• Parkinsonism

Rytary Generic Name & Formulations

General Description

Carbidopa, levodopa; 23.75mg/95mg, 36.25mg/145mg, 48.75mg/195mg, 61.25mg/245mg; ext-rel caps.

Pharmacological Class

Dopa-decarboxylase inhibitor + dopamine precursor.

How Supplied

Ext-rel caps—100, 240


Rytary Indications


Treatment of Parkinson's disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication.

Rytary Dosage and Administration


Swallow whole. If difficulty swallowing, may open capsule and sprinkle contents on applesauce (1–2tbsp); consume immediately. Individualize. Levodopa-naive: initially 23.75mg/95mg 3 times daily for the first 3 days; may increase to 36.25mg/145mg 3 times daily on the fourth day; up to max 97.5mg/390mg 3 times daily. May increase to max 5 times daily if more frequent dosing needed and tolerated. Max daily dose: 612.5mg/2450mg. Converting from IR carbidopa-levodopa: see full labeling. Currently taking carbidopa-levodopa with concomitant COMT inhibitors (eg, entacapone): may need to increase initial daily dose; see full labeling.


Not established.

Rytary Contraindications


During or within 2 weeks of nonselective MAOIs (eg, phenelzine, tranylcypromine).

Rytary Boxed Warnings

Not Applicable

Rytary Warnings/Precautions


Not interchangeable with other carbidopa-levodopa products. Sleep disorders: consider discontinuing if significant daytime sleepiness occurs. History of MI or arrhythmias; monitor cardiac function. Risk of hallucinations and psychosis. Major psychotic disorder: not recommended. Impulse control/compulsive behaviors; consider dose reduction or discontinuation if develops. Peptic ulcer. Glaucoma: monitor IOP. Perform skin exams to monitor for melanoma. Withdrawal-emergent hyperpyrexia or confusion: avoid sudden discontinuation or rapid dose reduction. Pregnancy. Nursing mothers.

Rytary Pharmacokinetics

See Literature

Rytary Interactions


See Contraindications. Orthostatic hypotension with MAO-B inhibitors (eg, rasagiline, selegiline); monitor. Antagonized by dopamine D2 receptor antagonists (eg, phenothiazines, butyrophenones, risperidone, metoclopramide), isoniazid, iron salts. Delayed absorption with high-fat, high-calorie meals.

Rytary Adverse Reactions

Adverse Reactions

Nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia (reduce doses), anxiety, constipation, vomiting, orthostatic hypotension.

Rytary Clinical Trials

See Literature

Rytary Note

Not Applicable

Rytary Patient Counseling

See Literature