[01] Robert A. Hauser, Departments of Neurology, Molecular Pharmacology and Physiology, University of South Florida Parkinson’s Disease and Movement Disorders Center, National Parkinson Foundation Center of Excellence, Tampa FL, USA.

Carbidopa and levodopa extended-release capsules (Rytary) are designed to provide benefit as quickly as carbidopa/levodopa immediate release (IR) and levodopa plasma concentrations are maintained for about 4 to 5 hours before declining. Dosages of Rytary are not interchangeable with other carbidopa/levodopa products and those wishing to prescribe Rytary must be familiar with its dosing. In clinical trials, patients on carbidopa/levodopda IR were converted to Rytary according to a dose conversion table followed by tiration according to clinical response and ended up on approximately twice the daily levodopa milligram dose. For levodopa naïve patients, the usual Rytary maintenance dose is 145 mg three times daily, although lower doses may suffice.

Rytary, Levodopa, IPX066, Extended Release, Parkinson’s Disease, Treatment

[01] Hauser RA, Ellenbogen AL, Metman LV, Hsu A, O'Connell MJ, Modi NB, Yao HM, Kell SH, Gupta SK. Crossover comparison of IPX066 and a standard levodopa formulation in advanced Parkinson's disease. Mov Disord 2011;26:2246-52. [02] Hauser RA, Hsu A, Kell S, Espay AJ, Sethi K, Stacy M, Ondo W, O'Connell M, Gupta S; IPX066 ADVANCE-PD investigators. Extended-release carbidopa-levodopa (IPX066) compared with immediate-release carbidopa-levodopa in patients with Parkinson's disease and motor fluctuations: a phase 3 randomised, double-blind trial. Lancet Neurol 2013;12:346-56. [03] Stocchi F, Hsu A, Khanna S, Ellenbogen A, Mahler A, Liang G, Dillmann U, Rubens R, Kell S, Gupta S. Comparison of IPX066 with carbidopa-levodopa plus entacapone in advanced PD patients. Parkinsonism Relat Disord 2014;20:1335-40. [04] Pahwa R, Lyons KE, Hauser RA, Fahn S, Jankovic J, Pourcher E, Hsu A, O'Connell M, Kell S, Gupta S; APEX-PD Investigators. Randomized trial of IPX066, carbidopa/levodopa extended release, in early Parkinson's disease. Parkinsonism Relat Disord 2014;20:142-8.