Syndopa 110 Tablet

Syndopa 110 Tablet is used for: Parkinson's disease

Parkinson Disease & Parkinson like Disorders Indicated for Parkinson disease, postencephalitic parkinsonism, and symptomatic parkinsonism that may follow carbon monoxide intoxication or manganese intoxication. Maintain patients on the lowest dosage required to achieve symptomatic control and to minimize adverse reactions such as dyskinesia and nausea. Adult: PO: Immediate release: Carbidopa/Levodopa 25 mg/100 mg three times a day or 10 mg/100 mg PO three or four times a day initially; Levodopa may be increased by 100 mg/day every 1-2 days Carbidopa should be 70-100 mg/day but not to exceed 200 mg/day; levodopa not to exceed 800 mg/day CR tablet: 50 mg/200 mg PO 12 hourly initially maybe increased up to 1600 mg/day of levodopa doses must be given at least 6 hours apart

Safety and efficacy not established

Renal impairment: Safety and efficacy not established; use with caution

Lactation, narrow angle glaucoma, melanoma, psychosis, severely decompensated endocrine.

May cause falling asleep during activities of daily living Avoid sudden discontinuation or rapid dose reduction to reduce the risk of withdrawal-emergent hyperpyrexia and confusion Cardiovascular Ischemic Events: Monitor patients with a history of cardiovascular disease Hallucinations/Psychosis may occur Impulse Control/Compulsive Behaviors: Consider dose reduction or stopping Carbidopa + Levodopa if impulse control disorders occur May cause or exacerbate dyskinesia: Consider dose reduction Monitoring Parameters Regular monitoring of renal and hepatic function is recommended. Monitor patients with a history of cardiovascular disease Monitor patients with a history of myocardial infarction who have residual atrial, nodal, or ventricular arrhythmia, cardiac function in an intensive cardiac care facility during the initial dosage adjustment

Pregnancy There are no adequate data on development risk associated with use in pregnant females Animal data Carbidopa/levodopa has been shown to be developmentally toxic (including teratogenic effects at clinically relevant doses Lactation Levodopa has been detected in human milk after administration of carbidopa-levodopa There are no data on the presence of carbidopa in human milk, effects of levodopa or carbidopa on breastfed infants, or the effects on milk production However, inhibition of lactation may occur because levodopa decreases secretion of prolactin in humans

Monoamine oxidase (MAO) inhibitors Contraindicated Discontinue use of any nonselective MAO inhibitors at least 2 weeks before initiating Carbidopa/levodopa may be administered concomitantly with the manufacturer's recommended dose of selective MAO-B inhibitors (eg, rasagiline or selegiline HCl) Coadministration with selegiline and carbidopa/levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa/levodopa alone Dopamine D2-receptor antagonists and isoniazid Monitor for worsening Parkinson’s symptoms Dopamine D2 receptor antagonists (eg, phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the effectiveness of levodopa Iron salts If iron salts or multivitamins containing iron salts are coadministered with carbidopa/levodopa, monitor for worsening Parkinson’s symptoms Iron salts or multivitamins containing iron salts can form chelates with levodopa and carbidopa and may reduce the bioavailability of carbidopa/levodopa Antihypertensive drugs Dosage adjustment of antihypertensive therapy may be required when initiating carbidopa/levodopa Symptomatic postural hypotension occurred when treated patients are concomitantly receiving antihypertensive drugs Dopamine-depleting agents Use is not recommended Metoclopramide Although metoclopramide may increase the bioavailability of levodopa by increasing gastric emptying, metoclopramide may also reduce effectiveness of levodopa by its dopamine receptor antagonistic properties Potentially Fatal: Enhances hypotensive effects of bethanidine, bretylium, guanethidine. Hypertensive crises with furazolidone or MAO inhibitors. Contraindicated (6) isocarboxazid phenelzine procarbazine selegiline selegiline transdermal tranylcypromine Serious (31) amisulpride aripiprazole chlorpromazine clozapine desvenlafaxine droperidol fluphenazine haloperidol iloperidone linezolid loxapine loxapine inhaled macimorelin methylene blue metoclopramide intranasal olanzapine olanzapine/samidorphan olopatadine intranasal paliperidone perphenazine pimozide procarbazine prochlorperazine promethazine quetiapine risperidone thioridazine thiothixene trifluoperazine ziprasidone zuranolone

Side effects of Carbidopa + Levodopa : Frequency Not Defined Edema Agitation Anxiety Ataxia Bruxism Confusion Daytime somnolence Decreased attention span Dyskinesia Dystonia Euphoria Insomnia Fainting Fatigue Increased trembling of hands Insouciance Malaise Memory loss Nightmares Nervousness Restlessness Trismus Vivid dreams Alopecia Hot flashes Increased or dark perspiration Skin eruptions Abdominal pain and discomfort Burning feeling in tongue Constipation Diarrhea Dysgeusia Dry mouth Dysphagia Hiccups Meteorism Sialorrhea Nausea Weight loss Muscular spasms Muscular cramp Hematuria Dark urine Incontinence Priapism Urine retention Blurred vision Diplopia or dilated pupil Oculogyric problems Atelectasis Potentially Fatal: Severe postural hypotension in elderly.

Levodopa is the metabolic precurosor of dopamine, it crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa increases the amount of levodopa that is transported into the CNS by inhibiting the decarboxylation of peripheral levodopa.

Syndopa 110 10 mg + 100 mg Tablet manufactured by Sun Pharmaceutical (Bangladesh) Ltd.. Its generic name is Carbidopa + Levodopa. Syndopa 110 is availble in Bangladesh. Farmaco BD drug index information on Syndopa 110 Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.