Sinemet

CLINICAL USE

Treatment of Parkinsonism

DOSE IN NORMAL RENAL FUNCTION

75–800 mg carbidopa daily in divided doses after meals

PHARMACOKINETICS

Molecular weight :Carbidopa: 244.2, levodopa: 197.2

%Protein binding :Carbidopa: 36, levodopa: 10–30

%Excreted unchanged in urine : Carbidopa: 30, levodopa: <1

Volume of distribution (L/kg) :Carbidopa: no data, levodopa: 0.36–1.6

half-life – normal/ESRD (hrs) :Carbidopa: 2–3, levodopa: 0.6–1.3/Unknown

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysed. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnaesthetics: risk of arrhythmias with volatile liquid anaesthetics such as halothaneAntidepressants: hypertensive crisis with MAOIs and linezolid (including moclobemide) – avoid for at least 2 weeks after stopping MAOIBupropion: increased risk of side effects of levodopaFerrous sulphate: reduces AUC of levodopa by 30–50%, clinically significant in some but not all patients

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

OTHER INFORMATION

Can be used to treat restless legs syndrome May cause dark urine

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