Rytary is an extended release formulation of carbidopa and levodopa. Carbidopa is an inhibitor of aromatic amino acid decarboxylation and levodopa is an aromatic amino acid. Carbidopa inhibits the decarboxylation of peripheral levodopa, making more levodopa available for delivery to the brain.
Rytary is specifically indicated for the treatment of Parkinson’s disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication.
Rytary is supplied as a capsule for oral administration. Rytary should be swallowed whole with or without food. A high-fat, high-calorie meal may delay the absorption of levodopa by about 2 hours.
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Adverse effects associated with the use of Rytary may include, but are not limited to, the following:
The recommended starting dosage in levodopa-naïve patients is 23.75 mg / 95 mg taken orally three times a day for the first 3 days. On the fourth day of treatment, the dosage of Rytary may be increased to 36.25 mg / 145 mg taken three times a day. Based upon individual patient clinical response and tolerability, the Rytary dose may be increased up to a maximum recommended dose of 97.5 mg / 390 mg taken three times a day. The dosing frequency may be changed from three times a day to a maximum of five times a day if more frequent dosing is needed and if tolerated. The maximum recommended daily dose of Rytary is 612.5 mg / 2450 mg. Maintain patients on the lowest dosage required to achieve symptomatic control and to minimize adverse reactions. For the conversion of patients from immediate-release carbidopa-levodopa to Rytary, please see the drug label.