Sinemet® Shortage Recommendations
Sinemet® (levodopa/carbidopa) is a medication commonly used in the treatment of Parkinson’s disease as well as other neurological disorders. From 23 August 2018, there has been an international supply shortage of various formulations of Sinemet® including:
Sinemet® 250/25 immediate release
Sinemet ® 100/25 immediate release
Sinemet® CR 200/50 controlled release
The shortage is expected to continue until 31 December 2019 and only emergency supplies for these products are available.
The following table is intended to provide clinicians and patients with information about options regarding substitute medications for Sinemet®.
|Sinemet® (Levodopa/Carbidopa)||Recommended substitute brand and dosage with closest Levodopa dose equivalence|
|Sinemet® 100/25 tablet (Immediate release)||– Kinson® (Levodopa/Carbidopa) 100/25 tablet
– Madopar® (Levodopa/Benserazide) 100/25 tablet
– Madopar® (Levodopa/Benserazide) 100/25 Capsule
|Sinemet® 250/25 tablets (Immediate release)||– Kinson® (Levodopa/Carbidopa) 100/25 (x2½) tablets
– Madopar® (Levodopa/Benserazide) 100/25 (x2½) tablets
– Madopar® (Levodopa/Benserazide) 200/50 (x1¼) tablets
|Sinemet® CR 200/50
Controlled Release tablets
|– Stalevo® (Levodopa/Carbidopa/Entacapone) 150/37.5/200 tablet
– Madopar® HBS (Levodopa/Benserazide) slow release 100/25 (x2) tablets
(HBS – hydrodynamically balanced system)
Reference: Tomlinson, C, Stowe, R, Patel, S, Rick, C, Gray, R &Clarke, C 2010, ‘Systematic review of levodopa dose equivalency reporting in Parkinson’s disease’ Movement Disorders, vol. 25, no. 15, p. 2649-2653
*The listed medication conversions are provided for guidance only, are not intended as personal medical advice and that any such changes should be discussed with the patient’s treating doctor.
*Following conversions to a non-identical formulation, patients should be monitored for any unexpected deterioration in symptom control.
During this time, alternative products which are not on the Australian Register of Therapeutic Goods (ARTG), have been made available under Section 19A of the Therapeutics Goods Act.
Carbidopa and Levodopa tablets, USP 25mg/250mg
Carbidopa and Levodopa Extended-release tablets 50mg/200mg
For more information regarding these products, contact Medsurge on 1300 788 261.
A community pharmacist can access these medicines via wholesalers such as API, Sigma and Symbion.
Please contact your wholesaler for more information regarding ordering, stock availability and time required for stock to arrive:
API: 1300 363 303
Sigma: 1300 132 293
Symbion: 1300 772 000
Written by the Australasian Neuroscience Nurses Association (ANNA) Movement Disorder Chapter (MDC) committee in collaboration with the Movement Disorder Society of Australia and New Zealand (MDSANZ) to release a position statement to address the recent shortage of Sinemet supply internationally.