If you have parkinsonism or Parkinson’s disease (PD), your doctor may prescribe Rytary for you.

Rytary is a prescription drug. It’s used in adults to treat parkinsonism that happens after:

Rytary is also used to treat PD in adults.

To learn more about Rytary’s uses, see “Is Rytary used for Parkinson’s disease?” and “Is Rytary used for other conditions?” below.

Rytary basics

Rytary comes as a capsule you take by mouth.

Rytary contains an extended-release (long-acting) form of carbidopa and levodopa. Carbidopa belongs to a group of drugs called decarboxylase inhibitors. Levodopa belongs to a group of drugs called dopamine precursors.

Rytary isn’t available in a generic form.

Keep reading to learn about Rytary’s side effects, dosage, and more.

Like most drugs, Rytary may cause mild or serious side effects. The lists below describe some of the more common side effects Rytary may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Rytary. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Rytary can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Rytary’s prescribing information.

Mild side effects of Rytary that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Rytary can occur, but they aren’t common. If you have serious side effects from Rytary, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Rytary that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Rytary may cause.

Hallucinations

You may have hallucinations with Rytary. But this side effect wasn’t very common in studies of the drug.

Hallucinations happen when you hear or see things that aren’t really there. In some cases, hallucinations may also affect your sense of smell, taste, or touch.

In addition to the symptoms above, hallucinations may happen along with other abnormal thoughts or behaviors. These include:

  • psychosis (loss of contact with reality)
  • delusions (believing things that aren’t real)
  • paranoia (extreme or unrealistic distrust of other people)
  • agitation

The factors below may raise your risk of hallucinations with Rytary:

  • You’ve recently started taking the drug.
  • You currently have certain mental health conditions, or you’ve had them in the past. An example is psychosis.
  • You take certain medications that treat mental health conditions, such as the antipsychotic drug risperidone (Risperdal). (For other possible drug interactions with Rytary, see “What to consider” below.)

What might help

Before taking Rytary, tell your doctor about any mental health conditions you have. Also tell them about all of the medications you’re taking. Your doctor can determine if Rytary is right for you.

If you have hallucinations with Rytary, talk with your doctor. You may find this side effect goes away within a few days or weeks after you start taking the drug. But if your hallucinations are bothersome or don’t go away, your doctor may lower your dosage or prescribe a different medication instead.

Suicidal thoughts or behaviors

In rare cases, you may have suicidal thoughts or behaviors with Rytary. This side effect wasn’t reported in studies of the drug. But there have been reports of this side effect by people taking Rytary after it became available for use.

While you’re taking Rytary, watch for the following symptoms. These may occur in people with suicidal thoughts or behaviors:

  • mood changes, such as agitation, irritability, aggressiveness, or hostility
  • trouble concentrating
  • loss of interest in things that you used to enjoy, such as social activities
  • separating yourself from others

What might help

If you or a caregiver notice any mood changes while you’re taking Rytary, tell your doctor right away. They can determine whether you should keep taking the drug.

If you have thoughts of harming yourself, call 911 or your local emergency number right away.

SUICIDE PREVENTION

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Uncontrollable urges

With Rytary, you may have uncontrollable urges to do certain activities. This side effect wasn’t reported in studies of the drug. But in rare cases, it’s known to occur with drugs that affect dopamine, such as Rytary.

It’s important that you or a caregiver watch for signs of unusual or excessive behaviors while you’re taking Rytary. Examples include:

  • excessive spending, such as shopping or gambling more than usual
  • binge eating
  • engaging in sexual activity that may have risks, such as the risk of infection

For many people, these uncontrollable urges go away when their Rytary dosage is lowered or they stop taking the drug.

What might help

If you have uncontrollable urges while taking Rytary, tell your doctor right away. They can determine if your dosage should be lowered or if you should try a different drug instead.

Allergic reaction

Some people may have an allergic reaction to Rytary. While allergic reaction wasn’t reported in studies of Rytary, it can still happen.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Rytary. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Rytary that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form

Rytary comes as a capsule you take by mouth.

Recommended dosage

Rytary contains an extended-release (long-acting) form of the drugs carbidopa and levodopa. Your Rytary dosage is usually based on whether:

  • you’ve taken levodopa in the past
  • you’re switching to Rytary after taking an immediate-release (short-acting) form of carbidopa and levodopa

If you haven’t taken levodopa in the past, your doctor will typically start you on a low dosage of Rytary. And they’ll keep adjusting your dosage over time until you reach a dose that works to treat your condition.

If you’re switching to Rytary from a short-acting form of carbidopa and levodopa, your doctor will calculate your Rytary dosage for you. You won’t need to use a dose calculator to determine your own dosage. For details about recommended dosages in this situation, see the dosing chart in Rytary’s prescribing information.

Questions about Rytary’s dosage

Below are a few common questions about Rytary’s dosage.

  • What if I miss a dose of Rytary? If you miss a dose of Rytary, talk with your doctor or pharmacist. They’ll let you know if you should take the missed dose or skip it.
  • Will I need to use Rytary long term? Yes. If Rytary is working well to treat your condition without causing bothersome side effects, you’ll likely take it long term.
  • How long does Rytary take to work? You’ll likely notice your symptoms beginning to ease within 1 hour of taking Rytary. However, taking Rytary with foods that are high in calories, fat, or protein may increase the time it takes your body to absorb the drug. This means it may take Rytary longer than usual to begin relieving your symptoms.

Rytary and Sinemet both contain the same active drugs: carbidopa and levodopa.

Rytary comes as a capsule you take by mouth. It contains an extended-release (long-acting) form of carbidopa and levodopa.

Sinemet, on the other hand, comes as a tablet you take by mouth. And it contains an immediate-release* (short-acting) form of carbidopa and levodopa.

If you’d like to know more about how this alternative drug compares with Rytary, check out this article. Also, talk with your doctor to find out if Rytary or Sinemet is right for your condition.

* In the past, an extended-release form of Sinemet was available. The brand name for this drug was Sinemet CR. For details about how this drug compares with Rytary and Sinemet, see this article.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. And you can visit the Rytary manufacturer’s website to see if they have support options.

You can also check out this article to learn more about saving money on prescriptions.

Find answers below to some commonly asked questions about Rytary.

Does Rytary cause weight loss?

Weight loss wasn’t reported as a side effect in studies of Rytary. But keep in mind that Rytary can cause problems with digestion, such as nausea and vomiting. These side effects can lead to loss of appetite, which may result in weight loss.

Weight loss is also common in people with Parkinson’s disease, which Rytary is used to treat.

If you’re concerned about weight loss while taking Rytary, talk with your doctor. They can suggest ways to manage your weight while taking the drug.

Will I have withdrawal symptoms if I stop taking Rytary?

You may have withdrawal symptoms if you stop taking Rytary. Withdrawal symptoms are side effects that may occur if you stop taking a drug that your body has become dependent on.

Suddenly stopping Rytary treatment or lowering your dosage too quickly can cause a life threatening condition that’s similar to neuroleptic malignant syndrome. This can lead to symptoms such as:

It’s important that you do not stop taking Rytary without your doctor’s guidance. If they tell you it’s safe to stop your treatment, they’ll slowly decrease your dosage over time. This will help lower your risk of withdrawal symptoms after you stop taking the drug.

What’s the half-life of Rytary? How long does it stay in your system?

The half-life of Rytary is about 2 hours. This means it takes about 2 hours for your body to get rid of half of a dose of Rytary.

It usually takes four to five half-lives for a drug to completely leave your system. For Rytary, this means a dose of the drug stays in your system for 8 to 10 hours.

If you have other questions about how long Rytary may stay in your system, talk with your doctor or pharmacist.

How does Rytary work?

The way Rytary works (its mechanism of action) is by increasing the dopamine level in your brain. Dopamine is a chemical that helps with muscle control and coordination.

Rytary is used to treat parkinsonism and Parkinson’s disease (PD). These conditions cause cells in your brain to produce less dopamine. And having a low level of dopamine causes the symptoms of these conditions. (For more information, see “Is Rytary used for Parkinson’s disease?” and “Is Rytary used for other conditions?” below.)

Rytary contains an extended-release (long-acting) form of carbidopa and levodopa. These medications work together to increase the dopamine level in your brain. Carbidopa prevents your body from breaking down levodopa before it gets into your brain. Once levodopa reaches your brain, it’s converted into dopamine.

If you have other questions about how Rytary works, talk with your doctor or pharmacist.

What’s the effectiveness of Rytary?

Studies have shown Rytary to be an effective treatment for Parkinson’s disease (PD) and certain forms of parkinsonism.

In fact, guidelines from the American Academy of Neurology recommend using drugs that contain levodopa (such as Rytary) for managing PD symptoms.

If you have questions about the effectiveness of Rytary for your condition, talk with your doctor or pharmacist.

If you have Parkinson’s disease (PD), your doctor may prescribe Rytary for you. Below are details about how Rytary is used for PD. To learn about other conditions it’s used for, see “Is Rytary used for other conditions?” directly below.

PD is a condition that’s caused by damage to brain cells that make dopamine. Dopamine is a chemical that helps with muscle control and coordination.

PD causes symptoms such as:

Typically, these symptoms are worse on one side of your body than the other.

Rytary eases the symptoms of PD by increasing the dopamine level in your brain. To learn more, see “How does Rytary work?” in the “What are some frequently asked questions about Rytary?” section above.

In addition to treating Parkinson’s disease (PD), Rytary is also used to treat certain forms of parkinsonism. (To learn more about the drug’s use for PD, see the section directly above.)

As with PD, parkinsonism is typically caused by a low dopamine level in the brain. But this low dopamine level usually isn’t caused by damaged brain cells.

Rytary is used to treat parkinsonism that happens after:

Parkinsonism causes many of the same symptoms as PD, such as tremor and loss of coordination. But these symptoms typically affect both sides of the body equally. (With PD, these symptoms usually affect one side of the body more than the other.)

Rytary relieves the symptoms of parkinsonism by increasing the dopamine level in your brain. To learn more, see “How does Rytary work?” in “What are some frequently asked questions about Rytary?” above.

Do not take more Rytary than your doctor prescribes. Using more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much Rytary

Call your doctor if you think you’ve taken too much Rytary. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. However, if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Your doctor will explain how you should take Rytary. They will also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Rytary

Rytary comes as a capsule you take by mouth.

Accessible medication containers and labels

If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

  • have large print
  • use braille
  • contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.

Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Rytary in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.

Questions about taking Rytary

Here are answers to a few important questions about taking Rytary.

  • Can Rytary be chewed, crushed, or split? If possible, you should swallow Rytary capsules whole. Rytary should not be chewed or crushed. But if you have trouble swallowing Rytary capsules, you can split the capsules and mix their contents with applesauce. For details about how to do this, see the instructions in Rytary’s prescribing information.
  • Should I take Rytary with food? You can take Rytary with or without food. Keep in mind that foods that are high in calories, fat, or protein may affect how well the drug works to treat your condition. For details, see “Other interactions” in “What should be considered before taking Rytary?” directly below.
  • Is there a certain time of day when I should take Rytary? You’ll typically take Rytary three times each day, so about every 8 hours. You don’t have to take Rytary at a certain time of day. But you may find it easiest to take it 1 to 2 hours before mealtimes. Keep in mind that foods high in calories, fat, or protein may affect how well the drug works to treat your condition. For details, see “Other interactions” in “What should be considered before taking Rytary?” directly below.
Questions for your doctor

You may have questions about Rytary and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Rytary affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

Before you take Rytary, talk with your doctor. It’s important to tell them about:

  • other medications you take
  • your overall health
  • other medical conditions you have

These factors are discussed in more detail below.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Rytary, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Rytary.

Interactions with drugs or supplements

Rytary can interact with several types of drugs. These drugs include:

This list does not contain all types of drugs that may interact with Rytary. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with this drug.

* Due to this interaction, doctors typically will not prescribe Rytary with certain MAOIs. For details, see “Warnings” below.

Other interactions

Taking Rytary with foods that are high in calories, fat, or protein may affect how well the drug works to treat your condition. These types of foods may increase the time it takes your body to absorb Rytary. This means it may take Rytary longer than usual to begin easing your symptoms.

Examples of high-fat, high-calorie foods include nuts or nut butters, cheese, and avocados. Examples of high-protein foods include Greek yogurt, eggs, and chicken.

You can take Rytary with or without food. But it may be best to take each dose 1 to 2 hours before eating. This can reduce the risk of Rytary being affected by foods you eat.

Your doctor can recommend how to manage your calorie, fat, or protein intake while using Rytary.

Warnings

Rytary may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Rytary. Factors to consider include those in the list below.

  • Heart problems. Before taking Rytary, tell your doctor if you currently have heart problems or have had them in the past. This includes conditions such as irregular heart rhythm and heart attack. Rytary can raise your risk of heart attack or other heart problems if you already have certain conditions. Your doctor can determine if it’s safe for you to take Rytary.
  • Glaucoma. Before taking Rytary, tell your doctor if you have glaucoma. Rytary may increase the fluid pressure in your eye. If you have glaucoma, this increased pressure could make your condition worse. Your doctor can advise if Rytary is safe for you to take. If you do take the drug, your doctor may check the level of pressure inside your eye more often than usual during your treatment.
  • Peptic ulcers. Be sure to tell your doctor if you have peptic ulcers or have had them in the past. These are sores that develop in the lining of your esophagus, stomach, or intestine. If you have a history of this condition, you may have a higher risk for stomach bleeding with Rytary. Your doctor can determine whether Rytary is safe for you to take.
  • Mental health conditions. Hallucinations are a possible side effect of Rytary. Your risk of hallucinations may be higher if you have certain mental health conditions (including psychosis) or have had these conditions in the past. Before starting Rytary treatment, talk with your doctor about your mental health history. Your doctor can determine if this drug is right for you.
  • Allergic reaction. If you’ve had an allergic reaction to Rytary or any of its ingredients, your doctor will likely not prescribe Rytary. Ask your doctor what other medications are better options for you.
  • Use of monoamine oxidase inhibitors (MAOIs). MAOIsare a type of antidepressant. Tell your doctor if you take an MAOI such as phenelzine (Nardil) or tranylcypromine (Parnate). Taking certain MAOIs with Rytary can cause high blood pressure. Due to this risk, doctors typically will not prescribe Rytary with certain MAOIs. Your doctor will have you wait 2 weeks or more after you’ve stopped taking an MAOI before you start treatment with Rytary.

Rytary and alcohol

Rytary isn’t known to interact with alcohol. But it’s possible that drinking alcohol could worsen certain side effects of the drug. Examples of these side effects include:

  • problems with digestion, such as nausea and vomiting
  • extreme sleepiness, which may cause you to fall asleep during regular daily activities, such as driving

Because of this, it may be best to avoid drinking alcohol while taking the drug.

If you drink alcohol, talk with your doctor before taking Rytary. They can tell you how much alcohol (if any) may be safe for you to drink during your treatment.

Pregnancy and breastfeeding

It’s not known if Rytary is safe to take during pregnancy or while breastfeeding. If you’re pregnant, breastfeeding, or planning for either, talk with your doctor before starting Rytary treatment.

If you have questions about taking Rytary to treat parkinsonism or Parkinson’s disease (PD), talk with your doctor.

Below are examples of questions you may want to ask:

  • Am I taking any medications that could raise my risk of side effects with Rytary?
  • How should I manage my meals and the timing of my Rytary doses?
  • Should I take other treatments with Rytary for parkinsonism or PD?

If you’d like to learn about other treatment options for PD, check out this article.

Q:

How do I know if my Rytary dosage should be adjusted?

Anonymous

A:

If you experience bothersome side effects from Rytary, or you have less time without symptoms between doses, your dosage may need to be adjusted.

It’s common to need a dosage adjustment when you first start taking Rytary. But your dosage may also need adjusted periodically throughout your treatment. This may depend on how well the drug is working for you and any side effects you experience.

Remember, you should not change your dosage or stop taking Rytary unless your doctor recommends it. If you have questions about your dosage, talk with your doctor or pharmacist.

Heather Bruce, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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