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Escavite D and Sinemet CR 200/50

Determining the interaction of Escavite D and Sinemet CR 200/50 and the possibility of their joint administration.

Check result:

Escavite D <> Sinemet CR 200/50

Relevance: 05.08.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Levodopa and multivitamin with iron and fluoride should not be taken orally at the same time. Products that contain iron may interfere with the absorption of levodopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Contact your doctor if your Parkinson symptoms worsen. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSING INTERVAL: The oral bioavailability and pharmacologic effects of levodopa and carbidopa may be decreased during concurrent administration with iron-containing products. The proposed mechanism is chelation of levodopa and carbidopa by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In nine patients with Parkinson's disease, administration of levodopa-carbidopa 100 mg-25 mg with ferrous sulfate 325 mg decreased levodopa peak plasma concentration (Cmax) and systemic exposure (AUC) by 47% and 30%, respectively, and carbidopa Cmax and AUC by 77% and 82%, respectively, compared to administration with placebo. There was also evidence of reduced efficacy of levodopa in some patients. In another study consisting of eight healthy subjects, coadministration of levodopa 250 mg with ferrous sulfate 325 mg resulted in greater than 50% reductions in the Cmax and AUC of levodopa compared to administration of levodopa alone. The magnitude of the interaction was the greatest in patients whose plasma levels of levodopa were the highest following administration of levodopa alone.

MANAGEMENT: Until more information is available, patients receiving levodopa and/or carbidopa in combination with iron-containing products should be advised to separate the times of administration by as much as possible. Patients should be monitored for reduced efficacy of levodopa, and the dosage adjusted as necessary.

References

Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
Greene RJ, Hall AD, Hider RC "The interaction of orally administered iron with levodopa and methyldopa therapy." J Pharm Pharmacol 42 (1990): 502-4
Campbell NR, Hasinoff B "Ferrous sulfate reduces levodopa bioavailability: chelation as a possible mechanism." Clin Pharmacol Ther 45 (1989): 220-5
Campbell NR, Rankine D, Goodridge AE, Hasinoff BB, Kara M "Sinemet-ferrous sulphate interaction in patients with Parkinson's disease." Br J Clin Pharmacol 30 (1990): 599-605

Escavite D

Generic Name: multivitamin with iron and fluoride

Brand name: Escavite, Escavite D, Poly-Vi-Flor, MyKidz Iron FL, Poly-Vi-Flor with Iron, TL Fluorivitamin, Tri Vites with Fluoride and Iron, Becomject-100, MVI-12, NephPlex RX, Nephrocaps, B-Ject 100, Therobec, B-Plex, Formula B, Vitaplex, Tri-Vi-Sol, Vi-Daylin ADC, Nephro-Vite Rx, Lipogen, Lipotriad, Lipoflavonoid, Cholinoid, Liponol, Bee-Comp with C, Cholidase, Cota-B-Plex, 1000 BC, Neurodep, Neuroforte-Six, MVI. Pediatric, B-Plex Plus, Nephrolan Rx, Zymacap, Vi-Daylin, Poly-Vi-Sol, Dayalets, Sigtab, Therems, StressTabs, Allbee-C 800, Cefol, Cod Liver Oil, Daily Multiple Vitamins, Daily Vite, Protegra, Sesame St. Vitamins with Extra C, Surbex-T, Theragran, Superplex-T, Vi-Stress, Cod Liver Oil Mint, Animal Shape Vitamins, B-50 Complex, B-Complex 50, Vitamin B Complex 100, Balanced B-100, B-Stress, B-Scorbic, Bee with C, Children's Chewable Multivitamins, Balanced B-50, Balanced B-150, Unicap Capsule, Unicap Jr, Unicap, Optilets-500, Super Plenamins, Vitamins for Hair, Tab-A-Vite, One-A-Day Essentials, Essential Balance, Vi-Daylin Chewable, Sunkist Child Chewable with C, Sunkist Child Chewable, Poly-Vi-Sol Chewable, Fruity Chew, Poly-Vit Chew, Chewable-Vite, Flintstones Multivitamins, Bugs Bunny with Extra C, Flintstones with C Multivitamins, Bounty Bear Vitamins, Garfield Vitamins, Vi-Daylin Drops, Poly-Vi-Sol Drops, Baby Vitamin Drop, Vita Drop, Poly Vit Drops, MVC. SDV, Glutofac, Allbee-C, Nephro-Vite, Vitabee with C, Stress B with C, High Potency B+C, Farbee with C, Surbex with C, Super B Complex, Surbex, Vitamin B-50, Vitamin B-100, Vitamin B-100 T/R, Hexavitamin, Kenwood Therapeutic, Thera, Theravite, Thera-Plus, Oncovite, Beminal-500, High Potency B Complex with B12 and C, Super B-50, Super B-100 TD, Tri-Vit Drops, Stress Formula, One Tab Daily, Vitamin C, E, and Rose Hips, Scotts Emulsion, Stress Formula 600, Tri-Vit, B Complex 50, Mega B, Folgard, Apatate, T-Vites, High B Complex, Theragenerix, Cernevit, Cardiotek, Beminal, Beminal with C Fortis, Bugs Bunny Multiple Vitamins, Fletanol, Male Formula, Allbee with C, Prevital, Surbex Filmtab, T-BMP, Tender Age Vitamin ADC, Watkins Harvest, Foltx, Folgard Rx 22, Cernevit-12, Infuvite, Infuvite Pediatric, Diatx, Vitamin A, D, One-A-Day 50+, Thex Forte, Protegra Cardio, Vitamin Daily Liquid, Rena-Vite Rx, Renal Caps, Icar C, Renaphro, Cerefolin, Dialyvite Rx, Dialyvite 800, Vesselvite, Folbee Plus, Folbee, Folcaps, Combgen, Abidec, Unichem Multivitamin, Topfit Vitamin B Complex, Topfit Vitamin B Complex Forte, Vitamin B Compound Strong, Health Aid Multivitamin, Vitamins, Daflon, Essentiale, Jetepar, Neurobion, Vitamin A and D Concentrate, Centrum 8400, MVI. Adult, Nephronex, Animi-3, Foltrate, Cardiotek Rx, Folbic, Metanx, D-400 international units, Folbalin Plus, Folbalin, Multi Vits with Beta Carotene, Foltabs 800, Folgard Rx, B-Complex with B-12, FaBB, CerefolinNAC, Folamin, DexFol, One-A-Day Men's Health Formula, Rena-Vite, Equaline One Daily Essential, Daily-Vite Men's Formula, Folplex, Folmor, Zycose, Biotin Forte, Vigomar Forte, Vimar, Multi-Delyn, Foleve Plus, Folnate, Folnate Plus, Foleve, B 100 Complex, Renatabs, AllanTex, Cardiotek-Rx, NuFol, Folplex 22, Reno Caps, Ivites Rx, TL Gard, Vita-Respa, Folast, Triphrocaps, Enfolast-N, Enfolast, Neurpath-B, Triveen-CF, Rovin-CF, Vol-Care Rx, Nephrocaps QT, B-Complex SR, Apetigen, L-methylfolate Ca, Me-Cbl NAC, P-5-P, Me-Cbl, MTX Support, Menopause Relief with Lifenol, Vitacirc-B, Alz-Nac, Tri-Vita Drops, Poly-Vita Drops, Prostate 24, Apetex, Folastin, Folbee AR, Metafolbic, Metafolbic Plus, Foltanx, Virt-Vite Forte, Virt-Vite, Foltanx RF, Folbic RF, One Daily Multi-Essential, Flintstones Toddler, Full Spectrum B with C, Metafolbic Plus RF, PoDiaPN, Super Theravite-M, Nature's Bounty Hair Skin & Nails, Total B with C, Hair, Skin, & Nails Gummies, Concentrated Whole Food Multivitamin, Niva-Fol, Glycogenics, SeroSyn, Virt-Vite Plus, Rheumate, Folinic-Plus, Allbee Plus, Av-VITE FB Forte, Celebrate B-12, Virt-Gard, Mebolic, DEKAs Essential, Multi Vitamin+, Xyzbac, Nufola, Folika-T, Hylavite, K2 Plus D3, Dosoquin, VP-Vite Rx, Genicin Vita-S, Genicin Vita-Q, Zyvit, Folika-V, Tobakient, Renal Vitamin, Folic-K

Synonyms: n.a.

What is Escavite D?

Sinemet CR 200/50

Generic Name: carbidopa / levodopa

Brand name: Parcopa, Rytary, Sinemet, Sinemet CR, Duopa

Synonyms: Carbidopa and levodopa, Carbidopa and Levodopa

What is Sinemet CR 200/50?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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