Rytary Dosage

Generic name: carbidopa and levodopa
Drug class: Dopaminergic antiparkinsonism agents

Medically reviewed by  A Ras MD.

 Recommended Adult Dosing

Dosage forms:  ER CAP: 23.75 mg/95 mg, 36.25 mg/145 mg, 48.75 mg/195 mg, 61.25 mg/245 mg

Parkinsonism

[levodopa-naive pts]

Dose: individualize dose PO tid; Start: 23.75 mg/95 mg PO tid x3 days, may incr. to 36.25 mg/145 mg PO tid on day 4, then may incr. to 97.5 mg/390 mg PO tid; Max: 612.5 mg/2450 mg per day; Info: dosing frequency may be incr. from tid to 5x/day if needed; use lowest effective dose; may open cap; taper dose gradually to D/C

[conversion from IR levodopa 400-549 mg/day]

Dose: individualize dose PO tid; Start: 3 caps (23.75 mg/95 mg) PO tid; Max: 612.5 mg/2450 mg per day; Info: titrate dose to optimal effect; dosing frequency may be incr. from tid to 5x/day if needed; use lowest effective dose; may open cap; taper dose gradually to D/C

[conversion from IR levodopa 550-749 mg/day]

Dose: individualize dose PO tid; Start: 4 caps (23.75 mg/95 mg) PO tid; Max: 612.5 mg/2450 mg per day; Info: titrate dose to optimal effect; dosing frequency may be incr. from tid to 5x/day if needed; use lowest effective dose; may open cap; taper dose gradually to D/C

[conversion from IR levodopa 750-949 mg/day]

Dose: individualize dose PO tid; Start: 3 caps (36.25 mg/145 mg) PO tid; Max: 612.5 mg/2450 mg per day; Info: titrate dose to optimal effect; dosing frequency may be incr. from tid to 5x/day if needed; use lowest effective dose; may open cap; taper dose gradually to D/C

[conversion from IR levodopa 950-1249 mg/day]

Dose: individualize dose PO tid; Start: 3 caps (48.75 mg/195 mg) PO tid; Max: 612.5 mg/2450 mg per day; Info: titrate dose to optimal effect; dosing frequency may be incr. from tid to 5x/day if needed; use lowest effective dose; may open cap; taper dose gradually to D/C

[conversion from IR levodopa 1250 mg/day or greater]

Dose: individualize dose PO tid; Start: 4 caps (48.75 mg/195 mg) PO tid or 3 caps (61.25 mg/245 mg) PO tid; Max: 612.5 mg/2450 mg per day; Info: titrate dose to optimal effect; dosing frequency may be incr. from tid to 5x/day if needed; use lowest effective dose; may open cap; taper dose gradually to D/C

Renal dosing

[adjust dose amount]

CrCl <50: decr. usual dose by up to 50%

HD: decr. usual dose by up to 50%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by up to 50%; no supplement

Hepatic dosing

[not defined]

hepatic impairment: caution advis

SRC: NLM .