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No more Sinemet® CR? Now what?

no-more-sinemet-cr-now-what

No more Sinemet® CR? Now what?

Merck recently announced they have discontinued the manufacturing of Sinemet® CR (carbidopa-levodopa). They have had trouble securing a reliable and stable supply for a while, so the decision has been a long time coming.

According to Merck, Sinemet® CR 50/200 mg will remain available in the US until on or near November 2019 and Sinemet® CR 25/100 mg until on or near February 2020; however, demand may cause those dates to change.

What does that mean for you?

Fortunately, there are alternatives to Sinemet® CR. So, while we recognize that this may be difficult news to hear, especially for those of you who have tried the generic formula and it hasn’t worked for you and for those of you who are unable to speak with your doctors quickly about the specific alternatives that may work for you, we want to make sure you know that there are options available.

In order to get the best information about that, we reached out to Dr. Aaron Haug, a Movement Disorder Specialist at Blue Sky Neurology in Englewood, CO and a longtime trusted source for the Foundation. Here’s what he said:

Aaron Haug“Carbidopa/levodopa controlled-release (CR) has been available for many years as a generic formulation and as brand name Sinemet® CR. Although most patients taking the CR formulation of carbidopa/levodopa use the generic formulation rather than the brand name, some patients and providers have found that Sinemet® CR has provided a better or more consistent therapeutic effect. Unfortunately, Sinemet® CR is no longer being manufactured.

Fortunately, there are several alternatives that can be considered. Generic carbidopa/levodopa CR works well for many patients, as evidenced by the fact that approximately 99% of patients using CR are using the generic. Even if this has been tried in the past without the best results, it may be worth trying again. Adding or increasing immediate-release (IR) carbidopa/levodopa may be appropriate. There is also Rytary, a different type of carbidopa/levodopa that comes as an extended-release capsule. This has been available since 2015. It is available only as a brand name, however, and cost can sometimes be an issue.

Discuss with your provider whether one of these or other options may be appropriate for you.”

At the Davis Phinney Foundation, we’re excited that there are new drugs that have been successful in treating Parkinson’s symptoms hitting the market every day. We believe that you will be able to work with your doctor to find the best alternative for you and combined with exercise and connecting to your community, you’ll have just what you need to keep living well with Parkinson’s today.

6 Comments on “No more Sinemet® CR? Now what?

    • Jean mellano

      July 22, 2019 at 7:02 pm Reply

      This is not the first time Merck has done this (See my blog url). Sinemet 25/100 is not available in NY now and no eta according to my pharmacy. I am on my third generic and none of them have worked. As a matter of fact, since I have been on generic, I have dyskinesia and jaw clenching about 2-3hours after a dose which dissipates well before my next dose, something that did not happen on sinemet

      • Melani Dizon

        July 23, 2019 at 4:58 am Reply

        Hi Jean – I’m so sorry the generics are not working for you right now. I hope you are able to find a better fit very soon.

    • Deborah Corbett

      July 23, 2019 at 3:04 am Reply

      I still don’t understand how this can happen. They couldn’t secure a stable supply of what? The drug itself or the components needed to make up the drug. I rely heavily on this drug but of course am trying alternatives because obviously Big Pharma doesn’t really have our interests at heart.

      • Melani Dizon

        July 23, 2019 at 5:06 am Reply

        Hi Deborah – I’m sorry about this change. I wish I had more information to share. In terms of supply, this is what Anne de Papp, MD, Vice President and Head of U.S. Medical Affairs at Merck said, “Decisions like this are not easy, and we do not take them lightly. In this case, despite significant efforts to secure a reliable and stable supply and after a careful and extensive evaluation of the situation, we are no longer able to provide this medication to patients in the U.S.” In addition, here’s a bit more information on that: https://parkinsonquebec.ca/en/parkinson-news/sinemet-expected-drug-shortage-and-discontinued-sale-of-sinemet-cr/

        I hope that you and your doctor are able to find a generic or alternative that works for you.

    • Marcia Guberman

      August 19, 2019 at 7:21 pm Reply

      What is the difference beyween C/L er and C/L cr?

      • Melani Dizon

        August 20, 2019 at 6:53 am Reply

        Hi Marcia – Sinemet CR stands for controlled release. The controlled release version has been shown to reduce daily OFF time better. You can read a little bit more about it here.

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