What is Rytary?
Rytary is a combination of levodopa and carbidopa. Rytary capsules with extended release are used to treat symptoms such as muscle stiffness and spasms. Parkinson's may be caused by low levels of a brain chemical called dopamine. Rytary can also be used to treat Parkinson's symptoms that are caused by carbon dioxide, carbon monooxide poisoning, or manganese poisoning.
Warnings
Rytary should not be used if you suffer from narrow-angle glaucoma (or glaucoma). Rytary should not be used if you've taken an MAO inhibitor in the last 14 days. This includes isocarboxazid injection, linezolid injection, phenelzine, or tranylcypromine.
Before you take this drug
Rytary should not be used if:
- Narrow-angle glaucoma.
Rytary should not be used if mao inhibitors have been taken in the last 14 days. It is possible that a dangerous drug interaction will occur. Mao inhibitors are isocarboxazid and linezolid.
Tell your doctor about any of the following to ensure that rytary will be safe for you:
- Heart attack or high blood pressure.
- Liver or kidney disease
- An endocrine (hormonal) disorder;
- Asthma (a chronic respiratory disease) or another breathing disorder.
- A stomach or intestinal ulcer
- Open-angle glaucoma
- Depression, mental illness, or psychosis.
Parkinson's patients may be at a greater risk for skin cancer (melanoma). Speak to your doctor to learn more about the risk of skin cancer and to be aware of any symptoms. Inform your physician immediately if you become pregnant or nursing.
How to take Rytary?
Follow the instructions on your prescription label and read all medication guides or instruction sheets. Read all the instructions and directions that come with your prescription. Sometimes your doctor will change the dose. Rytary must be taken at least 12 hours after you stop taking levodopa. Rytary may be taken either with or without food. To maintain a constant amount of drugs in your system, take your doses regularly. Do not open, crush, chew on or break a capsule. Rytary may take several weeks to improve your symptoms. To get the best results, use Rytary as directed. If your symptoms don't improve after a couple of weeks, talk to your doctor. Tell your doctor if you notice that the effects of the medication wear off rapidly between doses. You may need to undergo frequent medical testing if you use Rytary for a long time. It can interfere with certain tests. Rytary can affect the results of certain medical tests. If you suddenly stop taking Rytary, you may experience unpleasant withdrawal symptoms. You should ask your doctor about how to safely discontinue this medication. Store products away from moisture, heat and light at room temperature to protect from degradation.
Details on dosage
Adult dosage for Parkinson's disease:
The optimal dosage is determined through careful individual titration. All doses are expressed as CARBIDOPA/LEVODOPA.
Rytary capsules with extended release:
Initial dose (levodopa naive): 23,75 mg–95 mg orally, 3 times daily for 3 days. On the 4th day, you may increase this to 36.25 mg–145 mg three times daily.
If tolerated, the interval between doses may be increased to 5 times per day.
Maximum daily dose: 612.5 mg–2450 mg
Conversion of IMMEDIATE RELEASE carbidopa/levodopa into Rytary These recommended starting doses are divided and should be given three times a week.
For patients taking levodopa between 400 and 549 mg/day, the total dose of levodopa per day in Rytary is 855 mg/day.
Rytary: Total daily dose of Levodopa for patients taking 550–749 mg/day
Rytary: Total daily dose of Levodopa for patients taking 750–949 mg/day
Rytary: Total daily dose of Levodopa for patients taking 950–1249 mg/day
For patients who receive levodopa at or above 1250 mg/day, the rytary dose of levodopa should be 2205 mg/day or 2340 mg/day.
Comments:
Patients receiving carbidopa less than 100 mg/day are more likely than those who receive this dose to experience nausea or vomiting. Experience with carbidopa dosages higher than 200 mg/day has been limited.
The initial daily recommended dose of levodopa for patients taking carbidopa and levodopa with catechol-Omethyltransferase inhibitors may need to increase.
Use: To treat the symptoms of postencephalitic Parkinson's, idiopathic Parkinson’s, and symptomatic Parkinson’s that may result from injury to the nervous systems caused by carbon monoxide and/or manganese poisoning.
What happens if I miss the dose?
If you are almost due for your next dose, skip the missed one. Never take two doses of the same medicine at once. Refill your prescription before you run out.
What happens if I overdose?
Call 1-800-222-1222 for poison help or seek immediate medical attention.
What should be avoided?
Rytary can affect your reactions. Stay away from hazardous activities until you know exactly how they will impact you. You may have impaired reactions. You may feel dizzy if you get up quickly from a seated or lying position. Avoid iron supplements and eat a high-protein diet (proteins include meat, cheese, eggs, etc.). This can make it more difficult for your body's to absorb and digest carbidopa or levodopa. Speak to your doctor or a dietitian for advice on the best foods you can eat when taking this medication.
Side effects of Rytary
If you experience any of the following symptoms of an allergic reaction: hives, difficulty breathing, swelling of your lips, face, tongue, or throat, contact emergency medical assistance.
If you experience:
- Uncontrolled facial movements (such as lip smacking and frowning; tongue movement or blinking);
- Tremors that are worsening (uncontrolled shaking)
- Severe or persistent diarrhea or nausea.
- Confusion, hallucinations, or unusual changes in mood and behavior
- Depression or suicidal feelings;
- Severe nerve system reaction: stiff muscles (rigid), high fever, sweating and confusion, rapid or irregular heartbeats Tremors. Feeling like you could pass out.
Rytary can cause some people to fall asleep while doing normal activities during the day, such as driving, working, talking, or eating. You should tell your doctor if daytime sleepiness is a problem. While taking this medication, you may experience increased sexual desire, urges to gamble, or other intense desires. If this happens, talk to your doctor. Your urine, saliva, or sweat may appear dark, like red, brown, or black. It is not harmful, but your clothing or bedsheets may be stained.
Rytary may cause side effects such as:
- The jerky or twisting of muscle movements
- Headache, dizziness;
- Low blood pressure (feeling a little light-headed);
- Sleep problems, strange dreams;
- Dry mouth
- Muscle contractions
- Nausea, vomiting, and constipation.
There may be other side effects. For medical advice on side effects, call your doctor. The FDA can be contacted at 1-800-FDA-1088 to report side effects.
Interaction with other drug
Carbidopa or levodopa may interact with other drugs, such as prescription and over-the-counter medicines, vitamins, and herbal products. Inform your doctor of all the medicines you are taking, as well as any new ones.
