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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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