |
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Carbidopa 50mg, levodopa 200mg; sust rel scored tabs. |
| Also |
• SINEMET 10-100
• SINEMET 25-100
• SINEMET 25-250
• SINEMET CR 25-100
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| Indications |
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Parkinsonism. |
| Children |
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<18 yrs: not recommended. |
| Adults |
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≥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. |
| Contraindications |
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During or within 14 days of nonselective MAOIs (e.g., phenelzine). Narrow-angle glaucoma. Undiagnosed skin lesions. History of melanoma. |
| Precautions |
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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. |
| Interactions |
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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. |
| Adverse Reactions |
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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. |
| How Supplied |
CR—100, 500
Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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