Generic Name and Formulations:
Carbidopa, levodopa; 23.75mg/95mg, 36.25mg/145mg, 48.75mg/195mg, 61.25mg/245mg; ext-rel caps.
Impax Laboratories, Inc.
Indications for RYTARY:
Treatment of Parkinson's disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication.
Swallow whole. If difficulty swallowing, may open capsule and sprinkle contents on applesauce (1–2tbsp); consume immediately. Individualize. Levodopa-naive: initially 23.75mg/95mg 3 times daily for the first 3 days; may increase to 36.25mg/145mg 3 times daily on the fourth day; up to max 97.5mg/390mg 3 times daily. May increase to max 5 times daily if more frequent dosing needed and tolerated. Max daily dose: 612.5mg/2450mg. Converting from IR carbidopa-levodopa: see full labeling. Currently taking carbidopa-levodopa with concomitant COMT inhibitors (eg, entacapone): may need to increase initial daily dose; see full labeling.
During or within 2 weeks of nonselective MAOIs (eg, phenelzine, tranylcypromine).
Not interchangeable with other carbidopa-levodopa products. Sleep disorders: consider discontinuing if significant daytime sleepiness occurs. History of MI or arrhythmias; monitor cardiac function. Increased risk of hallucinations and psychosis. Major psychotic disorder: not recommended. Impulse control disorders: consider reducing dose or discontinuing if occurs. Peptic ulcer. Glaucoma: monitor intraocular pressure. Perform skin exams to monitor for melanoma. Withdrawal-emergent hyperpyrexia or confusion: avoid sudden discontinuation or rapid dose reduction. Pregnancy (Cat.C). Nursing mothers.
Dopa-decarboxylase inhibitor + dopamine precursor.
See Contraindications. Orthostatic hypotension with MAO-B inhibitors (eg, rasagiline, selegiline); monitor. Antagonized by dopamine D2 receptor antagonists (eg, phenothiazines, butyrophenones, risperidone, metoclopramide), isoniazid, iron salts. Delayed absorption with high-fat, high-calorie meals.
Nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia (reduce doses), anxiety, constipation, vomiting, orthostatic hypotension.
Ext-rel caps—100, 240
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