Rytary vs Sinemet – detailed comparison:
Rytary
It is the generic name of a combination of carbidopa and levodopa. Levodopa is in a class of drugs called central nervous system agents and is converted to dopamine in the brain. Carbidopa helps prevent the breakdown of levodopa before it can reach the brain.
Uses
This medication is used to treat Parkinson’s disease as well as signs similar to the symptoms of PD caused by other health problems.
PD is a disorder of the central nervous system (spinal cord and brain). Its symptoms include rigidity, resting tremor, and bradykinetic movements. It may be caused by low levels of a chemical called dopamine in the brain.
Dosage
The usual recommended starting dose is 23.75 mg/95 mg taken orally 3 times a day for the first three days of treatment. Then, the dose may be increased to 36.25 mg/145 mg taken 3 times per day.
Note – do not stop taking the medication all of a sudden or lower your dose without calling your healthcare provider. In addition, a regular diet that is rich in protein may decrease the body’s capacity to absorb this medication properly.
Side Effects and Precautions
Common side effects include:
- vomiting;
- dizziness;
- dry mouth;
- nausea;
- constipation;
- loss of appetite;
- nightmares;
- diarrhea;
- headaches;
- changes in sense of taste;
- weakness;
- forgetfulness or confusion;
- drowsiness;
- nervousness;
- abnormal or impaired movement;
- increased sweating;
- difficulty sleeping.
Rare side effects may include:
- feeling confused;
- rash;
- a skin lump or growth;
- change in size or color of a mole;
- black, tarry, or bloody stools;
- hives;
- belly pain;
- swelling of the lips, mouth, face, tongue, or throat;
- a fast heartbeat;
- chest pain or pressure;
- fever or chills;
- peeling skin with or without fever;
- a heartbeat that does not feel normal;
- unusual hoarseness;
- throwing up blood or vomit which looks like coffee grounds;
- trouble swallowing, breathing, or talking;
- tightness in the chest or throat;
- trouble controlling body movements that are new or worse;
- wheezing;
- a sore throat;
- very bad headache;
- thoughts of killing yourself;
- passing out;
- very bad dizziness;
- hallucinations (seeing or hearing things that are not there);
- feeling very tired or weak;
- lack of interest in life;
- yellow skin or eyes;
- dark urine;
- shortness of breath;
- history of heart attack;
- anxiety;
- emotional ups and downs;
- nervousness;
- very bad eye irritation;
- strong urges that are hard to control;
- eye pain;
- any unexplained bruising.
To make sure that this medication is safe for you, tell your healthcare provider if you have:
- kidney disease;
- high blood pressure;
- an endocrine disorder;
- heart disease;
- a stomach or intestinal ulcer;
- liver disease;
- open-angle glaucoma;
- a history of mental illness, depression, or psychosis;
- chronic obstructive pulmonary disease (COPD);
- asthma.
Drug Interactions
Tell your doctor about all the medications you take, since the combination of carbidopa and levodopa may interact with many medications, especially:
- isocarboxazid (Marplan);
- antidepressants, like – amoxapine (Asendin), amitriptyline (Elavil), desipramine (Norpramin), clomipramine (Anafranil), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and trimipramine (Surmontil);
- isoniazid (INH, Nydrazid);
- antihistamines;
- metoclopramide (Reglan);
- haloperidol (Haldol);
- Ortho Tri-Cyclen;
- rasagiline (Azilect);
- ipratropium (Atrovent);
- selegiline (Eldepryl);
- iron pills and vitamins containing iron;
- risperidone (Risperdal);
- phenytoin (Dilantin);
- papaverine (Pavabid);
- lomotil;
- medications for irritable bowel disease, high blood pressure, motion sickness, mental illness, nausea, or urinary problems.
Sinemet
It is the generic name of a combination of carbidopa and levodopa. This combination medicine was approved by the US FDA in 1988.
Uses
It is typically used to treat Parkinson’s disease.
Note – although the medication helps relieve symptoms of PD, it does not slow down the progression of the disease.
Additionally, this prescription drug can treat PD-like symptoms after an injury to the nervous system or encephalitis.
Dosage
It comes with an orally-disintegrating tablet, a tablet, and an extended-release tablet.
The extended-release tablet is taken 2 to 7 times per day. The regular and orally-disintegrating tablets are taken 3 or 4 times per day.
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Side Effects and Precautions
Common side effects may include:
- muscle contractions;
- nausea;
- jerky or twisting muscle movements.
Rare side effects may include:
- severe or ongoing vomiting or diarrhea;
- uncontrolled muscle movements in your face;
- unusual changes in mood or behavior;
- worsening of tremors (uncontrolled shaking);
- depression or suicidal thoughts;
- hallucinations;
- a feeling like you might pass out;
- confusion;
- tremors;
- fast or uneven heartbeats;
- very stiff (rigid) muscles.
To make sure that this medication is safe for you, tell your healthcare provider if you have:
- an endocrine (hormonal) disorder;
- high blood pressure;
- kidney disease;
- history of heart attack;
- liver disease;
- heart disease;
- a stomach or intestinal ulcer;
- asthma;
- open-angle glaucoma;
- chronic obstructive pulmonary disease;
- a history of depression.
Pregnancy & Breastfeeding
The medication can pass into breast milk and may negatively affect the infant. Thus, if you are taking this medication, do not breastfeed a baby without first talking to your doctor.
It is not known whether the medication will harm an unborn baby, hence, if you are pregnant or plan to become pregnant, talk with your healthcare provider before taking this medicine.
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Drug Interactions
Tell your doctor about all the medications you are taking, especially:
- Azilect (rasagiline);
- Eldepryl (selegiline);
- antidepressants, like – Asendin (amoxapine) or Elavil (amitriptyline);
- Haldol (haloperidol);
- antihistamines;
- Marplan (isocarboxazid);
- Atrovent or Combivent (Ipratropium);
- iron pills and vitamins containing iron;
- Risperdal (risperidone);
- Dilantin (phenytoin);
- Reglan (metoclopramide);
- INH or Nydrazid (isoniazid);
- Pavabid (papaverine).
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Bottom Line – Rytary vs Sinemet
Rytary is a prescription medication that contains levodopa (an aromatic amino acid) and carbidopa (an inhibitor of aromatic amino acid decarboxylation) in extended-release capsules for oral use. It is used to treat symptoms of Parkinson’s disease and is usually taken 3 to 4 times a day.
Sinemet is a combination medicine (carbidopa and levodopa) used to treat symptoms of Parkinson’s disease, such as tremors, muscle stiffness, poor muscle control, and spasms. Over time, the drug may begin to lose its effectiveness and may start to cause intolerable side effects. The benefits of Sinemet are usually limited to five years of use.
Note – one of the benefits of Rytary is that patients may be able to modestly reduce the number of pills they take as they switch from Sinemet to Rytary.
Image credit – Shutterstock
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References https://www.ncbi.nlm.nih.gov/pubmed/28236251 https://www.centerwatch.com/drug-information/fda-approved- https://www.ncbi.nlm.nih.gov/pubmed/27044646