Rytary side effects and how to avoid them

Rytary is an FDA (Food and Drug Administration) approved brand-name medication manufactured by Amneal Pharmaceuticals used to treat Parkinson’s disease. While Rytary is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Rytary include muscle stiffness. Less common but more serious side effects can include serious allergic reactions.

Learn more about the side effects of Rytary and what you can do to avoid them.

What is Rytary used for?

Rytary is a prescription medication used to treat the symptoms of:

  • Parkinson’s disease
  • Parkinsonism caused by carbon monoxide or manganese poisoning
  • Parkinsonism caused by viral infections of your brain (post-encephalitic parkinsonism)

Parkinson’s disease is a long-term degenerative condition that affects your brain and is caused by the death and loss of brain cells. It’s thought that cells are killed by a build-up of harmful proteins in your brain. Cells are usually lost in an area of your brain called your substantia nigra that produces a chemical called dopamine. This loss of dopamine makes it harder for your brain to coordinate your body movements.

The symptoms of Parkinson’s disease usually come on slowly. The first signs are typically movement problems, like moving slowly, rigid muscles, and shaking. Over time these problems can become more pronounced and lead to tremors, difficulties walking, and problems with speech. Other symptoms of Parkinson’s disease include problems with thinking, mood swings, anger, and emotional outbursts. Depression, anxiety, and other mental health issues are common. As the disease progresses, it often causes dementia – severe thinking and memory problems.

Parkinsonism is the name for the group of movement symptoms of Parkinson’s disease causes. As well as being brought on by Parkinson’s disease, they can be caused by exposure to toxins like manganese or carbon monoxide. Parkinsonism can also be caused by viral infections that produce swelling that damages the substantia nigra (post-encephalitic parkinsonism).

What does Rytary do for Parkinson’s?

Parkinson’s disease can’t be cured, but you can manage the movement symptoms of Parkinson’s and parkinsonism with medications like Rytary. You take Rytary as a capsule that you swallow. It helps to increase levels of dopamine in your brain, relieving or slowing the worsening of movement symptoms.

Rytary has two active ingredients called carbidopa-levodopa. They both help to increase levels of dopamine in your brain. Levodopa is an amino acid, but once it’s taken into your body, it’s converted in your brain cells into dopamine. Carbidopa is a type of medicine called an ‘amino acid decarboxylase inhibitor. This means it’s a drug that slows down how fast amino acids, like levodopa, are broken down in your body. This allows more levodopa to make it through your blood-brain barrier, increasing the amount of dopamine. You can think of levodopa as the ingredient that has the initial effect (increasing dopamine), and carbidopa is the ingredient that boosts the effect of levodopa.

Rytary dosage

Rytary is available as extended-release capsules of carbidopa and levodopa in doses of 23.75 mg/95 mg, 36.25 mg/145 mg, 48.75 mg/195 mg, and 61.25 mg/245 mg.

Take your first dose of the day around 1 to 2 hours before food. Swallow Rytary capsules whole three times a day. If you are unable to swallow the capsules, open them and sprinkle the contents onto a small amount of applesauce. Swallow the mixture right away.

Avoid taking Rytary with a high-fat meal, as this can slow down how quickly it works. Do not take Rytary with iron supplements or multivitamins with minerals containing iron, as this can reduce the amount of carbidopa/levodopa absorbed by your body.

You are advised to read the medication guide provided with this medicine for the drug information and patient information, and always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.

How much is too much Rytary?

The maximum recommended daily dose of Rytary is 612.5 mg/2450 mg.

Rytary side effects

The most common possible side effects of Rytary include:

  • Headaches
  • Dizziness
  • Drowsiness
  • A dry mouth
  • Feeling sick (nausea)
  • Being sick (vomiting)
  • Constipation
  • Problems falling asleep (insomnia)
  • Abnormal dreams
  • Muscle stiffness
  • Difficulties with voluntary movements (dyskinesia)
  • Anxiety
  • Falls in blood pressure after standing up (orthostatic hypotension)

In rare instances, Rytary can cause more serious side effects, including:

  • Severe allergic reactions including rash, itching, swelling of the face, tongue, or throat, severe dizziness, trouble breathing
  • Daytime sleepiness
  • Falling asleep during daily activities
  • Reduced blood flow to your heart (cardiovascular ischemic events)
  • An increased risk of developing peptic ulcers (ulcers in your digestive system)
  • An increased risk of developing the eye problem glaucoma
  • An increased risk of developing a type of skin cancer called melanoma
  • Hallucinations and periods of psychosis (a loss of connection with reality)
  • An increase in compulsive behaviors
  • Confusion and worsening of symptoms caused by reducing your dose or when you stop taking Rytary

If you experience any of these serious side effects, stop taking Rytary and seek medical attention immediately. You are encouraged to report the negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

What are the long-term side effects of Rytary?

Long-term serious side effects of Rytary include anxiety, extreme sleepiness, dyskinesia, and psychosis.

Does Rytary cause weight loss?

Weight loss is not a side effect reported with the use of Rytary. Rytary may cause problems with your digestion, leading to a loss of appetite and weight loss.

Does Rytary cause anxiety?

Anxiety is a side effect of using Rytary. Speak to your doctor if you experience this side effect.

Does Rytary cause hallucinations?

Rytary commonly causes low blood pressure which can result in dizziness, lightheadedness, and hallucinations.

Rytary drug interactions

Rytary can interact with other medications including:

  • Nonselective monoamine oxidase inhibitors (MAO inhibitors) such as rasagiline, safinamide, and selegiline, usually taken as antidepressants (may cause high blood pressure)
  • Any other medications taken for mental health problems
  • Any other medications for Parkinson’s disease
  • Any other medications that contain levodopa
  • Medications used to treat any movement disorders
  • Medications taken to treat low iron
  • Phenytoin used to treat fits (convulsions)
  • Isoniazid a antituberculosis agent
  • Metoclopramide a prokinetic agent
  • Anticholinergic medicines; like orphenadrine, trihexyphenidyl, benztropine, or procyclidine

Before taking Rytary, be sure to tell your doctor about all of the medications you are taking to ensure they are safe to take at the same time.

Rytary warnings & precautions

Don’t take Rytary if you:

  • Are allergic to the active ingredients levodopa and carbidopa
  • Are allergic to any of the other ingredients in Rytary
  • Are taking, or have recently taken, a type of medication called a nonselective monoamine oxidase inhibitor (MAOI), like phenelzine and tranylcypromine, usually taken as an antidepressant
  • Have ever had skin cancer
  • Have ever had an eye condition called narrow-angle glaucoma
  • Are under 18 years of age

Talk to your doctor before taking Rytary if you:

  • Have blood disorders
  • Have breathing problems
  • Have glaucoma
  • Have heart or blood vessel problems such as an irregular heartbeat, heart attack, or angina
  • Have ever had any heart, liver, kidney, or hormonal problems
  • Have any mental health problems
  • Have epilepsy or have a history of fits (convulsions)
  • Have ever had a peptic ulcer
  • Have problems with sleepiness or falling asleep in the daytime
  • Are planning to have surgery
  • Are pregnant or are planning to get pregnant
  • Are breastfeeding or are planning to breastfeed

Rytary can cause side effects like sleepiness and dizziness that can impair your ability to drive, operate machinery, or perform other dangerous tasks.

Is Rytary better than Sinemet?

The effects of Rytary last longer than they do for Sinemet (immediate release) and Sinemet CR (controlled release). Rytary is, therefore, better at helping to control Parkinson’s symptoms.

How to avoid Rytary side effects

The best way to avoid side effects is to take Rytary as directed by your doctor. Follow your doctor’s instructions carefully, and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They may be able to recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dosage

Take your prescribed dose of Rytary that has been recommended by your healthcare professional. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to monitor your blood sugar levels closely while taking Rytary. Check your blood sugar levels as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids every day to help prevent dehydration, which can make side effects worse.

4. Avoid alcohol

Avoid drinking alcohol while taking Rytary as it can increase your risk of side effects such as sleepiness and impaired cognitive function.

5. Don’t skip meals

Eating regular meals and snacks will help to prevent low blood sugar levels (hypoglycemia).

6. Check your feet

If you have diabetes, check your feet for any cuts, sores, or redness regularly. Tell your doctor if you experience any problems with your feet while taking Rytary.

7. Know the signs and symptoms of Rytary side effects

Signs and symptoms of side effects include sleepiness and daytime drowsiness. If you experience these symptoms, speak to your doctor for medical advice.

8. Tell your doctor about all medications you’re taking

Be sure to tell your doctor about all other medications you’re taking, including over-the-counter drugs, vitamins, and herbal supplements, as they can interact with Rytary.

9. Get regular medical checkups

It is important to get regular medical checkups and monitor your medical conditions. Your doctor will monitor your condition and may adjust your dose of Rytary as needed.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.

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Sources (3)

  1. Drugs.com - Rytary

  2. WebMD - Rytary - Uses, Side Effects, and More

  3. FDA - highlights of prescribing information for Rytary

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.