Syndopa 275 Sun Pharma drugs treat Parkinson's symptoms (5 blisters x 10 tablets)

Dosage form Box of 5 blisters x 10 tablets
Specifications Levodopa, carbidopa

Ingredient

Composition information	Content
Levodopa	250mg
Carbidopa	25mg

Uses

indications

Syndopa drug are indicated for treatment and Parkinson's syndrome.

Pharmacology

levodopa is a precursor of dopamine, and is said to be alternative therapy in Parkinson's disease.

Carbidopa is a peripheral dopa decarboxylase inhibitor. It prevents the metabolism of levodopa into dopamine in the peripheral circulatory system, ensuring a higher rate than the dose to the brain - where dopamine works.

A combination of Levodopa/Carbidopa: It is helpful in reducing many symptoms of Parkinson's disease, especially hard and slow movement. This combination is often helpful in controlling tremor, difficulty swallowing, increasing salivary glands, and posture instability related to disease and Parkinson's syndrome.

When patients cannot respond to regular Levodopa single therapy, the signs and symptoms of Parkinson's disease are not controlled regularly during the day, replaced by a combination of Levodopa/Carbidopa often reduces the fluctuations in response. By reducing some adverse reactions due to the use of Levodopa single therapy, the combination of Levodopa/Carbidopa allows more patients to reduce symptoms in Parksinson's disease in the most complete direction.

Dynamic pharmacokinetics

In the absence of decarboxylase inheror, Levodopa after drinking will be absorbed quickly but change through the gastrointestinal tract. Selling plasma waste time is about 1 hour, converted mainly to dopamine thanks to Dopa - Decarboxylase, partly converted to Noradrenalin. Up to 30% is converted to 3 - O - Methyldopa with a selling time from 9 - 22 hours. About 80% Levodopa is excreted in urine within 24 hours mainly in the form of homovanillic acid and dihydroxyphenylactic acid. Less than 1% is excreted in the form of unchanged.

When circulating, Levodopa will compete with other neutral amino acids to transport through the brain blood barrier. Once you have entered the fortune neurons, Levodopa will be decarboxylation to form dopamine - stored and released from the Synap Money Neuron. Because Levodopa has very fast decarboxylation in the gastrointestinal tract and liver, only a very small amount of unchanged is available to transport into the brain.

Peripheral carboxyl reducing reactions reduce the effectiveness of Levodopa's treatment. For this reason Levodopa is often used with peripheral decarboxylase inhibitors like Carbidopa, so it can be used lower doses to give the same effect on the treatment of Carbidopa when absent Levodopa: It is quickly absorbed but not completely through the digestive tract after drinking.

After drinking, about 50% are found in urine in about 3% in constant form. It does not pass the bloody barrier but passes the placenta and excretes in breast milk. Fast rotation, almost constant drugs will be found in urine within 7 hours.

Before taking Syndopa 275 Sun Pharma drugs treat Parkinson's symptoms (5 blisters x 10 tablets)

How to use

Syndopa 275 is prepared in the form of oral tablets.

Dosage

Daily optimal dose must be determined by careful dose standard on each patient. Levodopa/Carbidopa tablets contain active ingredients with a ratio of 1: 4 or 1:10 (Levodopa: Carbidopa). Syndopa 275 tablets contain active ingredients with a ratio of 1:10 (Levodopa 250 mg: Carbidopa 25 mg), may not be suitable to perform the standard dose, which can be considered for using other medicinal preparations in these cases.

Common dosage recommends for Levodopa/Carbidopa tablets are presented as below:

Studies show that the decadboxylase process of peripheral DOPA is saturated because Carbidopa has a dose of about 70 - 100 mg/day. Patients taking the dose below this level of Carbidopa tend to vomit and nausea.

In addition to the Levodopa single -use therapy, the standard drugs used to treat Parkinson's disease can be used simultaneously with Levodopa/Carbidopa tablets, although the dose may be adjusted.

Due to the treatment effect and unwanted reactions are observed when using Levodopa/Carbidopa tablets rather than when using Levodopa alone, careful monitoring of patients during the dose adjustment process. Unconscious movement, especially eyelash spasm, is a useful early sign that the amount of dosage in some patients.

If using Levodopa/Carbidopa 100 mg/10 mg or 50 mg/12.5 mg; The starting dose is 1 tablet x 3 - 4 times/day. It may be necessary to titrate the dose in several patients to be able to achieve the optimal dose of Carbidopa. It is possible to increase by 1 tablet daily or daily until the total dose is 8 capsules (2 tablets x 4 times/day).

responds to the observed drug within 1 day, and sometimes after only 1 dose. The full effect of the drug is achieved within 7 days when compared to the effect of achieved in a few weeks or a few months if only used alone levodopa.

Levodopa/Carbidopa 100 mg/10 mg or 50 mg/12.5 mg is used to facilitate the titration of dosage according to the needs of each patient.

Patients use Levodopa

Stop using Levodopa at least 12 hours (24 hours for slow -released preparations) before starting using Levodopa/Carbidopa tablets. The simplest way to do this is to let patients use the first levodopa/carbidopa tablet in the morning after one night without using Levodopa. The dose of Levodopa/Carbidopa tablets should only be about 20% of the previous daily dose of Levodopa.

Patients using less than 1500 mg of levodopa/day should be started with Levodopa/Carbidopa 100 mg/25 mg, 3 or 4 times/day depending on the needs of the patient. The initial dose of suggestions for most patients taking more than 1500 mg Levodopa/day is a Levodopa/Carbidopa 250 mg/25 mg (Syndopa 275), 3 or 4 times a day.

Maintenance dose

Treatment should depend on the patient and adjust the dose according to the purpose of response to treatment. When it is necessary to use a larger amount than Carbidopa, Levodopa/Carbidopa 100 mg/10 mg can be replaced by tablets so Levodopa/Carbidopa 100 mg/25 mg or 50 mg/12.5 mg.

When needed more than Levodopa, use Levodopa/Carbidopa 250 mg/25 mg (Syndopa 275) 1 tablet x 3-4 times/day. If necessary, the dose of Syndopa 275 may increase to 1 tablet daily or daily until a maximum of 8 tablets/day. Experience when the total daily dose of Carbidopa> 200 mg is still limited.

Patients use Levodopa with a decarboxylase inhibitor

When transferring a patient taking levodopa + a decarboxylase inhibitor to use Levodopa/Carbidopa tablet, stopped at least 12 hours before using Levodopa/Carbidopa tablets. Start the dose with Levodopa/Carbidopa tablet will provide the same amount of Levodopa as in preparations combining Levodopa + a decarboxylase inhibitor.

Patients taking other anti -Parkinson drugs

The current evidence shows that other anti -Parkinson drugs can be used when using Levodopa/Carbidopa tablets, although the dose may have to adjust the dose in accordance with the manufacturer's recommendations.

used in children

Safety province of Levodopa/Carbidopa tablets has not been set for patients

Used in older adults

Experience widely when taking this drug in older patients.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when overdose? However, vitamin B6 is not too effective to recover from Syndopa.

Need to treat the whole body with the gastroentric pump immediately after an overdose, appropriate infusion and ensure adequate ventilation. Electrolyte monitoring should be monitored and monitor patients carefully to find signs of arrhythmia: if necessary, anti -arrhythmic drugs must be treated when indicated. The possibility that patients can take other medications like Syndopa should be considered. So far, no experience has been reported by dialysis because the value of dialysis in an overdose is unknown.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Syndopa 275 , you may experience unwanted effects (ADR).

wrong results of some tests: iodine concentration associated with increased protein; Uric acid concentration in blood and urine increases (measured in decoction); false positive reaction when qualitative glucose (copper sulfate method); negative reactions assumption of urinary glucose (method of using glucose oxydase); The positive reaction assumes the ureter qualitative (method of using sodium nitroprusiat); High urinary catecholamin concentration (Hingery method).

Common, ADR> 1/100

Common side effects include:

Central nervous system: anxiety , confusion, stimulating state, depression, dementia, insomnia, fatigue, hallucinations, loss of coordination, disorders of force, disorder. Eye.

The less common side effects include:

digestive: duodenum ulcer. Cramps, muscle weakness, sweat, skin and black teeth, increase or lose weight, edema, hair loss, penis erection, postmenopausal bleeding.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Syndopa 275 contraindications in the following cases:

Monoamine oxidase and Syndopa inhibitors are not used at the same time. Melanoma malignant disease.

In patients with serious mental disorders.

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

When using Syndopa (Carbidopa-LEVODOPA) for patients treated with Levodopa, Levodopa must be stopped at least 12 hours before starting to use Syndopa (Carbidopa-LEVODOPA).

Like Levodopa, Syndopa can cause mental disorders. These reactions are thought to be due to increased dopamine in the brain after using levodopa. All patients should be carefully observed the development of depression and suicide tendency. Be careful when treating patients before or now mentally ill.

When using Carbidopa - Levodopa, it is necessary to periodically assess liver function, hematopoietic, cardiovascular and cautious treatment for long -term treatment.

Be cautious when using Levodopa as well as with a combination of products for people with a history of myocardial infarction, atrial, button or ventricular sequelae.

Be cautious when using Carbidopa - Levodopa for people with cardiovascular disease or severe lung disease, bronchial asthma, kidney disease, liver or endocrine.

Carbidopa allows more Levodopa to the brain; Therefore, dopamine hyperactive disorders can occur earlier with carbidopa -levodopa doses lower than Levodopa.

As with Levodopa, when using this combination preparation may occur gastrointestinal bleeding in patients with a history of stomach and duodenal ulcer.

There have been reports on malignant neuroleptic syndrome including muscle spasms, hyperthermia, mental disorders and increased serum creatin phosphokinase when suddenly stopping Parkinson's anti -Parkinson drugs.

Because cessation syndrome can occur, careful monitoring of patients when a sudden decrease in dosage or stop using Carbidopa - Levodopa, especially when the patient is taking sedative drugs.

Using drugs at meals can hinder absorption but reduce digestive disorders.

The ability to drive and operate machinery

does not apply to patients when using the drug.

pregnancy

Currently, there are no good and complete control studies in pregnant women. There have been separate levodopa reports through the fence of the placenta, into the fetus, and being metabolized. Carbidopa concentration in the fetal tissue is very low.

Patients should assess the benefits of the drug compared to the risk of mothers and babies when using Carbidopa and Levodopa tablets in women of reproductive age.

Breastfeeding period

There is no report on whether the drug is excreted through breast milk or not. Because many drugs are secreted into breast milk, caution should be used when using Carbidopa and Levodopa for nursing women.

Drug interaction

drug interactions may affect the activity of the drug or cause side effects. Should notify the doctor or pharmacist a list of drugs and functional foods you are using. Do not use or increase or decrease the dose of the drug without the guidance of a doctor.

Should be cautious about the following drugs at the same time as Levodopa - Carbidopa:

Hypotension with symptoms may occur when using Levodopa - Carbidopa is added in the treatment of patients who are taking antihypertensive drugs. So when treated with Levodopa - Carbidopa needs to adjust the dose of antihypertensive drugs.

Patients who use monoamine oxidase inhibitors should not be used in combination with Syndopa.

There are a few reports on side effects, including hypertension, disturbance due to the use of 3 -round antidepressants at the same time with Levodopa - Carbidopa.

Phenothiazin, Butyrophenon, Phenytoin and Papaverin can reduce the treatment effect of Carbidopa - Levodopa. Do not simultaneously use these drugs with Carbidopa - Levodopa.

Levodopa antagonists: Clorpromazin, Clonazepam, Diapezam, Fluphenazin, Haloperidol, Methyldopa, Pyridoxin, Reserpine (Reserpin simultaneously reduce the effect of levodopa should avoid using these two drugs at the same time).

Body anesthesia (cyclopropan, halogen hydrocarbon) simultaneously with Carbidopa - Levodopa can cause arrhythmia. Another type of anesthetic should be used in Levodopa users.

Metoclopramid makes food from the stomach thus increases the bioavailability of Levodopa but increases the symptoms of Parkinson's disease because of the antagonistic effect on the dopamine receptors.

Isoniazids may be opposed to Levodopa's treatment effects. Need to monitor the response to the patient's medicine.

Storage

Leave a cool place, avoid light, avoid moisture, temperature below 25⁰C.

To be out of reach of children.

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