Sinemet CR for Parkinson's disease

Article Abstract:

Parkinson's disease is a chronic and progressive disease of the nervous system that manifests itself in tremor, muscle weakness, rigidity, and an unusual manner of walking. This disorder results from a deficiency of dopamine in the brain. Dopamine is a substance that is involved in various cell functions including the transmission of nerve impulses. The drug levodopa is used to treat parkinsonism because it can penetrate into the brain, where it is converted to dopamine. The drug carbidopa prevents the breakdown of levodopa outside of the brain and thereby reduces the incidence of adverse side effects of levodopa. This also increases the amount of levodopa that can be penetrate into the brain. Sinemet CR is a combined preparation of the drugs carbidopa and levodopa, which are released into the body in a controlled-release fashion. The drugs are prepared in a structure called a polymeric matrix that slowly degrades in the digestive tract. Sinemet CR produces constant blood levels of levodopa for four to six hours. In comparison with standard Sinemet, which is not a controlled-release preparation, Sinemet CR takes longer to reach maximum levels, releases 25 to 20 percent less drug available for action, and has a slower onset of action. Although levodopa is the most effective drug used to treat Parkinson's disease, its long-term use may be associated with wide variations in motor function. Steady levels of levodopa may diminish such motor fluctuations. Sinemet CR has been shown to improve motor fluctuations, but also may increase dyskinesias (uncontrollable movements) associated with an excess of dopamine. The combined use of Sinemet and Sinemet CR caused shorter periods of dyskinesias and reduced motor fluctuations. The adverse effects of Sinemet CR include nausea, dizziness, sleepiness, tiredness, a drop in blood pressure upon standing erect, constipation, dry mouth, dyskinesias, hallucinations, confusion, and motor fluctuations after long-term use. The recommended dose and cost of Sinemet CR are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration, Dopa, L-dopa, Timed release drugs, Controlled release preparations, Sinemet

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Tolcapone for Parkinson's disease

Article Abstract:

The drug tolcapone (Tasmar) is available as a treatment for Parkinson's disease. The drug should be used in addition to levodopa because it increases the bioavailability of levodopa, which is the primary drug used to treat Parkinson's disease. Many patients who take tolcapone can reduce the dose of levodopa and it can also reduce the amount of "off" time, or the time patients do not respond to levodopa. The most common side effect is diarrhea, but the drug can also increase the side effects of levodopa.

Tasmar (Medication)

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Entacapone for Parkinson's disease

Article Abstract:

The FDA has approved entacapone for the treatment of Parkinson's disease. Sold under the trade name Comtan, the drug inhibits an enzyme called catechol-O-methyltransferase (COMT). COMT breaks down levodopa, so inhibiting the enzyme keeps levodopa available. Since the drug is given in addition to levodopa, it increases the amount of time the levodopa is effective. Because it enhances the availability of levodopa, it can increase the risk of side effects from levodopa.

Comtan (Medication)

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