1.
Syndopa CR Tablets
Syndopa CR Tablets (combination of Carbidopa
and Levodopa) is used in the treatment of the
symptoms of idiopathic Parkinson's disease
(paralysis agitans), postencephalitic
parkinsonism, and symptomatic parkinsonism
which may follow injury to the nervous system by
carbon monoxide intoxication and/or manganese
intoxication.
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2.
Syndopa CR Tablets
Indications
Syndopa CR Tablets is used in the treatment of
Idiopathic Parkinson's disease, Postencephalitic
parkinsonism, Symptomatic parkinsonism (carbon
monoxide or manganese intoxication), Patients with
Parkinson's disease or parkinsonism who are
taking vitamin preparations that contain pyridoxine,
to reduce "off" time in patients previously treated
with levodopa/decarboxylase inhibitor preparations,
or with levodopa alone, who have had motor
fluctuations characterised by end-of-dose
deterioration ("wearing-off" phenomenon), peak
dose dyskinesias, akinesia, or similar evidence of
short-duration motor disturbances.
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3.
Syndopa CR Tablets
Active Ingredient
The active pharmaceutical ingredients
contained in Syndopa CR Tablets are
Carbidopa and Levodopa
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4.
Syndopa CR Tablets
Strengths
Syndopa CR is supplied as tablets in two
strengths:
Syndopa CR 125 mg (Levodopa 100mg &
Carbidopa 25mg) or Syndopa CR 25-100
Syndopa CR 250 mg (Levodopa 200mg &
Carbidopa 50mg) or Syndopa CR 50-250
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5.
Syndopa CR Tablets
Difference between IR and CR
Syndopa CR Tablets is supplied as tablets in
two types:
Immediate Release (IR) or normal version and
Controlled Release (CR).
The difference between IR and CR tablets is
that the CR tablets have a special coating on
them that causes the Syndopa CR tablet to
break down in your system more slowly than the
IR ones, thereby allowing a more prolonged
release of medication into the body.
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6.
Syndopa CR Tablets
Chemical Structure - Carbidopa
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7.
Syndopa CR Tablets
Chemical Structure - Levodopa
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8.
Syndopa CR Tablets
Recommended Dosage
The recommended dosage of Syndopa CR
tablets is given below:
➔Patients Without Prior Levodopa Therapy: The
recommended adult starting dosage of Syndopa CR
is one tablet of Syndopa CR 100/25 which may be
used in early stage patients who have not had prior
levodopa therapy or to facilitate titration when
necessary in patients receiving Syndopa CR 200/50.
➔The initial recommended dose is 1 tablet of
Syndopa CR 100/25 twice daily.
➔For patients who require more Levodopa, a daily
dose of 1 to 4 tablets of Syndopa CR 100/25 twice a
day is generally well tolerated.
© The Swiss Pharmacy, Geneva Switzerland

9.
Syndopa CR Tablets
Recommended Dosage
The recommended dosage of Syndopa CR
Tablets is given below:
➔Syndopa CR 250 mg (Levodopa 200mg &
Carbidopa 50mg): When appropriate, Levodopa
therapy may also be initiated with Syndopa CR
200/50.
➔The initial recommended dose in patients with mild
to moderate disease is 1 tablet of Syndopa CR
200/50 two times daily.
➔Initial dosages should not exceed 600 mg per day
of Levodopa or be given at intervals of less than 6
hours.
© The Swiss Pharmacy, Geneva Switzerland

10.
Syndopa CR Tablets
Contraindications
Syndopa CR Tablets is contraindicated in
patients with the following conditions:
Known hypersensitivity to Carbidopa or
Levodopa or any inactive component of this
medication.
➔Syndopa CR 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 Syndopa
CR tablets.
➔
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11.
Syndopa CR Tablets
Side Effects of Syndopa CR Tablets
The most common adverse effects of Syndopa CR
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.
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12.
Syndopa CR Tablets
Side Effects of Syndopa CR Tablets
Gastrointestinal:
vomiting,
gastrointestinal
bleeding, development of duodenal ulcer, diarrhoea,
dark saliva.
Haematologic: leukopenia, haemolytic and nonhaemolytic
anaemia,
thrombocytopenia,
agranulocytosis.
Hypersensitivity: angioedema, urticaria, pruritus,
Henoch-Schonlein purpura.
Respiratory: dyspnoea.
Skin: alopecia, rash, dark sweat.
Urogenital: dark urine. Rarely convulsions have
occurred;
© The Swiss Pharmacy, Geneva Switzerland

13.
Syndopa CR Tablets
Side Effects of Syndopa CR Tablets
Nervous
System/Psychiatric:
neuroleptic
malignant syndrome, bradykinetic episodes (the "onoff" 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.
© The Swiss Pharmacy, Geneva Switzerland

14.
Syndopa CR Tablets
Side Effects of Syndopa CR Tablets
Other adverse effects that have been reported with
Levodopa or Levodopa/Carbidopa combinations and
may be potential adverse effects with Syndopa CR
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.
© The Swiss Pharmacy, Geneva Switzerland

15.
Syndopa CR Tablets
Side Effects of Syndopa CR Tablets
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.
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16.
Syndopa CR Tablets
Warnings And Precautions
When Syndopa CR (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 Syndopa CR (Carbidopa-Levodopa) is started.
➔Levodopa alone, as well as Syndopa CR, is associated
with dyskinesias. The occurrence of dyskinesias may
require dosage reduction
➔As
with Levodopa, Syndopa CR 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.
➔
© The Swiss Pharmacy, Geneva Switzerland

17.
Syndopa CR Tablets
Warnings And Precautions
Syndopa CR tablets 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 Syndopa CR 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.
➔
© The Swiss Pharmacy, Geneva Switzerland

18.
Syndopa CR Tablets
Warnings And Precautions
As with Levodopa, treatment with Syndopa CR 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 Syndopa CR. Therefore,
patients should be observed carefully when the
dosage of Syndopa CR tablets is reduced abruptly
or discontinued, especially if the patient is receiving
neuroleptics.
➔
© The Swiss Pharmacy, Geneva Switzerland

19.
Syndopa CR Tablets
Overdose Symptoms
Reported symptoms two hours after ingestion of 60
tablets of 25-250 (Levodopa 200 mg & Carbidopa
25 mg) 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.
© The Swiss Pharmacy, Geneva Switzerland

20.
Syndopa CR Tablets
Syndopa CR Tablets from Sun
Pharmaceutical Industries Ltd., India
For more information click here
© The Swiss Pharmacy, Geneva Switzerland