Sinemet Cr

Sinemet C is a sustained-release combination of carbidopa and levodopa for the treatment of Parkinson’s disease and syndrome.

How does it work?

This pharmaceutical preparation is a combined antiparkinsonian drug of a systemic nature.

The main active substances are levodopa and carbidopa. These substances belong to dopaminergic drugs. Levodopa is a metabolic precursor of dopamine. Carbidopa, in turn, is a substance that has the ability to inhibit peripheral dopa-decarboxylase. Levodopa also has the property of stopping the symptoms of Parkinson’s disease due to metabolic processes, including decarboxylation of the brain.

Carbidopa, in turn, promotes the penetration of levodopa into the brain, as well as its conversion to dopamine. If carbidopa is not present in the preparation, then a significantly larger amount of levodopa must be used to provide the expected effect.

The dug reduces impaired motor reactions, dyskinesia and hyperkinesia. The effect is observed from the first days of therapy.

Composition and release form

The main active components: levodopa, carbidopa.

Auxiliary substances: starch, lactose, cellulose, magnesium stearate, etc.

The drug is produced in tablet form. Each tablet contains 250 mg of levodopa and 25 mg of carbidopa.

Indications

Sinemet Cr is used to treat Parkinson’s disease and its symptoms.

The initial effect can be observed already on the first day of administration, the maximum effect – during the first week of administration.

Contraindications

Sinemet Cr is contraindicated in cases where the patient has a pronounced hypersensitivity (allergy) to the main or one of the auxiliary components.

The drug is also contraindicated in the presence of the following conditions/diseases:

• glaucoma;
• severe hepatic and renal failure;
• severe heart failure, arrhythmias;
• severe psychosis;
• a ban on taking sympathomimetics.
• simultaneous administration of non-selective MAO inhibitors;
• the simultaneous administration of selective MAO inhibitors (use should be discontinued at least 2 weeks before the use of this drug).

Before use, it is necessary to make sure that the patient does not have suspicious neoplasms on the skin in order to exclude the suspicion of malignant melanoma.

Pregnancy and breastfeeding

Sinemet Cr is contraindicated in the period of pregnancy and breastfeeding.

If there is a need to take this drug, then lactation (breastfeeding) should be stopped during treatment.

Dosage and administration

The dosage is determined by the attending physician individually. The tablet, if necessary, can be divided in half. The duration of treatment is up to six months. The more accurate duration of therapy with this drug will depend on the body’s response to treatment. It is determined by the attending physician.

Recommended dosages:

• patients taking the drug for the first time – 0.5 tablets 1 or 2 times a day;
• patients undergoing levodopa therapy – the drug is taken after a minimum pause of 12 hours, the dose is 20% of the previous daily dose of levodopa;
• the initial dose is 75-100 mg of carbidopa and 300-400 mg of levodopa for 3-4 doses per day (if the dose was less than 1500 mg of levodopa per day), and 1 tablet of the drug 3-4 times a day (if the dose was more than 1500 mg levodopa per day);
• maintenance dose – usually 1 tablet 3-4 times a day, the maximum dose per day is 8 tablets).

Overdose

In case of an overdose, a patient may experience the following symptoms:

• dystonia, dyskinesia;
• blepharospasm;
• arrhythmia;
• confusion, anxiety, anxiety.

Treatment is symptomatic. It is necessary to rinse the stomach as soon as possible and take sorbents.

Side effects

Side effects are usually caused by the neuropharmacological effect of dopamine, reduced by a decrease in the dose of levodopa.

In particular, the patient may experience:

• leukopenia, anemia, thrombocytopenia, agranulocytosis;
• changes in body weight;
• hallucinations, confusion, nightmares, drowsiness, fatigue, insomnia, depression;
  dyskinesia, dystonia, dizziness, bradykinesia, drowsiness, ataxia, increased hand tremor;
• paresthesia, headache, cramps;
• blepharospasm, dilated pupils;
• palpitations, arrhythmia, fainting;
• phlebitis;
• nausea, vomiting, dry mouth, gastrointestinal pain, dark saliva, duodenal ulcers;
• angioedema, allergic urticaria, itching, redness of the face, dark sweat, malignant melanoma;
• dark urine, anuria, priapism.

Drug interactions

Avoid taking Sinemet Cr if you taking any of the following drugs:

• antacids;
• antipsychotics, derivatives of butyrophenone, diphenylbutylpiperidine, thioxanthene, phenothiazine, pyridoxine;
• beta-adrenergic agonists;
• MAO inhibitors;
• m-anticholinergics;
• tricyclic antidepressants;
• diazepam, clozapine, methionine, clonidine, phenytoin;
• lithium salts;
• papaverine hydrochloride, reserpine;
• carbidopa.

Additional information

• During the treatment period, patients should be especially careful with the management of transport, as well as other types of labor, which require increased attention and a good psychomotor reaction since drowsiness may occur when taking this medicine. In addition, before taking the drug you should carefully study the list of drugs that are not compatible with Sinemet Cr;
• To avoid side effects and to achieve maximum effectiveness in the treatment with the drug, it is necessary to strictly adhere to the dosages and course of treatment prescribed by the attending specialist;
• Sudden discontinuation of treatment is unacceptable (abrupt cancellation of the drug can cause muscle rigidity, fever, mental disorders and increased activity of CPK in blood serum);
• It is necessary to monitor patients who need to suddenly reduce the dose or stop taking the drug, especially if the patient receives antipsychotic drugs;
• Do not take these pills to eliminate extrapyramidal reactions caused by drugs;
• In the course of treatment, it is necessary to monitor the patient’s mental status, peripheral blood picture;
• High protein foods may interfere with absorption;
• Patients with glaucoma should regularly monitor intraocular pressure;
• During prolonged treatment, periodic monitoring of the functions of the liver, hematopoiesis, kidneys and CVS are indicated;
• Before the planned general anesthesia, the drug can be taken as long as the patient is allowed oral administration;
• After surgery, the usual dose can be taken again as soon as the patient is able to take the drug orally;
• During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.