Product Description

ndications: Syndopa is indicated for the treatment of Parkinson’s disease and Parkinsonian syndrome. It helps relieve symptoms such as rigidity, bradykinesia, tremor, dysphagia, sialorrhea, and postural instability associated with Parkinsonism. Levodopa plus Carbidopa therapy before physiotherapy may also improve motor recovery after stroke.

Pharmacology: Syndopa combines Levodopa and Carbidopa. Levodopa is the metabolic precursor of dopamine that crosses the blood-brain barrier and is converted into dopamine in the brain, helping to relieve symptoms of Parkinson’s disease. Carbidopa is a dopa decarboxylase inhibitor that prevents the peripheral breakdown of Levodopa, allowing more Levodopa to reach the brain and reducing peripheral side effects.

Dosage & Administration:

100/10 mg tablet: Treatment may begin with one tablet three or four times daily. The dose may be increased gradually by one tablet every day or every other day until the desired response is achieved, up to a maximum of eight tablets daily.

250/25 mg tablet: Initial dose is usually half a tablet once or twice daily. The dose may be increased gradually until optimal response is obtained. Patients previously taking more than 1500 mg of Levodopa daily are generally started on one tablet three or four times daily.

100/25 mg tablet: Initial therapy usually starts with one tablet three times daily, providing 75 mg of Carbidopa daily. The dose may be increased gradually as needed up to eight tablets daily.

50/12.5 mg tablet: Recommended dose is one tablet three or four times daily.

Maintenance dose: Therapy should be individualized according to patient response. If higher Levodopa doses are needed, 250/25 mg tablets may be substituted and adjusted gradually. Daily Carbidopa doses above 200 mg have limited clinical experience.

Interaction: Postural hypotension may occur when Syndopa is used with antihypertensive medications, requiring possible dose adjustment of antihypertensives. Tricyclic antidepressants may rarely cause hypertension or dyskinesia when used together. Iron preparations such as ferrous sulfate or ferrous gluconate may reduce the absorption of Levodopa and Carbidopa. Dopamine-2 receptor antagonists, isoniazid, phenytoin, and papaverine may reduce the therapeutic effects of Levodopa. Severe orthostatic hypotension may occur with concomitant Selegiline use.

Contraindications: Syndopa is contraindicated in patients with hypersensitivity to Levodopa or Carbidopa, narrow-angle glaucoma, suspicious undiagnosed skin lesions, or a history of malignant melanoma.

Side Effects: Common adverse effects include dyskinesia, involuntary movements, nausea, dizziness, somnolence, hallucinations, confusion, orthostatic hypotension, palpitations, depression, insomnia, gastrointestinal disturbances, dark saliva, dark urine, rash, and headache. Rare but serious reactions may include agranulocytosis, thrombocytopenia, angioedema, and psychiatric disturbances.

Pregnancy & Lactation: The safety of Carbidopa-Levodopa during pregnancy has not been established. Animal studies have shown fetal abnormalities; therefore, use during pregnancy only if benefits outweigh risks. It is not known whether Carbidopa is excreted into human milk, so caution is advised during breastfeeding.

Precautions & Warnings: Syndopa is not recommended for drug-induced extrapyramidal reactions. Patients previously taking Levodopa alone should discontinue it at least 12 hours before starting Syndopa. Dyskinesias may occur due to increased dopamine formation and may require dose reduction. Use cautiously in patients with psychosis, depression, cardiovascular disease, pulmonary disease, asthma, renal or hepatic impairment, endocrine disorders, peptic ulcer disease, or seizure history. Patients with glaucoma should have intraocular pressure monitored regularly.

Use in Special Populations: Safety and effectiveness in children under 18 years have not been established, and its use in pediatric patients is not recommended.

Therapeutic Class: Antiparkinson drugs.

Storage Conditions: Store in a cool, dry place protected from light. Keep out of reach of children.