HELP finding my pills! 2 years on Carbidopa/Levadopa ER 25/100. My pharmacy changed from Accord (pink pills) to blue pills that don’t work.

[Nikosmom]

i can’t find the Accord (generic) pills near me here in Orlando FL. I’m wondering if they are discontinued. There’s some rumblings in the internet of the 25/100 being discontinued I tried to contact Accord manufacturer in NC but I’ll need to call tomorrow. I have the prescription and pills for a day and half. Maybe i can try the 50/200 and cut in half- there is a cutting line but i understand cutting ER defeats the purpose. Any ideas?? ?Manufacturing suggestions???

[Hikoi]

Accord is the company name not the medication name as far as I can see. It is difficult to make out what you are taking now. Could you clarify or sombody cleverer than I may be able to answer.

[Nikosmom in reply to Hikoi]

See picture of med bottle

.

[Hikoi in reply to Nikosmom]

Ok I see.

You mention the 200/50 extended release tabs as a substitute but was wondering about cutting them in half. You are right that in general long acting pills should not be divided. However this seems not to apply to carb/ lev. I have made a point of questioning my neuro and he says i can divide them. Also the manufacturers would not have put in the cutting line if it wasn’t to be used.

[Nikosmom in reply to Hikoi]

Thanks for your interst in my problem. I’m waiting to hear from Dr. Mischley’s opinion

[park_bear in reply to Nikosmom]

My C.L ER pills can be cut without destroying the extended release property.

[WinnieThePoo in reply to Hikoi]

"The cutting line" is not necessarily a cutting line. In France tablets are labelled "secable" or "non secable" and I have known the latter with a score on the tablet. That said, it would appear that it is quite common for L\C tablets to be cuttable, but not to be crushed or chewed. This is probably because the extended release is not that extended (it's not like my Pramipexole, a once-a-day pill) and the cut tablets are usually long, instead of round, and the cut surface area is pretty small compared with the uncut, coated part. So they end up being a bit less extended release than an uncut tablet, but not enough to worry about

[PDGal4]

I'll be curious to hear what Dr. Mischley has to say. Unfortunately I've been hearing this more and more. My neurologist writes my C/L prescription for a specific generic. The other generics don't work as well; neurologist says it could be the fillers. It's no longer being manufactured. Nor is the non-generic original sinemet. I've done some research. The same companies making all these incredibly expensive new PD drugs are also making the generics. The profits are not in the generics.

[Nikosmom in reply to PDGal4]

After many of the comments posted I am beginning to worry Parkinson's patients have yet another looming challenge in the form of scarcity of affordable generic medication.

[beehive23]

Er and CR are enterically coated so they dont dissolve in the stomach but start to release in the intestine, cutting them exposes the inside so they release in the stomach...defeating the controlled release. hang tough.....

[beehive23 in reply to beehive23]

Sun Pharma discontinued carbidopa/levodopa orally disintegrating tablets in December 2022.

Viatris (Mylan) discontinued carbidopa/levodopa orally disintegrating tablets in 2021.

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.

Accord has 50 mg/200 mg tablets available. Accord discontinued carbidopa and levodopa 25 mg/100 mg extended-release tablets.

Sun Pharma has carbidopa and levodopa extended-release tablets available.

Merck will be discontinuing Sinemet CR 50 mg/200 mg tablets around November 2019. The 25 mg/100 mg tablets will be discontinued around February 2020.

Mylan has carbidopa and levodopa extended-release tablets available.

[Nikosmom in reply to beehive23]

You seem to be well informed about this. I was wasting a lot of time calling pharmacies until I reasoned that the problem might be that the drug was discontinued by the manufacturer, which by the way has the drugs manufactured in India. After many of the comments posted I am beginning to worry Parkinson's patients have yet another looming challenge in the form of scarcity of affordable generic medication.

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[beehive23 in reply to Nikosmom]

im afraid thats true....after the Canadian production shortage several years ago i started following the situation carefully. hang tough

[PDGal4 in reply to beehive23]

Merck dates have passed -- 2019 and 2020. Verifies my research that Sinemet is no longer being manufactured. TEVA is also making C/L. It works better for me than MYLAN which I believe is the only other generic available in my geographic area (although your notes indicate it's no longer manufactured). The one that worked best for me was Activis generic, which is no longer being manufactured either. My problems with the generic C/L available are, 1. they are not scored, making it near impossible to cut in half with any accuracy, and 2. they are not coated in any way, just rough round tablets making them more difficult to swallow.

[beehive23 in reply to PDGal4]

crush the med and divide it with a razor blade. only CR and ER are enterically coated.....so far

[rebtar in reply to beehive23]

Where do you find this information?

[beehive23 in reply to rebtar]

i make it up.......

[beehive23 in reply to beehive23]

and among many other sources easily fact checked such as.........July 17, 2019

Merck announces its decision to stop the manufacturing of Sinemet CR

July 17, 2019: Merck has informed the Food and Drug Administration (FDA) that it will discontinue the manufacturing of Sinemet CR (controlled release). It emphasized that its decision is not a safety issue, but rather a manufacturing one. Patients who currently have Merck Sinemet CR at home can continue to use it until their supply runs out and pharmacies who currently have Sinemet CR will continue to dispense it until their supply runs out.

and...........listening to people that cant get thier meds.........and the fda website and actually the big P itself.....and the parkinsons foundation etc etc etc etc....

[beehive23 in reply to beehive23]

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[rebtar in reply to beehive23]

😆

[beehive23 in reply to rebtar]

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[beehive23 in reply to rebtar]

‘Devastating effects’ caused by switching between branded and generic Parkinson’s disease medication

Charity Parkinson's UK said patients had experienced pain and other symptoms after being switched between branded and generic medications.

These guidelines have been developed to assist Parkinson's Europe member organisations in dealing with a shortage of Parkinson's medication before it happens, when it happens and after it has happened.

A shortage of one – or more than one – Parkinson’s medication at a national level can be particularly disruptive for the Parkinson’s community resulting in a major impact on the quality of life of people living with the condition, their families and carers.

Following shortages in several European countries in 2018 of some of the most common Parkinson’s medications, Parkinson's Europe at their 2019 Members’ Meeting organised an expert panel session involving representatives from the European Medicines Agency (EMA), Medicines for Europe and Parkinson's Europe member organisations to discuss how Parkinson's Europe could help its member organisations resolve the shortage difficulties at a national level. It was agreed that Parkinson's Europe could become a contact point between the EU regulatory bodies, the treatment industry and national Parkinson’s organisations.

Following discussions with Parkinson's Europe Board it was agreed that Parkinson's Europe would develop guidelines for potential actions for both the national Parkinson’s organisations and Parkinson's Europe in case of further Parkinson’s medication shortages in Europe.........

[WinnieThePoo in reply to beehive23]

That's not always correct. See my comment a bit further up this thread

[beehive23 in reply to WinnieThePoo]

that is true.....there are always exceptions..

[pdpatient]

Why would you want to hear from a Natural Healing proponent instead of a doctor. You should really ask for the advice of a MDS. Taking medicine without medical supervision is not advisable and is fraught with danger.

[beehive23]

see my post from 18 days ago......Practical suggestions for PWP.....Hedge against medication scarcity.

[HolisticPeds]

Express Scripts changed mine, too. I contacted them and spoke with a pharmacist, letting them know the new pills didn't work for me. They noted this and sent the pink ones that they'd sent previously...

[Nikosmom in reply to HolisticPeds]

Your particular brand of drugs might have been discontinued but they keep selling them until supplies last See some of the comments above.

I investigated further and i confirmed my dosage has been discontinued a few years back but pharmacies are now unable to get them. My dr wrote a new prescription for the dosage available. I got the new pills which require cutting in half. After half a day they seem to be working.

[CapSage88008]

I noticed the same facts, that for me, the BLUE Sinemet 50/200 ER by Sigen doesn't work as well as Accord. I searched all over for the Accord tabs, and then finally found out how to contact Accord labs, the manufacturer. They told me about a month ago that ACCORD NO LONGER MANUFACTURES GENERIC SINEMET.

[Nikosmom in reply to CapSage88008]

My doctor switched me 50/200 ER. (Double the dosage). After 3 months i am tolerating the new pills and I am establishing a routine. Not a 100 percent satisfied and i would like to go back lower dosages. I might look around for another generic of 25/100 ER. This might require some trial and error adjusting the dosage. I wish they would perfect some skin patch that can dispense meds evenly by bypassing the stomach I get nauseous easily. There’s one almost ready for patients in the UK

Good luck to you