Syndopa
Generic Name
Levodopa 100 mg & Carbidopa 25 mg Tablet
Manufacturer
Sun Pharmaceutical Industries Ltd.
Country
India
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| syndopa 100 mg tablet | ৳ 7.02 | ৳ 70.20 |
Description
Overview of the medicine
Syndopa-100 mg tablet is a combination medicine containing Levodopa and Carbidopa, primarily used in the treatment of Parkinson's disease and parkinsonism. Levodopa is converted to dopamine in the brain, helping to replenish its levels, while Carbidopa prevents the breakdown of Levodopa in the bloodstream, allowing more of it to reach the brain.
Uses & Indications
Dosage
Adults
Initially, one tablet (Levodopa 100 mg/Carbidopa 25 mg) two to three times daily. Dosage may be increased by one tablet every 1-2 days until an optimal response is achieved, usually not exceeding 8 tablets per day for this strength. Doses should be individualized.
Elderly
Similar to adult dosage, but individualization and careful monitoring for adverse effects are crucial due to increased sensitivity and potential comorbidities.
Renal_impairment
No specific dosage adjustment is usually required for renal impairment, but caution is advised, and close monitoring for adverse effects is recommended.
How to Take
Take orally, preferably with food to reduce gastrointestinal upset, but avoid high protein meals as they can interfere with absorption. Do not crush or chew extended-release tablets if applicable.
Mechanism of Action
Levodopa crosses the blood-brain barrier and is converted to dopamine by DOPA-decarboxylase in the brain. Carbidopa, a peripheral DOPA-decarboxylase inhibitor, prevents the peripheral conversion of Levodopa to dopamine, thereby increasing the amount of Levodopa available to cross the blood-brain barrier and be converted to dopamine in the central nervous system. This reduces the dose of Levodopa required and minimizes peripheral side effects.
Pharmacokinetics
Onset
Within 30-60 minutes, clinical effects may be delayed for several weeks after initiation.
Excretion
Mainly excreted in urine as metabolites. Approximately 80% of levodopa metabolites are eliminated renally within 24 hours.
Half life
Levodopa: approximately 1.5 hours (when administered with carbidopa); Carbidopa: approximately 2-3 hours.
Absorption
Levodopa is rapidly absorbed from the small intestine. Absorption is variable and can be affected by gastric emptying time and pH. Carbidopa is also absorbed from the GI tract but does not cross the blood-brain barrier.
Metabolism
Levodopa is extensively metabolized via decarboxylation to dopamine and by catechol-O-methyltransferase (COMT) to 3-O-methyldopa. Carbidopa is also metabolized but its specific pathways are not fully elucidated.
Side Effects
Contraindications
- Narrow-angle glaucoma
- Known hypersensitivity to Levodopa or Carbidopa
- Undiagnosed skin lesions or a history of melanoma (as Levodopa may activate malignant melanoma)
- Concomitant use with non-selective monoamine oxidase (MAO) inhibitors
Drug Interactions
Iron salts
May reduce the bioavailability of Levodopa.
Metoclopramide
May increase the risk of dyskinesia and antagonize antiparkinsonian effects.
Antihypertensives
May cause or exacerbate orthostatic hypotension.
Non-selective MAO inhibitors
May cause hypertensive crisis. Discontinue MAOIs at least 2 weeks before starting Levodopa/Carbidopa.
Antipsychotics (Dopamine receptor blockers)
May reduce the therapeutic effects of Levodopa/Carbidopa.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include cardiac arrhythmias, dyskinesia, agitation, confusion, and insomnia. Treatment is symptomatic and supportive, including general supportive measures and hospitalization if severe.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is unknown if Levodopa/Carbidopa is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Narrow-angle glaucoma
- Known hypersensitivity to Levodopa or Carbidopa
- Undiagnosed skin lesions or a history of melanoma (as Levodopa may activate malignant melanoma)
- Concomitant use with non-selective monoamine oxidase (MAO) inhibitors
Drug Interactions
Iron salts
May reduce the bioavailability of Levodopa.
Metoclopramide
May increase the risk of dyskinesia and antagonize antiparkinsonian effects.
Antihypertensives
May cause or exacerbate orthostatic hypotension.
Non-selective MAO inhibitors
May cause hypertensive crisis. Discontinue MAOIs at least 2 weeks before starting Levodopa/Carbidopa.
Antipsychotics (Dopamine receptor blockers)
May reduce the therapeutic effects of Levodopa/Carbidopa.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include cardiac arrhythmias, dyskinesia, agitation, confusion, and insomnia. Treatment is symptomatic and supportive, including general supportive measures and hospitalization if severe.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is unknown if Levodopa/Carbidopa is excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Levodopa/Carbidopa in the treatment of Parkinson's disease, showing significant improvements in motor symptoms.
Lab Monitoring
- Periodically monitor liver function tests (LFTs)
- Renal function tests
- Complete blood count (CBC)
- Intraocular pressure (for glaucoma patients)
Doctor Notes
- Individualize dosage to achieve optimal control with minimal side effects.
- Counsel patients on potential sudden sleep onset and orthostatic hypotension.
- Monitor for psychiatric side effects, especially in elderly patients.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor; do not stop abruptly without consulting your doctor.
- Report any new or worsening involuntary movements, hallucinations, or unusual changes in mood or behavior.
- Be aware of potential dizziness or lightheadedness, especially when standing up quickly, and take precautions to prevent falls.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Syndopa can cause drowsiness or sudden sleep onset. Patients should be warned not to drive or operate machinery if they experience somnolence.
Lifestyle Advice
- Maintain a consistent meal schedule, avoiding large protein meals at the same time as medication.
- Stay hydrated and avoid excessive alcohol intake.
- Engage in light to moderate exercise as advised by your healthcare provider.
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