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Medications for Motor Symptoms

Rytary (levodopa/carbidopa)

About

Rytary was approved in 2015 by the U.S. Food and Drug Administration (FDA) for Parkinson's motor symptoms (tremor, slowness and stiffness). In capsule form, it contains immediate and extended-release levodopa with carbidopa. (Levodopa is converted in the brain to dopamine, the chemical that goes missing in Parkinson's; carbidopa helps levodopa get into the brain and decreases side effects.) In addition to lessening motor symptoms, Rytary may decrease total daily "off" time (when symptoms are not controlled). Rytary can be taken at any point in the course of disease, from recently diagnosed to living many years with Parkinson's. The drug typically is taken three to five times per day and each dose may last, on average, four to five hours, depending on the individual. Compared to other levodopa formulations, such as Sinemet, Rytary may require a higher total dose and more capsules, but may be taken less frequently throughout the day. (For example, a person who takes Sinemet every two hours may be able to switch to Rytary every four hours.)

Pros

The extended-release levodopa component of Rytary may allow some people to take medication less often while experiencing less daily "off" time. Many researchers and doctors also hope that by providing a more constant level of levodopa in the blood (and therefore in the brain) with medications like Rytary, long-term complications, such as dyskinesia, may be lessened.

For those who have difficulty swallowing pills, the Rytary capsule can be opened and its contents sprinkled on applesauce or food of similar consistency.

Cons and Complications

The most common potential side effects include nausea, low blood pressure (which can lead to dizziness and lightheadedness) and hallucinations. (These are the same with all levodopa drugs.) Dyskinesia (involuntary, uncontrolled movements) also may occur, though this might be lessened by adjusting the dose and/or timing of medication administration.

As with other oral levodopa drugs, Rytary competes with dietary protein for absorption. If it is not working optimally (wearing off before the next dose is due or taking a long time to start working), you may consider separating the medication from meals. Because high-fat, high-calorie meals can delay Rytary's absorption, some doctors recommend taking the first dose of the day one to two hours before you eat, if possible.


The medical information contained in this article is for general information purposes only. The Michael J. Fox Foundation for Parkinson's Research has a policy of refraining from advocating, endorsing or promoting any drug therapy, course of treatment, or specific company or institution. It is crucial that care and treatment decisions related to Parkinson's disease and any other medical condition be made in consultation with a physician or other qualified medical professional.

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