Sinemet (carbidopa/levodopa) is a Parkinson's disease medication that was produced by Merck. The Sinemet manufacturer discontinued its regular and controlled release (CR) version in 2019 due to an inability to secure a reliable supply of the medication. Since then, the Sinemet generic manufacturers have dealt with an inconsistent supply of the active ingredients used to make the medication. As a result, Sinemet is prone to shortages, making it more difficult for patients to get a hold of their prescription.
The FDA recommends that patients turn to other medications with similar formulations, but at issue is the fact that manufacturers of Sinemet generic forms aren't consistent in their production of the medication. The reasons for shortages range from an increase in demand for the active ingredients, demand for the medication, and generic Sinemet manufacturers discontinuing their production. Shortages of Sinemet are all but guaranteed going forward until supply chain issues for the active ingredients are worked out.
Patients who take Sinemet to control their Parkinson's disease symptoms may find that other versions of the medication don't work as well. Read on to learn more about Sinemet and the steps you can take to get ahead of shortages.
Contents
What Is Sinemet?
What Is Sinemet Used To Treat?
What Happens If There's A Sinemet Shortage?
Is The Sinemet Generic Formula As Effective?
Are There Alternative Treatments To Sinemet?
Final Notes
What Is Sinemet?
Sinemet is the brand name for a medication indicated for the treatment of the symptoms associated with Parkinson's disease. It contains carbidopa and levodopa, two active ingredients that help the brain maintain effective levels of dopamine. Upon ingestion, levodopa is converted to dopamine by the body and transports the chemical to the brain. Carbidopa stops levodopa from being broken down in the gut during digestion, making more of the chemical available for transport to the brain. Levodopa, the major chemical used in Sinemet and other Parkinson's disease medications, has been found to be the most effective treatment for the symptoms of the disease.
Parkinson's is thought to be the result of a lack of dopamine production in the brain. When the brain doesn't produce enough dopamine, the body expresses this lack through tremors, muscle stiffness, lack of muscle control, and spasms. Sinemet works by supplying the brain with a sufficient amount of dopamine to the brain and using levodopa to maximize the amount that reaches the brain. The medication also comes in a controlled release format to maintain a constant flow of dopamine to the brain over time.
Sinemet side effects
The most commonly experienced side effects of Sinemet include:
- Jerky or twisting muscles
- Headache
- Dizziness
- Low blood pressure
- Sleep problems
- Strange dreams
- Dry mouth
- Muscle contractions
- Nausea
- Vomiting
- Constipation
Anyone who experiences one or more of these side effects should tell their physician immediately. Some side effects are normal and harmless, while others can affect the quality of life in a negative way. There may be other therapies available to treat the symptoms of Parkinson's disease that are safer.
What Is Sinemet Used To Treat?
Sinemet is primarily used to treat symptoms of Parkinson's disease including muscle stiffness, shakiness, and restriction of movement. It's also used to treat conditions that are similar to Parkinson's and involve a lack of dopamine production in the brain. These similar conditions include carbon monoxide exposure or poisoning and manganese intoxication.
What Happens If There's A Sinemet Shortage?
Generic sinemet shortages are frequent and they're most likely to be a problem for the foreseeable future. The fact that the active ingredients are difficult to procure often results in a generic Sinemet manufacturer discontinuing its production of the medication. Other generic drug manufacturers pick up the formula for production, but the quantities are limited and won't ease the shortage.
That means users of Sinemet and its generic equivalents have to either find another formulation that works for them, or use a compounding pharmacy to obtain a reliable supply. Pill hoarding is another option, but the FDA doesn't allow patients to have more than eight pills a day, putting patients in a position of taking less medication than they should.
In summary, there is no guarantee that the various forms of Sinemet generic will return to the market with regularity. Users have little choice but to find alternatives that work for them and discuss their options with their healthcare professionals. Chemical and natural remedies are available that can help a patient deal with the physical effects of Parkinson's disease, allowing them to live a more normal life.
Is The Sinemet Generic Formula As Effective?
The generic form of Sinemet can differ by as much as 20% in effectiveness, depending on the generic Sinemet manufacturer. The difference tends to go towards less effective than more effective, and the side effects can be worse than the non-generic version. What this means is that patients who require a stronger dose may not get sufficient relief from their symptoms with a weaker generic. On the other hand, patients who respond well to small doses of Sinemet may find that a weaker form provides a sufficient amount of relief.
It's worth noting that the FDA only requires a generic to contain the same ingredients at the same amounts and show the same bioequivalence for the generic to gain approval for sale. The only assurance that a patient has with a Sinemet generic is that it's safe to use and works in a fashion that's similar to the branded version.
During a Sinemet shortage, people with Parkinson's disease are faced with the decision to use a generic alternative and hope it works, or find other medications with similar chemical profiles and hope they work just as well as Sinemet. Patients can find themselves suffering from stronger symptoms than they should due to the lower effectiveness of the medication. The same goes for other generics and brands that have a similar chemical profile.
Are There Alternative Treatments To Sinemet?
Yes, there are many alternative treatments to Sinemet, but Parkinson's patients should check with their healthcare provider before starting a new Parkinson’s treatment of any kind. Some of the alternative treatments include the following:
Surgical
Surgery tends to be reserved for patients who have severe cases of Parkinson's disease and experience restricted movement as a result. The different surgical options are:
Deep brain stimulation
Deep brain stimulation involves the placement of an electrode into the areas of the brain that control movement, and is sometimes done while the patient is awake. The surgeon needs to test the electrode placement with a stimulator that the patient will eventually control themselves. The awareness of the patient helps inform the surgeon of a successful placement.
Lesion surgery (burning of lesions)
The process for lesion surgery is similar to deep brain stimulation, but the goal is to burn the areas of the brain that are contributing to uncontrollable movements. Burning the tissue that's causing issues results in a lessening of the symptoms or stops them outright.
Tissue transplants
Tissue transplants are still in the experimental research phase. The research involves removing the malfunctioning brain tissue and replacing it with healthy, unaffected tissue to restore movement and control to the patient's brain and body.
Complementary and alternative medicine (CAM)
CAMs are usually used in conjunction with medical therapy to improve the efficacy of medication. Some alternative therapies include:
- Yoga
- Hypnosis
- Meditation
- Massage
- Biofeedback
- Music therapy
- Art therapy
- Acupuncture
And more. Just about any CAM that helps the brain produce dopamine can be beneficial to someone dealing with Parkinson's disease.
Final Notes
If you are experiencing tremor symptoms due to essential tremor, as opposed to Parkinson’s disease, Cala therapy can help. Cala TAPS therapy is delivered on a device that has undergone extensive clinical trials and has shown to be effective for 62% to 68% of patients.
Physicians measuring patient response reported findings of 62% of patients having measurable reductions from severe or moderate to mild or slight at the end of the study. Contact your physician today to find out if Cala TAPS therapy is right for your essential tremor symptoms.
WEB-20013 Rev A Mar 2023