Generic Sinemet Tablets for Treatment of Parkinson's Disease and Symptoms

Generic Sinemet Tablets
Generic Sinemet (Syndopa Tablets) is a
combination of Carbidopa and Levodopa used
for the treatment of Parkinson's disease and
syndrome.
© The Swiss Pharmacy, Geneva Switzerland

Chemical Structure - Carbidopa

Chemical Structure - Levodopa

Indications
Generic Sinemet is indicated in the treatment
of the symptoms of idiopathic Parkinson's
disease (paralysis agitans), post-encephalitic
parkinsonism, and symptomatic parkinsonism
which may follow injury to the nervous system
by carbon monoxide intoxication and/or
manganese intoxication.
Generic Sinemet is indicated in these
conditions to permit the administration of lower
doses of levodopa with reduced nausea and
vomiting, with more rapid dosage titration, with
a somewhat smoother response, and with
supplemental pyridoxine (vitamin B6).

Active Ingredient
The active pharmaceutical ingredients
contained in Generic Sinemet Tablets
(Syndopa Tablets) are Carbidopa and
Levodopa

Strengths
The Generic Sinemet (Syndopa) is supplied as
tablets in four strengths:
Syndopa 110 mg (Levodopa 100mg &
Carbidopa 10mg) or Generic Sinemet 10-100

Recommended Dosage
The recommended dosage of Generic Sinemet
(Syndopa Tablets) is given below:
➔Syndopa 125 mg (Levodopa 100mg &
Carbidopa 25mg) : The recommended starting
dosage is one tablet of Generic Sinemet 25-100
(Levodopa 100mg & Carbidopa 25mg) three times
a day. This dosage schedule provides 75 mg of
carbidopa per day. Dosage may be increased by
one tablet every day or every other day, as
necessary, until a dosage of eight tablets of Generic
Sinemet 25-100 a day is reached.

Recommended Dosage
The recommended dosage of Generic Sinemet
(Syndopa Tablets) is given below:
➔Syndopa 110 mg (Levodopa 100mg &
Carbidopa 10mg): The recommended starting
dosage of Generic Sinemet 10-100 (Levodopa
100mg & Carbidopa 10mg) is one tablet three or
four times a day. However, this will not provide an
adequate amount of carbidopa for many patients.
Dosage may be increased by one tablet every day
or every other day until a total of eight tablets (2
tablets four times a day) is reached.

Contraindications
Generic Sinemet is contraindicated in
patients with the following conditions:
➔Known hypersensitivity to Carbidopa or
Levodopa or any inactive component of this
medication.
➔Generic Sinemet should not be used in patients
with suspicious, undiagnosed skin lesions or a
history of melanoma
➔Nonselective monoamine oxidase (MAO)
inhibitors are contraindicated for use with Generic
Sinemet.

Side Effects of Generic Sinemet Tablets
The most common adverse effects of Generic
Sinemet are dyskinesias including choreiform,
dystonic, and other involuntary movements and
nausea. Muscle twitching and blepharospasm may
be taken as early signs to consider reduction. Other
adverse effects reported in clinical trials or in post-marketing
experience are as follows:
Body as a whole: syncope, chest pain,
anorexia. Cardiovascular: cardiac irregularities
and/or palpitation, orthostatic effects including
hypotensive episodes, hypertension, phlebitis.

Gastrointestinal: vomiting, gastrointestinal
bleeding, development of duodenal ulcer, diarrhoea,
dark saliva.
Haematologic: leukopenia, haemolytic and non-haemolytic
anaemia, thrombocytopenia,
agranulocytosis.
Hypersensitivity: angioedema, urticaria, pruritus,
Henoch-Schonlein purpura.
Respiratory: dyspnoea.
Skin: alopecia, rash, dark sweat.
Urogenital: dark urine. Rarely convulsions have
occurred;

Nervous System/Psychiatric: neuroleptic
malignant syndrome, bradykinetic episodes (the "on-off"
phenomenon), dizziness, somnolence including
very rarely excessive daytime somnolence and
sudden sleep onset episodes, paresthesia,
psychotic episodes including delusions,
hallucinations and paranoid ideation, depression
with or without development of suicidal tendencies,
dementia, dream abnormalities, agitation, confusion.

Other adverse effects that have been reported with
Levodopa or Levodopa/Carbidopa combinations and
may be potential adverse effects with Generic
Sinemet are listed below:
Nervous System/Psychiatric: asthenia, decreased
mental acuity, disorientation, ataxia, numbness,
increased hand tremor, muscle cramps, trismus,
activation of latent Horner's syndrome, insomnia,
anxiety, euphoria, falling and gait abnormalities.
Gastrointestinal: dyspepsia, dry mouth, bitter taste,
sialorrhoea, dysphagia, bruxism, hiccups, abdominal
pain and distress, constipation, flatulence, burning
sensation of tongue.

Metabolic: weight gain or loss, oedema.
Skin: flushing, increased sweating, pigmentation of
teeth and skin.
Urogenital: urinary retention, urinary incontinence,
priapism.
Special Senses: diplopia, blurred vision, dilated
pupils, oculogyric crises.
Miscellaneous: weakness, faintness, fatigue,
headache, hoarseness, malaise, hot flashes, sense
of stimulation, bizarre breathing patterns, malignant
melanoma.

Warnings And Precautions
➔When Generic Sinemet (Carbidopa-Levodopa) is to be
given to patients who are being treated with levodopa,
levodopa must be discontinued at least twelve hours
before therapy with Generic Sinemet (Carbidopa-
Levodopa) is started.
➔Levodopa alone, as well as Generic Sinemet, is
associated with dyskinesias. The occurrence of
dyskinesias may require dosage reduction
➔As with levodopa, Generic Sinemet may cause mental
disturbances. These reactions are thought to be due to
increased brain dopamine following administration of
levodopa. All patients should be observed carefully for the
development of depression with concomitant suicidal
tendencies.

➔Generic Sinemet should be administered cautiously
to patients with severe cardiovascular or pulmonary
disease, bronchial asthma, renal, hepatic or
endocrine disease.
➔As with levodopa, care should be exercised in
administering Generic Sinemet to patients with a
history of myocardial infarction who have residual
atrial, nodal, or ventricular arrhythmias. In such
patients, cardiac function should be monitored with
particular care during the period of initial dosage
adjustment, in a facility with provisions for intensive
cardiac care.

➔As with levodopa, treatment with Generic Sinemet
may increase the possibility of upper gastrointestinal
hemorrhage in patients with a history of peptic ulcer.
➔Neuroleptic Malignant Syndrome (NMS): Sporadic
cases of a symptom complex resembling NMS have
been reported in association with dose reductions or
withdrawal of therapy with Generic Sinemet.
Therefore, patients should be observed carefully
when the dosage of Generic Sinemet (Syndopa
Tablets) is reduced abruptly or discontinued,
especially if the patient is receiving neuroleptics.

Overdose Symptoms
Reported symptoms two hours after ingestion of 60
tablets of 25-250 Generic Sinemet were sinus
tachycardia, nausea and vomiting. Supportive
therapy has to be instituted.
Electrocardiographic monitoring should be instituted
and the patient carefully observed for the possible
development of arrhythmias; if required, appropriate
antiarrhythmic therapy should be given.

Syndopa Tablets from Sun
Pharmaceutical Industries Ltd., India
For more information click here

Generic Sinemet Tablets for Treatment of Parkinson's Disease and Symptoms

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