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Sinemet CR is the brand name for carbidopa/levadopa and is available as a sustained-release tablet.

Sinemet CR is available as a 25 mg/100 mg and 50 mg/200 mg sustained release tablet.

Sinemet CR is a dopa decarboxylase inhibitor / dopamine replacement and is used to treat the following:

• Parkinson’s disease (PD)
• Parkinsonism (conditions that cause people to have signs and symptoms of PD, including slowness, stiffness, shakiness, and imbalance)

Sinemet CR is a combination of two medications: carbidopa and levodopa. By working together, these medications help relieve symptoms of Parkinson’s disease (PD), which occur due to low dopamine levels in the brain. Levodopa is a dopamine replacement.

Levodopa travels into your brain, where it’s converted into dopamine. It helps relieve PD symptoms by restoring dopamine in your brain. Carbidopa is a dopa decarboxylase inhibitor.

Dopa decarboxylase is a protein in your body that breaks down levodopa before it can travel into your brain. By blocking this protein, carbidopa prevents levodopa from breaking down.

This raises the level of levodopa in your body and allows more levodopa to travel into your brain to be converted into dopamine. Levodopa and dopamine can then reach and remain at higher levels in your brain, which enhances levodopa’s ability to relieve PD symptoms.

Sinemet CR is typically started at 50 mg/200 mg (carbidopa/levodopa) by mouth 2 times per day at least 6 hours apart.

Sinemet CR is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. Nonselective monoamine oxidase (MAO) inhibitors are contraindicated for use with Sinemet CR. These inhibitors must be discontinued at least two weeks prior to initiating therapy with Sinemet CR.

Common side effects of Sinemet CR:

• Involuntary movements
• Nausea

Serious side effects are rare with Sinemet CR. Contact your healthcare provider immediately if you experience any of the following.

• Neuroleptic malignant syndrome (NMS): very high fevers, confusion, irregular pulse, sweating, muscle stiffness, changes in blood pressure

The following medications may interact with Sinemet CR:

• Symptomatic postural hypotension has occurred when carbidopa levodopa preparations were added to
• the treatment of patients receiving some antihypertensive drugs
• Concomitant therapy with selegiline and carbidopa levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa levodopa alone
• There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting
• from the concomitant use of tricyclic antidepressants and carbidopa levodopa preparations
• Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of levodopa. In addition, the beneficial effects of levodopa in Parkinson’s disease have been reported to be reversed by phenytoin and papaverine. Patients taking these drugs with Sinemet CR should be carefully observed for loss of therapeutic response
• Use of SINEMET with dopamine-depleting agents (e.g., reserpine and tetrabenazine) or other drugs known to deplete monoamine stores is not recommended
• Sinemet CR and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with levodopa and carbidopa and consequently reduce the bioavailability of carbidopa and levodopa

Merck & Co., Inc.

There are no adequate and well-controlled studies in pregnant women and Sinemet CR should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

• Carbidopa/Levodopa