Indications for: Carbidopa/Levodopa Ext-Rel Tabs


Adult Dosage:

≥18yrs: Do not crush or chew. Patients not receiving levodopa: initially one Sinemet CR 50–200 tab twice daily, at intervals of at least 6 hrs. Others: see literature. Allow 3 days between dosage adjustments. If given at intervals <4 hrs and/or divided doses not equal: give smaller doses at end of day. May add immediate-release Sinemet 25–100 or 10–100 in advanced disease.

Children Dosage:

<18yrs: not recommended.

Carbidopa/Levodopa Ext-Rel Tabs Contraindications:

During or within 14 days of nonselective MAOIs (eg, phenelzine). Narrow-angle glaucoma. Undiagnosed skin lesions. History of melanoma.

Carbidopa/Levodopa Ext-Rel Tabs Warnings/Precautions:

Severe cardiovascular or pulmonary disease. Asthma. Renal, hepatic, or endocrine disorders. History of peptic ulcer or MI with residual arrhythmias. Suicidal tendencies. Psychosis. Orthostatic hypotension. Chronic wide-angle glaucoma. Discontinue levodopa at least 12 hrs before starting Sinemet or Sinemet CR. Sinemet CR not bioequivalent to Sinemet; see literature when switching forms. Monitor renal and liver function, intraocular pressure, blood counts. May stain body fluids. Pregnancy (Cat.C). Nursing mothers.

See Also:

Carbidopa/Levodopa Ext-Rel Tabs Classification:

Dopa-decarboxylase inhibitor + dopamine precursor.

Carbidopa/Levodopa Ext-Rel Tabs Interactions:

See Contraindications. Orthostatic hypotension with selegiline, antihypertensives. Antagonized by phenothiazines, butyrophenones, risperidone, phenytoin, papaverine. Hypertension, dyskinesia with tricyclic antidepressants. May be antagonized by iron, high protein diets. May cause false (+) urinary ketone test or false (–) urinary glucose (glucose oxidase) test.

Adverse Reactions:

Dyskinesia, GI upset, hallucinations, confusion, psychological disturbances, depression, dizziness, headache, dream abnormalities, dystonia, cardiac arrhythmias, hypotension, dyspnea, on-off phenomenon, back pain, blepharospasm (may indicate excess dosage), hypertension, anticholinergic effects, anorexia, insomnia, leukopenia, renal and liver function disorders, seizures, neuroleptic malignant syndrome.


Formerly known under the brand name Sinemet CR.

How Supplied:

CR—contact supplier; Tabs—100