Rytary is a brand-name prescription medication. It’s FDA-approved to treat the following conditions:

  • Parkinson’s disease (PD). This condition affects your nervous system and movements. Symptoms of PD can include tremors (uncontrolled movements), rigid muscles, or problems balancing.
  • Certain kinds of parkinsonism. Parkinsonism causes symptoms similar to those of PD. Rytary is approved to treat parkinsonism that occurs after:
    • manganese toxicity (having too much of the mineral manganese in your body)

Rytary isn’t approved for use in children. For more information about the uses of Rytary, see the “Rytary for Parkinson’s disease” and “Other uses for Rytary” sections below.

Drug details

Rytary contains these two active drugs:

  • Levodopa. This drug belongs to a class of medications called central nervous system drugs. (A medication class is a group of drugs that work in a similar way.) Levodopa works to reduce PD symptoms by turning into the brain chemical dopamine, which increases dopamine levels in the brain. Low levels of dopamine are associated with symptoms of PD.
  • Carbidopa. This drug belongs to a class of medications called decarboxylase inhibitors. Carbidopa works to prevent levodopa from being broken down before it reaches the brain.

Rytary comes as extended-release (ER) capsules that you take by mouth. ER medications slowly release their active drugs into your body over time.

Rytary is typically taken three times a day. And it’s available in several strengths. For more information about forms and strengths of Rytary, see the “Rytary dosage” section below.

Effectiveness

For information about the effectiveness of Rytary, see the “Rytary for Parkinson’s disease” and “Other uses for Rytary” sections below.

Rytary is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Rytary contains two active drugs: carbidopa and levodopa. These two drugs are available together in generic medication. However, this generic medication doesn’t come in the same forms and strengths as Rytary does.

The Rytary dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Rytary to treat
  • whether you’ve used certain medications in the past to treat Parkinson’s disease (PD)
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Rytary comes as extended-release (ER) capsules that you take by mouth. ER medications slowly release their active drugs into your body over time.

Rytary contains two active drugs: levodopa and carbidopa. And it’s available in the following strengths:

  • 23.75 milligrams (mg) of carbidopa/95 mg of levodopa
  • 36.25 mg of carbidopa/145 mg of levodopa
  • 48.75 mg of carbidopa/195 mg of levodopa
  • 61.25 mg of carbidopa/245 mg of levodopa

Dosage if you haven’t taken levodopa before

If you’ve never taken levodopa before, you’ll follow a certain dosing schedule when you start using Rytary to treat either PD or parkinsonism. With this dosing schedule, you’ll start taking a low dosage of the drug. Then, your doctor will gradually increase your dosage until your symptoms improve.

When starting Rytary treatment, you’ll take it as follows:

  • For the first three days, you’ll take a Rytary dose of 23.75 mg of carbidopa/95 mg of levodopa three times per day.
  • Then, for the next three days, you’ll take a Rytary dose of 36.25 mg of carbidopa/145 mg of levodopa three times per day.

After the first 6 days of treatment, your doctor will evaluate how your body is responding to Rytary. If your symptoms of PD or parkinsonism haven’t been reduced, your doctor may increase your dosage of Rytary again.

The maximum recommended dosage of Rytary is typically 97.5 mg of carbidopa and 390 mg of levodopa, taken three times per day. However, if the effects of your dose don’t last long enough, your doctor may suggest that you take Rytary up to five times per day. In any case, you shouldn’t take more than 612.5 mg of carbidopa and 2,450 mg of levodopa in one day.

Your doctor will keep you on the lowest Rytary dosage possible to manage your symptoms. The lower your dosage of the drug, the lower your risk of side effects from Rytary.

Dosage if you’re switching from immediate-release levodopa/carbidopa to Rytary

Rytary comes as extended-release (ER) capsules that contain two active drugs: levodopa and carbidopa. ER medications slowly release their active drugs into your body over time. And ER medications work consistently over a longer period of time than do immediate-release (IR) medications.

Many other medications that contain both carbidopa and levodopa are IR formulations. This means the medications release their active drugs all at once into your body. The effects of IR drugs don’t last as long as the effects of ER drugs do.

Dosages for ER drugs are different than dosages are for IR drugs. Compared with ER drugs, you may have to take IR drugs more often to manage your symptoms. So if you’re currently taking an IR form of carbidopa and levodopa, your dosage won’t be the same if you switch to Rytary, which contains ER carbidopa and levodopa.

If you’re switching from IR carbidopa/levodopa, your Rytary dosage will be calculated based on how much IR levodopa you’re currently taking. Your doctor will determine your Rytary dosage using the dosing chart below.

Total daily dose of IR levodopaTypical recommended Rytary dosage
400 mg to 549 mg3 capsules of 23.75 mg of carbidopa/95 mg of levodopa, taken three times daily (9 total capsules per day)
550 mg to 749 mg4 capsules of 23.75 mg of carbidopa/95 mg of levodopa, taken three times daily (12 total capsules per day)
750 mg to 949 mg3 capsules of 36.25 mg of carbidopa/145 mg of levodopa, taken three times daily (9 total capsules per day)
950 mg to 1,249 mg3 capsules of 48.75 mg of carbidopa/195 mg of levodopa, taken three times daily (9 total capsules per day)
1,250 mg or more4 capsules of 48.75 mg of carbidopa/195 mg of levodopa, taken three times daily (12 total capsules per day)

OR

3 capsules of 61.25 mg of carbidopa/245 mg of levodopa, taken three times daily (9 total capsules per day)

For example, if each day you take eight IR tablets of 25 mg of carbidopa/100 mg levodopa, your total daily dose of IR levodopa is 800 mg. When you switch to Rytary, your dosage would typically be 3 capsules of 36.25 mg of carbidopa/145 mg of levodopa, three times per day. This would be a total of 9 total capsules daily.

In any case, you shouldn’t take more than 612.5 mg of carbidopa and 2,450 mg of levodopa in one day.

What if I miss a dose?

If you forget to take a dose of Rytary, call your doctor or pharmacist. Depending on how long ago you missed the dose, they may recommend that you either:

  • take the missed dose right away, or
  • skip the missed dose and take your next dose as scheduled

Never take two doses of Rytary at once to make up for a missed dose. “Doubling up” on a dose can increase your risk of side effects from the drug.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A kitchen timer may be useful, too.

Will I need to use this drug long term?

Rytary is meant to be used as a long-term treatment. If you and your doctor determine that Rytary is safe and effective for you, you’ll likely take it long term.

If you’d like to stop taking Rytary, be sure to talk with your doctor first. Suddenly stopping this medication could cause certain withdrawal symptoms. For more information about this, see the “Rytary withdrawal and dependence” section below.

Rytary can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Rytary. These lists don’t include all possible side effects.

For more information on the possible side effects of Rytary, talk with your doctor or pharmacist. They can give you tips for how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Rytary, you can do so through MedWatch.

Mild side effects

Mild side effects of Rytary can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Rytary. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Rytary’s prescribing information.
† This side effect is explained in more detail below in “Side effect details.”

Serious side effects

Serious side effects from Rytary aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Feeling sleepy or falling asleep during daily activities, which could lead to dangerous accidents. Symptoms can include:
    • feeling drowsy or more sleepy than usual
    • falling asleep while talking or eating
    • feeling sleepy during the day
  • Abnormal and uncontrollable urges. Symptoms can include:
    • feeling out of control
    • having a desire to eat more often than usual, spend money, or gamble
  • Allergic reaction.*
  • Movement disorders, such as dyskinesia (uncontrolled and unusual movements).*
  • Hallucinations (seeing or hearing something that’s not really there).*
  • Psychosis (trouble recognizing what’s real and what isn’t real).*
  • Suicidal thoughts or behaviors.*

* This serious side effect is further explained in the section below called “Side effect details.”

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Rytary. It’s not known how many people had allergic reactions to Rytary during clinical trials.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Rytary. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Hallucinations and psychosis

You may experience hallucinations or psychosis while you’re taking Rytary. With hallucinations, you may see or hear things that aren’t actually there. And with psychosis, you’re not in touch with reality. For example, with psychosis, you may believe things that aren’t true.

In a clinical trial involving people with advanced Parkinson’s disease (PD),* hallucinations or psychosis occurred in:

  • 4% of people taking Rytary
  • 1% of people taking immediate-release carbidopa and levodopa

In the trial, people’s symptoms of hallucinations included:

  • confusion
  • insomnia (trouble falling or staying asleep)
  • abnormal thoughts and behaviors, such as being unusually aggressive or agitated

If you have psychosis or you’ve had it in the past, talk with your doctor before starting Rytary. Because Rytary can worsen psychosis, your doctor may recommend a drug other than Rytary for you.

Also, if you have hallucinations or changes in your mood while you’re taking Rytary, talk with your doctor. They may decrease your dosage of Rytary and see if your symptoms go away. In some cases, your doctor may have you switch to a medication other than Rytary.

* Advanced PD means that your PD symptoms significantly affect your typical daily activities.
† Carbidopa and levodopa are the active drugs in Rytary. However, Rytary contains extended-release (ER) forms of these drugs. Unlike immediate-release (IR) forms, which release their drug into your body all at once, Rytary slowly releases the drugs into your body over time.

Abnormal dreams

You may have unusual dreams while you’re taking Rytary. For example, in clinical trials, abnormal dreams occurred in:

  • 2% to 6% of people taking Rytary three times per day
  • 0% of people taking a placebo (treatment with no active drug)

If you have unusual dreams that bother you while you’re taking Rytary, talk with your doctor. They may be able to decrease your dosage of the drug. Or in some cases, they may have you switch to a different medication.

Nausea

Nausea is a common side effect of Rytary. In a clinical trial, nausea occurred in:

  • 14% to 20% of people taking Rytary three times per day
  • 9% of people taking a placebo (treatment with no active drug)

In another clinical trial involving people with advanced Parkinson’s disease (PD),* nausea occurred in:

  • 3% to 4% of people taking Rytary
  • 2% to 6% of people taking immediate-release carbidopa/levodopa

If you have nausea that’s severe or bothersome to you, talk with your doctor. They may decrease your dosage of the drug, which could help relieve your nausea. Your doctor may also recommend a medication other than Rytary to treat your condition.

* Advanced PD means that your PD symptoms significantly affect your typical daily activities.
† Carbidopa and levodopa are the active drugs in Rytary. However, Rytary contains extended-release (ER) forms of these drugs. Unlike immediate-release (IR) forms, which release their drug into your body all at once, Rytary slowly releases the drugs into your body over time.

Movement disorders

You may develop movement disorders while taking Rytary. Below, we describe possible movement disorders that may occur with Rytary treatment.

Dyskinesia

It’s possible to develop dyskinesia while you’re taking Rytary. With dyskinesia, you have uncontrolled, involuntary movements.

In clinical trials of people with early-stage Parkinson’s disease (PD),* dyskinesia occurred in:

  • 2% to 5% of people taking Rytary three times per day
  • 0% of people taking a placebo (treatment with no active drug)

If you have dyskinesia while you’re taking Rytary, talk with your doctor. They may decrease your dose of Rytary. Or they may recommend other medications for your condition.

* Early-stage PD means that your PD symptoms don’t greatly impact your typical daily activities.

On and off episodes

While taking Rytary, you may experience on and off episodes. “On episodes” are periods of time when you aren’t having symptoms of Parkinson’s disease (PD) and you don’t have dyskinesia (uncontrolled movements). “Off episodes” are periods of time when you do have PD symptoms.

Off episodes occur when your PD symptoms get worse between doses of Rytary. These occur because the effect of your most recent dose of Rytary wears off before your next dose of the drug is taken. Taking your next scheduled dose of Rytary will typically relieve your symptoms.

In a clinical trial of people with advanced PD, on and off episodes were one of the most common reasons people stopped taking Rytary. (Advanced PD means that your PD symptoms significantly affect typical daily activities.)

In the study, 5% of people stopped taking Rytary due to either on and off episodes, dyskinesia, anxiety, or dizziness. But it’s not known exactly how many people in this study had on and off episodes.

If you have on and off episodes while you’re taking Rytary, your doctor may recommend more frequent doses of Rytary. For example, they may recommend that you take Rytary five times a day, rather than three times a day. Doing this will help keep the level of medication in your body steady over time, which may help reduce your symptoms between doses.

Suicidal thoughts or behaviors

In rare cases, you may have suicidal thoughts or behaviors while you’re taking Rytary.

In clinical trials, no one taking Rytary had these side effects. However, in some post-marketing studies, people taking Rytary did have suicidal thoughts and behaviors. (Post-marketing studies are done after a drug has been approved by the FDA and is available on the market.) But it’s not known exactly how many people taking Rytary have had suicidal thoughts or behaviors.

If you’ve had suicidal thoughts or behaviors in the past, talk with your doctor before starting Rytary. They may monitor you more often than usual during treatment to make sure that you’re feeling well. But in some cases, your doctor may recommend a medication other than Rytary to treat your condition.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Click here for more links and local resources.

Weight loss (not a side effect)

You shouldn’t have unexpected weight loss from taking Rytary. In clinical trials, weight loss wasn’t reported as a side effect of this drug.

If you lose weight unexpectedly while you’re taking Rytary, talk with your doctor. They can help you determine the cause of your weight loss. And they can help you manage a body weight that’s healthy for you.

You may wonder how Rytary compares with other medications that are prescribed for similar uses. Here we look at how Rytary and Sinemet are alike and different.

Ingredients

Rytary and Sinemet are brand-name medications that contain the same active drugs:

  • levodopa, which belongs to a class of medications called central nervous system drugs (A medication class is a group of drugs that work in a similar way.)
  • carbidopa, which belongs to a class of medications called decarboxylase inhibitors

Levodopa and carbidopa are available together in generic medication. (Generic medications contain exact copies of the active drugs found in brand-name medications.) For more information about generic carbidopa/levodopa, see the section below called “Drug forms and administration.”

Uses

Rytary, Sinemet, and generic carbidopa/levodopa are approved to treat the following conditions:

  • Parkinson’s disease (PD). This condition affects your nervous system and movements. Symptoms of PD can include tremors (uncontrolled movements), rigid muscles, or problems balancing.
  • Certain kinds of parkinsonism. Parkinsonism causes symptoms similar to those of PD. These drugs are approved to treat parkinsonism that occurs after:
    • manganese toxicity (having too much of the mineral manganese in your body)

Drug forms and administration

Rytary comes as capsules, while Sinemet and generic carbidopa/levodopa come as tablets. All of these medications are taken by mouth. Below we discuss the key differences between these medications.

Doses of Rytary, Sinemet, and generic carbidopa/levodopa

One of the main differences between these drugs is that there are different doses available depending on the form of the drug you take.

Generic carbidopa/levodopa is available only in the same doses as Sinemet. However, generic carbidopa/levodopa doesn’t come in the same doses as Rytary does.

Extended-release and immediate-release forms

The other key difference between Rytary, Sinemet, and generic carbidopa/levodopa is how quickly their active drugs are released into your body. For example:

  • Sinemet comes as immediate-release (IR) tablets. This means its active drugs are released all at once into your body.
  • Rytary, on the other hand, comes as extended-release (ER) capsules. This means its active drugs are slowly released into your body over time.
  • Generic carbidopa/levodopa medications come as both ER and IR tablets.

ER medications work consistently over a longer period of time than do IR medications. And the effects of ER drugs last longer than the effects of IR drugs do. To manage your symptoms, you may have to take IR drugs more often than you have to take ER drugs.

Sinemet CR form

ER medications are sometimes available in a controlled-release (CR) form. CR is a type of extended release. With CR, a medication’s active drugs are released into your body at a steady rate over time as the medication breaks down in your stomach. In comparison, ER medications are also sometimes available in a sustained-release (SR) form. With SR, a medication’s active drugs are released into your body over time, but not at a steady rate.

A CR form of Sinemet, called Sinemet CR, was available in the past. But as of July 2019, it’s no longer available.

Side effects and risks

Rytary, Sinemet, and generic carbidopa/levodopa all contain the same active drugs. Because of this, these medications can cause very similar side effects. Below are some examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with all three medications (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Rytary, with Sinemet or generic carbidopa/levodopa, or with all drugs (when taken individually).

  • Can occur with Rytary:
    • no unique serious side effects
  • Can occur with Sinemet or generic carbidopa/levodopa:
  • Can occur with Rytary, Sinemet, or generic carbidopa/levodopa:
    • abnormal and uncontrollable urges, such as desires to eat, gamble, or spend money
    • feeling sleepy or falling asleep during normal activities, can lead to serious accidents

Effectiveness

Rytary, Sinemet, and generic carbidopa/levodopa are approved to treat only PD and certain kinds of parkinsonism.

The use of Rytary and the generic form of Sinemet (IR carbidopa/levodopa) in treating advanced PD* has been directly compared in a clinical study.

In this study, people with advanced PD had a decrease in “off episodes” with treatment. (Off episodes are periods of time during which people have PD symptoms.) People also had an increase in “on episodes.” (On episodes are periods of time during which people don’t have PD symptoms and dyskinesia.)

For example, people in the study had:

  • 3.9 hours of off time when taking Rytary, compared with 6.1 hours of off time before starting Rytary
  • 4.9 hours of off time when taking IR carbidopa and levodopa, compared with 5.9 hours of off time before starting IR carbidopa and levodopa
  • 11.8 hours of on time when taking Rytary, compared with 10 hours of on time before starting Rytary
  • 10.9 hours of on time when taking IR carbidopa and levodopa, compared with 10.1 hours of on time before starting IR carbidopa and levodopa

* Advanced PD means that your PD symptoms significantly affect your typical daily activities.

Costs

According to estimates on GoodRx.com, Rytary costs significantly more than either Sinemet or generic carbidopa/levodopa. The actual price you’ll pay for these drugs depends on your insurance plan, your location, and the pharmacy you use.

Generic medications contain exact copies of the active drugs found in brand-name medications. Brand-name medications usually cost more than generics.

The Food and Drug Administration (FDA) approves prescription drugs such as Rytary to treat certain conditions.

Rytary is approved to treat Parkinson’s disease (PD). In addition, this drug is used to treat parkinsonism, which is a condition that causes symptoms similar to those of PD. (For more information about parkinsonism, see the “Other uses for Rytary” section below.)

PD is a condition that affects your nervous system and movements. Symptoms of PD develop slowly and they get worse over time. Examples of symptoms that may be caused by PD can include:

  • tremors (uncontrolled movements)
  • rigid muscles
  • problems balancing

People with PD have low levels of a brain chemical called dopamine. Dopamine helps send messages to the part of your brain that controls coordination and movement. Low dopamine levels can make it harder for you to control your movements. As dopamine levels fall in a person with PD, their disease symptoms gradually get worse.

Rytary contains these two active drugs:

  • Levodopa. This drug belongs to a class of medications called central nervous system drugs. (A medication class is a group of drugs that work in a similar way.) Levodopa works to reduce PD symptoms by turning into the brain chemical dopamine, which increases dopamine levels in the brain. Low levels of dopamine are associated with symptoms of PD.
  • Carbidopa. This drug belongs to a class of medications called decarboxylase inhibitors. Carbidopa works to prevent levodopa from being broken down before it reaches the brain.

Effectiveness for Parkinson’s disease

In clinical trials, Rytary was effective in treating PD. Below, we describe results from trials in people with early-stage PD and advanced PD.

Effectiveness in people with early-stage Parkinson’s disease

Rytary’s effectiveness has been studied in people with early-stage PD. With early-stage PD, your PD symptoms don’t greatly impact your typical daily activities. And it’s likely you either haven’t used levodopa for treatment or have used levodopa for only a short period of time.

In one clinical trial, researchers used a scale called Unified Parkinson’s Disease Rating Scale (UPDRS). Part II of this scale evaluates people’s ability to do typical daily activities. And part III of the scale evaluates people’s ability to move.

A decreased UPDRS score means that you can more easily do an activity or movement. An increased UPDRS score means that an activity or movement gets harder for you to do.

In this trial, people had their UPDRS scores (parts II and III) decreased by:

  • 11.7% when taking Rytary (36.25 mg of carbidopa/145 mg of levodopa) three times daily
  • 12.9% when taking Rytary (61.25 mg of carbidopa/245 mg of levodopa) three times daily
  • 14.9% when taking Rytary (97.5 mg of carbidopa/390 mg of levodopa) three times daily
  • 0.6% when taking a placebo (treatment with no active drug)

Effectiveness in people with advanced Parkinson’s disease

Rytary’s effectiveness has also been studied in people with advanced PD. With advanced PD, your symptoms significantly affect your typical daily activities. Some people took Rytary, while other people took immediate-release (IR)* carbidopa and levodopa.

In these clinical trials, people taking Rytary had a decrease in their “off time,” which is the period of time that you have symptoms of PD. They also had an increase in their “on time,” which is the period of time that you aren’t having PD symptoms and that you don’t have dyskinesia.

Specifically, for off time, people had:

  • 3.9 hours of off time when taking Rytary, compared with 6.1 hours of off time before starting Rytary
  • 4.9 hours of off time when taking IR carbidopa and levodopa, compared with 5.9 hours of off time before starting IR carbidopa and levodopa

And for on time, people had:

  • 11.8 hours of on time when taking Rytary, compared with 10 hours of on time before starting Rytary
  • 10.9 hours of on time when taking Rytary, compared with 10.1 hours of on time before starting IR carbidopa and levodopa

* Carbidopa and levodopa are the active drugs in Rytary. However, Rytary contains extended-release (ER) forms of these drugs. Unlike immediate-release (IR) forms, which release their drug into your body all at once, Rytary slowly releases the drugs into your body over time.

The Food and Drug Administration (FDA) approves prescription drugs such as Rytary to treat certain conditions. Rytary may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Rytary is FDA-approved to treat Parkinson’s disease (PD). (For more information on this use of Rytary, see the “Rytary for Parkinson’s disease” section above.)

In addition, Rytary is approved to treat parkinsonism, which is a condition that causes symptoms similar to those of PD. Below, we describe how Rytary is used for parkinsonism.

Rytary for post-encephalitic parkinsonism

Rytary is approved to treat post-encephalitic parkinsonism in adults. Parkinsonism is a condition that causes symptoms similar to those caused by Parkinson’s disease (PD). Symptoms of PD can include:

  • tremors (uncontrolled movements)
  • rigid muscles
  • problems balancing

With post-encephalitic parkinsonism, you develop parkinsonism after having encephalitis. With encephalitis, your brain becomes inflamed. Encephalitis is most commonly caused by a viral or bacterial infection. People with encephalitis may have swelling in their brain or a brain disease.

Sometimes, the swelling or disease that causes encephalitis can resolve, and you can make a full recovery. But other times, nerves in your brain and levels of dopamine (a brain chemical) may continue to be affected, even after the encephalitis has resolved. In this case, you could be affected by parkinsonism.

Rytary contains the following two active drugs:

  • levodopa, which works to reduce parkinsonism symptoms by increasing the amount of dopamine in the brain
  • carbidopa, which works to prevent levodopa from being broken down in the brain

Effectiveness for post-encephalitic parkinsonism

There aren’t any clinical studies on Rytary’s effectiveness in treating post-encephalitic parkinsonism. However, low dopamine levels in the brain cause both PD and parkinsonism. And Rytary has been shown effective for PD treatment. So it’s thought that Rytary can also help treat post-encephalitic parkinsonism by increasing dopamine levels in the brain.

Rytary for parkinsonism after carbon monoxide or manganese poisoning

Rytary is approved to treat parkinsonism that follows either carbon monoxide poisoning or manganese poisoning. Below, we describe how these poisonings may lead to parkinsonism.

Parkinsonism is a condition that causes symptoms similar to those caused by Parkinson’s disease (PD). Symptoms of PD can include:

  • tremors (uncontrolled movements)
  • rigid muscles
  • problems balancing

Rytary contains the following two active drugs:

  • levodopa, which works to reduce parkinsonism symptoms by increasing the amount of dopamine in the brain
  • carbidopa, which works to prevent levodopa from being broken down in the brain

Manganese poisoning and parkinsonism

Manganese is a mineral that your body needs in small amounts. However, exposure to too much manganese can cause it to build up in your brain, leading to parkinsonism.

Carbon monoxide poisoning and parkinsonism

Carbon monoxide is a colorless, odorless gas. Carbon monoxide poisoning causes lesions to develop on your brain, and it may cause parkinsonism. But it’s not known exactly how carbon monoxide poisoning causes parkinsonism.

Effectiveness for parkinsonism after carbon monoxide or manganese poisoning

There aren’t any clinical studies on Rytary’s effectiveness in treating parkinsonism after carbon monoxide or manganese poisoning. However, low dopamine levels in the brain cause both PD and parkinsonism. And Rytary has been shown effective for PD treatment.

So it’s thought that Rytary can also help treat parkinsonism caused by carbon monoxide or manganese poisoning by increasing dopamine levels in the brain.

Rytary and children

Rytary isn’t approved for use in children.

You shouldn’t drink alcohol while you’re taking Rytary. This is because both alcohol and Rytary can cause:

  • difficult and slowed breathing
  • decreased blood pressure
  • slowed thinking

Using Rytary and alcohol at the same time can worsen these effects, which could make them dangerous.

If you have questions about the risks of drinking alcohol while taking Rytary, talk with your doctor.

You should never suddenly stop taking Rytary, because doing so may cause withdrawal symptoms. With withdrawal, you have unpleasant symptoms when you stop taking a drug that your body has become dependent upon. (With dependence, your body needs the drug in order for you to feel normal.)

If you want to stop taking Rytary, talk with your doctor first. They’ll recommend that you gradually decrease your dosage of the drug. Gradually decreasing your dosage of Rytary helps you to avoid having withdrawal symptoms.

Because Rytary affects chemicals in your brain, suddenly stopping the drug can cause withdrawal symptoms, such as:

  • high fever
  • rigid muscles
  • changes in your level of consciousness
  • changes in your heart rate, which may cause a heart rate that’s faster or slower than usual
  • confusion

If you want to stop taking Rytary, be sure to talk with your doctor first. They’ll help you reduce your dose gradually.

Do not take more Rytary than your doctor recommends. Taking more than the recommended dosage of Rytary can lead to serious side effects.

Note: The maximum recommended daily dose of Rytary is 612.5 mg of carbidopa/2,450 mg of levodopa. For more information about typical dosages of Rytary, see the “Rytary dosage” section above.

Overdose symptoms

Symptoms of Rytary overdose can include:

In clinical trials, one person took too much Rytary. Specifically, they took a total of 4,680 mg of carbidopa and 18,700 mg of levodopa within 2 days. This person had both dyskinesia and psychosis.

The person’s symptoms went away, and they recovered from their overdose. And they completed the rest of the trial while taking a reduced dose of Rytary.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Here are answers to some frequently asked questions about Rytary.

What should I do if Rytary isn’t working?

If Rytary doesn’t seem to be reducing symptoms of your condition, talk with your doctor.

It’s important to note that you should never stop taking Rytary without first talking with your doctor. This is because suddenly stopping treatment with Rytary could cause withdrawal symptoms. For more information about this, see the “Rytary withdrawal and dependence” section above.

If your doctor recommends that you stop taking Rytary, they may have you gradually decrease your dosage of the drug. Doing this will help to reduce your risk of withdrawal symptoms.

How long does Rytary last?

Rytary lasts for about 4 to 5 hours inside your body. Over this period of time, the drug works to treat symptoms of your condition.

Rytary is an extended-release (ER) medication that contains two active drugs: carbidopa and levodopa. Because it’s ER, Rytary slowly releases these active drugs into your body over time. Rytary lasts longer in your body and works over a longer period of time than immediate-release (IR) drugs do. (With IR medications, their active drug is released all at once inside your body.)

Rytary is made up of:

  • one-third IR levodopa and carbidopa
  • two-thirds ER levodopa and carbidopa

So Rytary starts to work immediately, but it also continues to work over the following 4 to 5 hours. This helps to keep the medication levels more consistent in your body, so that your symptoms are better managed throughout the day.

Why would my doctor switch me from immediate-release levodopa/carbidopa to Rytary?

Your doctor may switch you from immediate release (IR) levodopa/carbidopa to Rytary so that you experience less “off time.” Off time is the time period during which you have symptoms of Parkinson’s disease (PD).

Rytary contains carbidopa and levodopa, but it’s an extended-release (ER) medication. Because it’s ER, Rytary slowly releases these active drugs into your body over time. This is unlike IR medications, which release their active drug all at once inside your body.

Rytary lasts longer in your body and works over a longer period of time than (IR) drugs do. This helps to keep the medication levels more consistent in your body, so that your symptoms are better managed throughout the day.

In clinical trials, people with advanced PD* had:

  • 3.9 hours of off time when taking Rytary, compared with 6.1 hours of off time before starting Rytary
  • 4.9 hours of off time when taking IR carbidopa and levodopa, compared with 5.9 hours of off time before starting IR carbidopa and levodopa

* Advanced PD means that your PD symptoms significantly affect your typical daily activities.

Is it safe for me to drive while I’m using Rytary?

Actually, you shouldn’t drive until you know how Rytary affects your body. In some people, Rytary can cause sleepiness. Sometimes, sleepiness may cause you to fall asleep while you’re doing daily activities, such as eating or talking. But sleepiness can also occur when you’re driving, and this could cause serious accidents.

Before you start taking Rytary, tell your doctor about any other medications that you’re taking. If you’re taking other medications that also make you sleepy, you may have an increased risk of falling asleep.

And if you have significant sleepiness during the day or you fall asleep while doing daily activities, tell your doctor. They may switch you to a medication other than Rytary. Or they may lower your dosage of Rytary.

For some people, decreasing their dosage of Rytary may decrease the risk of sleepiness. However, you shouldn’t drive until you know how Rytary affects you.

Will Rytary cure my condition?

No, unfortunately, Rytary won’t cure your condition. In fact, there’s currently no known cure for Parkinson’s disease (PD) or parkinsonism, which Rytary is used to treat.

However, Rytary will treat your condition so that you experience fewer symptoms. But keep in mind that if you stop taking Rytary, symptoms of your condition that improved during treatment may come back.

Rytary can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Rytary and other medications

Below are lists of medications that can interact with Rytary. These lists don’t contain all the drugs that may interact with Rytary.

Before taking Rytary, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Rytary and certain depression drugs

Rytary may interact with monoamine oxidase inhibitors (MAOIs), which are a group of drugs used to treat depression. There are two types of MAOIs: selective and nonselective. These two types of MAOIs work slightly differently in your body.

Rytary and nonselective MAOIs

You should never take Rytary with nonselective MAOIs. Taking Rytary along with nonselective MAOIs can cause your blood pressure to become too high. And in some cases, this can lead to a medical emergency.

Examples of nonselective MAOIs include:

  • phenelzine (Nardil)
  • tranylcypromine (Parnate)

If you’re taking a nonselective MAOI, you should stop taking it at least 2 weeks before you start Rytary. But, be sure to talk with your doctor before stopping any medications that you’re currently taking.

Rytary and selective MAOIs

If you take Rytary with selective MAOIs, you have an increased risk of orthostatic hypotension. (With orthostatic hypotension, you have a decrease in blood pressure that occurs when you are changing positions.) Orthostatic hypotension could cause you to feel dizzy or faint.

Examples of selective MAOIs include:

  • rasagiline (Azilect)
  • selegiline (Zelapar)

If you’re taking Rytary along with a selective MAO inhibitor, your doctor will monitor you more often than usual during treatment. Doing so allows them to ensure that you’re not have too many side effects from these medications.

Rytary and drugs that block dopamine

Rytary can interact with drugs that block the action of the dopamine, which is a brain chemical in your body. Dopamine helps your nerve cells to talk with each other, allowing them to function correctly. Rytary works by increasing the amount of dopamine in your body.

So if you take Rytary with drugs that block dopamine, Rytary won’t be able to work properly.

Examples of drugs that block dopamine include:

  • risperidone (Risperdal), which is used to treat certain mental health conditions
  • metoclopramide (Reglan), which is used to treat nausea and vomiting
  • chlorpromazine, which is used to treat certain mental health conditions
  • prochlorperazine, which is used to treat nausea and vomiting, as well as certain mental health conditions
  • haloperidol (Haldol), which is used to treat certain mental health conditions and movement disorders

If you’re taking Rytary with drugs that block dopamine, your doctor may change your Rytary dosage and monitor you more often than usual during treatment. Doing so allows them to ensure that you’re getting enough Rytary in your body to manage your symptoms.

Rytary and isoniazid

Taking Rytary with isoniazid may cause Rytary to not work as well as usual to treat your symptoms. Isoniazid is an antibiotic that’s used to treat tuberculosis (TB).

If you’re taking Rytary along with isoniazid, your doctor may increase your Rytary dose and monitor you more often than usual during treatment. This allows them to ensure that your symptoms are being effectively treated by Rytary.

Rytary and herbs and supplements

Rytary may interact with iron supplements, which is described just below. Be sure to check with your doctor or pharmacist before using any herbs or supplements while you’re taking Rytary.

Rytary and iron salts

Iron can bind to Rytary, causing the medication to not work properly. This includes iron that’s contained in multivitamins.

If you’re taking Rytary along with iron, your doctor may monitor you more often than usual during treatment. This allows them to ensure that your symptoms are being effectively treated by Rytary.

Rytary and foods

Rytary can be taken with or without food. There aren’t any foods that have been specifically reported to interact with Rytary. However, some foods may alter your body’s absorption of Rytary. We describe examples of these foods below.

If you have questions about eating certain foods while taking Rytary, talk with your doctor.

Rytary and high-fat, high-calorie meals

Taking Rytary with a high-fat, high-calorie meal may cause Rytary to be absorbed slower than usual by your body. And with this delay, the medication may take 2 to 3 hours longer than usual to start working.

So to avoid this delay, you may want to take your first dose of Rytary 1 to 2 hours before eating. That way, if you consume foods that are high in calories and fat, Rytary’s absorption won’t be delayed.

Rytary and protein

If you take Rytary along with a high-protein meal, your body may not absorb all of the medication. With this decreased absorption, the medication may not work as well as it should for your symptoms.

Talk with your doctor about whether you should follow a low-protein diet while you’re taking Rytary.

Rytary is approved treat the following conditions in adults:

  • Parkinson’s disease (PD). This condition affects your nervous system and movements. Symptoms of PD can include tremors (uncontrolled movements), rigid muscles, or problems balancing.
  • Certain kinds of parkinsonism. Parkinsonism causes symptoms similar to those of PD.

What happens in Parkinson’s disease and parkinsonism

With PD and parkinsonism, you don’t have enough of the brain chemical dopamine in your body. Dopamine works by helping your nerve cells talk with each other, allowing you to function correctly.

When your body doesn’t make enough dopamine, your nervous system is affected and symptoms of PD may begin to develop. PD is a progressive disease, which means that symptoms of PD get worse over time.

What Rytary does

Rytary contains two active drugs: levodopa and carbidopa.

Inside your brain, levodopa is converted into dopamine. So, by taking levodopa, you’re increasing the amount of dopamine in your brain. And this helps to decrease PD symptoms.

However, levodopa can also be broken down by your body before it even reaches your brain. And if it’s broken down before it reaches your brain, levodopa won’t be able to help with your PD symptoms.

But keep in mind that Rytary also contains carbidopa. This active drug works by blocking the breakdown of levodopa in your body. This allows more levodopa to get to your brain, where it works to help decrease PD symptoms.

How long does it take to work?

Rytary begins to work right after you’ve taken your first dose. This medication contains:

  • one-third immediate-release (IR) levodopa/carbidopa
  • two-thirds extended-release (ER) levodopa/carbidopa

With IR medications, their active drugs are released all at once into your body. On the other hand, ER medications slowly release their active drugs into your body over time.

ER medications work consistently over a longer period of time than do IR medications. And the effects of ER drugs last longer than the effects of IR drugs do.

Because Rytary contains a combination of IR and ER drugs, this medication does start to work right away. But it also continues to work over the 4 to 5 hours that follow. To help keep your symptoms managed, Rytary is usually taken three times daily.

You should take Rytary according to your doctor’s or healthcare provider’s instructions. This medication is usually taken three times daily. But if recommended by your doctor, it can be taken up to five times daily.

When to take

Rytary should be taken three to five times each day, depending on your doctor’s recommendation.

You should try to take your doses of Rytary at about the same times each day. Doing this helps to ensure that you have a consistent amount of the drug in your body at all times. And having a consistent amount of Rytary in your body means that your symptoms should be well managed.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A kitchen timer may be useful, too.

Taking Rytary with food

Rytary can be taken with or without food. However, taking Rytary along with a high-fat and high-calorie meal may delay your body’s absorption of the drug. This could cause you to absorb the medication 2 to 3 hours slower than usual.

With delayed absorption, Rytary may not work as quickly as usual. So to help avoid delayed absorption, you may want to take your Rytary 1 to 2 hours before eating. This way the drug will begin working as quickly as possible.

In addition, if you take Rytary along with a high-protein meal, you may not absorb all of the medication. And because Rytary may not be able to work as well as usual, you may have symptoms of your condition. Talk with your doctor about whether you should follow a low-protein diet while you’re taking Rytary.

Can Rytary be crushed, split, or chewed?

You should never crush, divide, or chew Rytary capsules. Instead, the capsules should be swallowed whole.

However, if you have trouble swallowing whole capsules, you can open Rytary capsules and sprinkle their contents into 1 to 2 tablespoons of applesauce. Once you mix the drug with applesauce, you should take it right away. Never store the applesauce that contains Rytary for later use.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Rytary, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for Parkinson’s disease

Examples of other drugs that may be used to treat Parkinson’s disease (PD) include:

  • apomorphine (Apokyn)
  • inhaled levodopa (Inbrija)
  • carbidopa/levodopa (Sinemet, Duopa)
  • pramipexole (Mirapex)
  • ropinirole (Requip)
  • rotigotine (Neupro)
  • istradefylline (Nourianz)
  • entacapone (Comtan)
  • tolcapone (Tasmar)
  • safinamide (Xadago)
  • selegiline (Zelapar)
  • rasagiline (Azilect)

Alternatives for post-encephalitic parkinsonism

Examples of other drugs that may be used to treat post-encephalitic parkinsonism include:

  • inhaled levodopa (Inbrija)
  • carbidopa/levodopa (Sinemet, Duopa)

Alternatives for parkinsonism after carbon monoxide poisoning or manganese poisoning

Examples of other drugs that may be used to treat parkinsonism after carbon monoxide poisoning or manganese poisoning include:

  • inhaled levodopa (Inbrija)
  • carbidopa/levodopa (Sinemet, Duopa)

As with all medications, the cost of Rytary can vary. To find current prices for Rytary capsules in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Rytary, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Rytary, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Rytary, or if you need help understanding your insurance coverage, help is available.

Amneal Pharmaceuticals LLC, the distributor of Rytary, offers the MyRytary Patient Support Program. For more information and to find out if you’re eligible for support, call 844-467-2928 or visit the program website.

Generic version

Rytary isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

It’s not known if Rytary is safe to take during pregnancy. However, animal studies showed that carbidopa and levodopa can cause issues in developing animals when they’re exposed to these drugs. (Carbidopa and levodopa are the active drugs in Rytary.)

For example, animals exposed to carbidopa and levodopa during pregnancy had problems with their skeleton and certain organs forming.

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Rytary. They may recommend a different medication for you.

It’s not known if Rytary is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Rytary.

For more information about taking Rytary during pregnancy, see the “Rytary and pregnancy” section above.

It’s not known whether it’s safe to breastfeed while you’re taking Rytary. Levodopa, one of the active drugs in Rytary, does pass into breast milk in females who take it. It’s not known if carbidopa, the other active drug in Rytary, passes into human breast milk. But carbidopa does pass into animal breast milk.

It’s not known if Rytary can have an effect on a child who’s breastfed. However, levodopa may reduce the amount of breastmilk your body makes.

If you are breastfeeding, talk with your doctor before taking Rytary.

This drug comes with several precautions. Before taking Rytary, talk with your doctor about your health history. Rytary may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Heart problems, such as heart attack. People with heart disease should be monitored when both starting and changing dosages of Rytary. Rytary can increase the risk of heart attack or other heart problems in people who already have certain heart issues. If you have an irregular heartbeat and you’ve had a heart attack before, your doctor will monitor you in a medical unit that specializes in heart care when you first start taking Rytary. This will be done to ensure that if you have heart problems, they can be treated right away. If you have a history of heart problems, be sure to tell your doctor before you start taking Rytary.
  • Psychotic disorders, such as schizophrenia. Rytary may worsen psychosis symptoms in people with psychotic disorders, such as schizophrenia. If you have a serious psychotic disorder, you shouldn’t take Rytary. Also, medications that are used to treat certain psychotic disorders may cause Rytary to not work as well as usual. If you have or have had any psychotic disorders, be sure to tell your doctor before starting Rytary.
  • Bleeds or ulcers in your intestines. If you have a history of a peptic ulcer, Rytary may increase the risk of bleeding in your intestines, which can be very serious. If you have a history of peptic ulcer disease, tell your doctor before you start taking Rytary. Your doctor may recommend a different medication for you to take, or they may monitor more often during treatment.
  • Glaucoma. Rytary may increase your pressure in your eye. If you have glaucoma, this increased pressure may worsen your glaucoma. If you have glaucoma, tell your doctor before you start taking Rytary. They may recommend a different medication for you to take, or they may monitor the pressure in your eye more often than usual during treatment.
  • Allergic reaction. If you’ve had an allergic reaction to Rytary or any of its ingredients, you shouldn’t take Rytary. Ask your doctor what other medications are better options for you. And if you’re not sure about your medication allergies, talk with your doctor.
  • Pregnancy. It isn’t known if Rytary is safe for you to take during pregnancy. For more information, please see the “Rytary and pregnancy” section above.
  • Breastfeeding. It isn’t known if Rytary is safe to take while breastfeeding. For more information, please see the “Rytary and breastfeeding” section above.

Note: For more information about the potential negative effects of Rytary, see the “Rytary side effects” section above.

When you get Rytary from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Rytary capsules should be stored at a room temperature of 68°F to 77°F (20°C to 25°C). They should be kept in a tightly sealed container. If needed, for a short period of time, Rytary can be stored between 59°F and 86°F (15°C and 30°C).

Rytary should be kept away from light and moisture. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Rytary and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Rytary is approved to treat:

  • Parkinson’s disease (PD)
  • parkinsonism that follows encephalitis, carbon monoxide poisoning, or manganese toxicity

Administration

Rytary is an oral capsule that is usually taken three times per day.

Mechanism of action

Rytary is an extended-release (ER) formulation of carbidopa and levodopa. Rytary beads are encapsulated, with one-third being immediate release (IR) and the remaining two-thirds being ER.

Levodopa is converted into dopamine in the brain. Because people with PD are dopamine deficient, levodopa replaces their missing dopamine. This reduces symptoms that people experience related to PD.

However, levodopa can also be decarboxylated in the body, outside of the brain. When this occurs, dopamine will not reduce symptoms of PD, as only a small amount of levodopa will be able to enter the brain before conversion. Therefore, the role of carbidopa is to block the decarboxylation of levodopa in the body, so that more levodopa can enter through the blood-brain barrier and exhibit its effect in the brain.

Pharmacokinetics and metabolism

The maximum plasma concentration of carbidopa occurs at 3 hours. The maximum plasma concentration of levodopa occurs about an hour after dosing, and then remains at that level for about 4 to 5 hours before plasma concentrations slowly decrease.

Rytary tablets are 50% bioavailable, as compared to immediate release (IR) carbidopa and levodopa tablets. When taking about equal doses, Rytary has a peak plasma concentration that is about 30% that of IR carbidopa and levodopa tablets.

Food may impact the absorption of Rytary. After a high-fat, high-calorie meal, the highest plasma drug concentration is decreased by about 21%. The total exposure of levodopa to a person’s body may be increased by about 13%, when compared to people who take the drug without eating.

A high-fat, high-calorie meal may also cause an absorption delay of levodopa by 2 hours. Therefore, taking the drug with a high-fat, high-calorie meal may cause a delay symptom relief.

A high protein meal may also decrease levodopa absorption.

About 36% of carbidopa is protein bound, whereas 10% to 30% of levodopa is also protein bound in plasma.

The half-life of carbidopa is about 2 hours, whereas the half-life of levodopa is about 2 hours if carbidopa is also present.

Carbidopa is broken down into two major metabolites. It can then be excreted unaltered through the urine or as a glucuronide. About 30% of total excretion is unaltered drug that is urinated out.

Levodopa is also metabolized via two main metabolic pathways into different metabolites.

Contraindications

Rytary is contraindicated for use in people who are taking nonselective monoamine oxidase inhibitors (MAOIs). People should stop treatment with nonselective MAOIs for at least 2 weeks before starting Rytary. Serious hypertension may occur if Rytary is taken along with a nonselective MAOI.

Misuse, withdrawal, and dependence

Rytary may cause people to develop a syndrome similar to neuroleptic malignant syndrome if they suddenly discontinue the drug. Therefore, Rytary dosages should slowly be titrated down over time to prevent symptoms, including fever, rigid muscles, and decreased consciousness.

Storage

Rytary should be stored at a room temperature of 68°F to 77°F (20°C to 25°C) in a tightly sealed container. If needed, for a short period of time, Rytary can be stored between 59°F and 86°F (15°C and 30°C). It should be kept away from light and moisture. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.