Carbidopa-Levodopa CR Dosage

There is no one standard carbidopa-levodopa CR dosage, as this medication must be individualized for each person. Before prescribing carbidopa-levodopa CR, your healthcare provider will consider several factors, such as your previous dose of immediate-release carbidopa-levodopa CR (if you were taking it), other medications you are taking, and other medical conditions you may have. Typically, carbidopa-levodopa CR is taken two or three times a day.

 

Carbidopa-Levodopa CR Dosage: An Introduction

The dose of carbidopa-levodopa CR (Sinemet® CR) that your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • Your previous dose of immediate-release carbidopa-levodopa (if you were taking it)
  • How you respond to carbidopa-levodopa CR (especially if you develop bothersome side effects)
  • Other medications you are taking
  • Other medical conditions you may have.
     
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 

Carbidopa-Levodopa CR Dosage for Parkinson's Disease

There is no one particular carbidopa-levodopa CR dosage that will work for all people. Instead, the dose must be individualized. Almost all people who start carbidopa-levodopa CR are switching from immediate-release carbidopa-levodopa. When switching from one to the other, it is very important to understand that the two products are absorbed differently in the body (carbidopa-levodopa CR is not absorbed as well as regular carbidopa-levodopa). Refer to the following chart for the recommended starting carbidopa-levodopa CR dosage based on the levodopa content of your previous carbidopa-levodopa dosage:
 
Previous Carbidopa-Levodopa Dose (levodopa content)
Recommended Carbidopa-Levodopa CR Dose (levodopa content)
300 to 400 mg per day
200 mg twice daily
500 to 600 mg per day
300 mg twice daily or 200 mg three times daily
700 to 800 mg per day
800 mg per day, split into three or more smaller doses (such as 300 mg in the morning, 300 mg in early evening, and 200 mg in the late evening)
900 to 1000 mg per day
1000 mg per day, split into three or more smaller doses (such as 400 mg in the morning, 400 mg in the early evening, and 200 mg in the late evening)

 

 

Carbidopa-levodopa CR comes in the following strengths:
 
  • Carbidopa-levodopa CR 25-100 mg (25 mg of carbidopa and 100 mg of levodopa)
  • Carbidopa-levodopa CR 50-200 mg (50 mg of carbidopa and 200 mg of levodopa).
     
Most people need at least 70 mg to 100 mg of the carbidopa component per day in order to avoid severe nausea and vomiting due to the levodopa component of carbidopa-levodopa CR. Doses that provide less than 70 mg of carbidopa per day are very likely to cause severe nausea and vomiting.
 
Do not suddenly stop taking carbidopa-levodopa CR, as a serious group of side effects known as neuroleptic malignant syndrome (NMS) may occur. Symptoms of NMS include:
 
  • High fever
  • Stiff muscles
  • Confusion
  • Irregular pulse or blood pressure
  • Fast heart rate (tachycardia)
  • Sweating
  • Irregular heart rhythms (arrhythmias).
     
(Carbidopa-Levodopa CR Dosage Continued: Page 2)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;