Rytary vs. Sinemet for Parkinson's Disease: Important Differences and Potential Risks.

Rytary

(carbidopa / levodopa)

Carbidopa / levodopa

(Sinemet)

Summary for Rytary

Prescription only

Rytary (carbidopa / levodopa) is a combination medication that helps treat adults with symptoms of Parkinson's disease (PD). It raises the dopamine levels in the brain to improve symptoms like stiff muscles and slowed movement. Rytary (carbidopa / levodopa) is an extended-release capsule. The typical dosage is taken by mouth three times a day. Common side effects include nausea, headache, and dizziness.

Indications for Rytary

Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have PD symptoms, including tremors, slowness, and stiffness)

Pros and Cons for Rytary

Pros

Can provide more "on" time and less "off" time than immediate-release carbidopa/levodopa in people with advanced PD
Available in 4 different strengths
Can open capsule and sprinkle contents onto applesauce if you have trouble swallowing pills whole

Cons

Usually need to take multiple times per day
Can make you very sleepy and cause you to fall asleep suddenly
Interacts with certain monoamine oxidase inhibitors (MAOIs) and iron

Common Side Effects for Rytary

Nausea (up to 20%)
Dizziness (up to 19%)
Headache (up to 17%)
Trouble sleeping (up to 9%)
Dry mouth (up to 7%)
Unusual dreams (up to 6%)
Constipation (up to 6%)
Involuntary movements (dyskinesia, up to 5%)
Anxiety (up to 5%)
Vomiting (up to 5%)
Drop in blood pressure when you get up (up to 5%)

Warnings for Rytary

Sleepiness or falling asleep during activities
High fevers and confusion with treatment changes
Heart problems
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Low vitamin B6 levels and seizures
Stomach bleeding in people who've had a stomach ulcer
Rise in eye pressure in people with glaucoma

Summary for Sinemet

Prescription only

Carbidopa / levodopa (Sinemet) is a first-choice option for Parkinson's disease (PD) in adults. It's also used to treat adults with conditions that cause PD symptoms, like shakiness and slowed movement. This medication helps raise and keep dopamine levels high in the brain to help with movement. But it's usually taken multiple times per day to relieve PD symptoms. Immediate-release tablets are available as brand name Sinemet and generic. Extended-release tablets and orally disintegrating tablets are generic only. Side effects can include movement problems, nausea, and possible hallucinations.

Indications for Sinemet

Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have PD symptoms, like slowness, stiffness, and tremors)

Pros and Cons for Sinemet

Pros

First-choice option for treating PD symptoms
Available in many forms: immediate-release (IR) tablets, extended-release (ER) tablets, and orally disintegrating tablets (ODTs)
Might work within 1 hour

Cons

Usually need to take many times per day to control PD symptoms
Can make you very sleepy and possibly fall asleep suddenly
Can darken the color of your saliva, sweat, and urine

Common Side Effects for Sinemet

Involuntary movements (dyskinesia or dystonia)
Nausea

Warnings for Sinemet

Sleepiness or falling asleep during activities
High fevers and confusion when lowering the dose or stopping too suddenly
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Risk of depression and thoughts of suicide
Low vitamin B6 levels and seizures
Caution use in people with a history of heart attack and arrhythmia
Caution use in people with a history of stomach ulcers
Higher eye pressure in people with glaucoma
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only