Rytary (levodopa/carbidopa) is a brand-name drug that’s prescribed for Parkinson’s disease and parkinsonism in adults. As with other drugs, Rytary can cause side effects, such as nausea and headache.
Levodopa and carbidopa are the active drugs in Rytary. Levodopa belongs to a drug class called central nervous system agents. Carbidopa belongs to a drug class called decarboxylase inhibitors.
Rytary isn’t available in a generic version.
Read on to learn about potential common, mild, and serious side effects of Rytary. For a general overview of the drug, including details about its uses, see this article.
Rytary can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Rytary in clinical trials:
Mild side effects can occur with Rytary use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Rytary’s prescribing information.
Mild side effects that have been reported with Rytary include:
- constipation
- dizziness
- dry mouth
- headache
- vomiting
- nausea
- insomnia
- unusual dreams
- anxiety*
- mild allergic reaction*
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Rytary and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see “Side effect specifics” below.
Rytary may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Rytary’s prescribing information.
If you develop serious side effects while taking Rytary, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
- Compulsive behaviors (new or increased behaviors that are difficult to stop). Behaviors can include:
- gambling urges
- sexual urges
- spending sprees
- Falling asleep during daily activities. Symptoms can include:
- excessive sleepiness
- sleep attacks (sleep that comes on suddenly)
- falling asleep while talking, eating, or even driving
- Reduced blood flow to the heart. Symptoms can include:
- chest pain or pressure
- nausea or vomiting
- pain in the jaw, neck, shoulder, or arm
- Dyskinesia.*
- Hallucinations or psychosis.*
- Orthostatic hypotension.*
- Suicidal thoughts or actions.*
- Severe allergic reaction.†
* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after taking Rytary. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.
Rytary may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
How do the side effects of Rytary compare with those of Sinemet?
The side effects of Rytary are similar to those of Sinemet. (Sinemet is another drug used to treat Parkinson’s disease [PD].) These two brand-name drugs contain the same active ingredients: levodopa and carbidopa. Because they have the same active ingredients, their side effects are very similar.
However, one review of studies found that Rytary may cause fewer side effects than Sinemet. This is because Rytary is an extended-release form of the drug. With extended-release drugs, the active ingredients release slowly into your body over a period.
Sinemet is an immediate-release drug. So if you take Rytary, you may have a steadier level of the drug in your body throughout the day. This may result in Rytary having fewer side effects than Sinemet.
If you’d like to learn more about how Sinemet compares with Rytary, talk with your doctor or pharmacist. You can also read this article comparing the two drugs.
Is weight loss a side effect of Rytary?
No, weight loss isn’t an expected side effect of Rytary. It wasn’t reported in clinical trials of the drug.
However, weight loss can occur in people with PD for several reasons. PD may cause decreased appetite and problems swallowing. So if you’re not able to eat as much due to these symptoms, you may lose weight.
If you experience unintended weight loss while taking Rytary, let your doctor know. They can determine the most likely cause and suggest ways to manage it.
Learn more about some of the side effects that Rytary may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Rytary.
Anxiety
Anxiety was commonly reported in clinical trials of Rytary. More people taking higher doses of Rytary reported anxiety compared with lower doses. Keep in mind that anxiety can also be a common symptom of Parkinson’s disease (PD), which Rytary is approved to treat.
Symptoms of anxiety can include:
- shakiness
- nervousness or worrying
- unusual increase in sweating
- feeling tired or weak
- trouble concentrating
Anxiety wasn’t a common reason people with early PD had to stop taking Rytary. However, it was a common reason people with advanced PD stopped the drug.
What you can do
If you start to feel anxious while taking Rytary, talk with your doctor about it. They can help determine the cause and suggest ways to manage it.
Dyskinesia
Some people reported dyskinesia during clinical trials of Rytary. Dyskinesia is a movement disorder that causes unusual body movements. It’s a common side effect of any medication containing levodopa, such as Rytary.
Symptoms can include unusual movements that you can’t stop. These can involve the face, neck, arms, legs, or trunk of the body.
Dyskinesia is typically associated with long-term Rytary treatment. However, in some cases, it can start after a few weeks or months of taking the drug.
What you can do
If you experience uncontrollable body movements after you start taking Rytary, tell your doctor. They may recommend a lower dose of Rytary or adjust your other medications.* Do not change the amount of Rytary you take without talking with your doctor first.
* To learn about typically recommended Rytary dosages, see this article.
Hallucinations or psychosis
Both hallucinations and psychosis were reported in clinical trials of Rytary. Hallucinations are seeing or hearing things that aren’t there. Psychosis is a condition that causes people to lose touch with reality.
In most cases, these side effects occurred soon after starting Rytary treatment. However, these side effects were not common.
Symptoms of either or both conditions can include:
- unusual thinking or behavior
- aggression or agitation
- confusion or disorientation
- paranoia
- insomnia
- dreaming more often or vividly than is typical
What you can do
Be sure to tell your doctor right away about any symptoms of hallucinations or psychosis. They may suggest lowering your Rytary dosage or making other adjustments.*
* To learn about typically recommended Rytary dosages, see this article.
Orthostatic hypotension
Taking Rytary may cause orthostatic hypotension. Orthostatic hypotension is a sudden drop in blood pressure when you change positions, such as standing up from sitting. It can lead to fainting and falls, which can be dangerous. It was one of the more common side effects reported in clinical trials of Rytary.
Symptoms can include:
- blurry vision
- vision that gets dim or dark
- dizziness
- lightheadedness
- weakness
What you can do
If you experience any of the above symptoms often, or if you faint or fall, talk with your doctor. If your dosage of Rytary is working well to treat your PD symptoms, they’ll likely not adjust it. Instead, they may be able to suggest strategies for helping reduce the risk of this side effect.
Examples include the following:
- Change positions slowly. For example, you can sit on the edge of your bed for a few minutes before standing.
- Move your legs or flex your feet a few times before and after you stand up. This gets your blood moving through your body, which helps stabilize your blood pressure.
- Sleep with your head elevated above your feet. You can do this by using a wedge pillow, inclined bed, or other technique to lift your head, neck, and shoulders.
- Stay hydrated by drinking plenty of water.
To help prevent falls, hold on to something when you stand up. If you feel dizzy, do not start walking. You should sit back down until your dizziness goes away.
Suicidal thoughts or actions
Suicidal thoughts or actions may occur while taking Rytary. However, these side effects weren’t reported in the drug’s clinical trials. Instead, reports of these side effects came in after the drug was approved for use. It’s unclear how often the side effects occurred or whether Rytary was the direct cause.
What you can do
Before taking Rytary, be sure to tell your doctor if you’ve ever had suicidal thoughts or tried to hurt yourself. They’ll likely monitor you closely during Rytary treatment. This is to make sure that you’re not having these symptoms while taking the drug.
If you experience thoughts of suicide or harming yourself, tell your doctor right away or call 911 or your local emergency number. You can also refer to this article for ways to seek support.
Allergic reaction
As with most drugs, Rytary can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials.
Symptoms can be mild or serious and can include:
- skin rash
- itching
- flushing
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do
For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Rytary. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Be sure to talk with your doctor about your health history before you take Rytary. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:
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 may be better options for you.
Glaucoma. Rytary can cause the pressure inside your eyes to increase, which can worsen glaucoma. If you have glaucoma, tell your doctor before starting Rytary. They may suggest monitoring your eye pressure more often.
Heart problems. Rytary can reduce the blood flow to your heart muscle. This can cause serious problems in certain people who have had a heart attack. If you have an irregular heart rhythm due to a past heart attack, you’ll start Rytary treatment in a hospital’s specialized heart care unit. Your doctor will monitor you there to make sure the drug will be safe for you. Be sure your doctor knows about any heart problems you have or have had before taking Rytary.
Taking a nonselective monoamine oxidase inhibitor (MAOI). Taking Rytary with drugs that are nonselective MAOIs, such as phenelzine (Nardil), can make your blood pressure too high. Due to this risk, doctors do not prescribe Rytary to people who take MAOIs. (MAOIs are prescribed for depression and certain anxiety disorders.) Always tell your doctor about all the medications you take before starting Rytary. (For information about drug interactions with Rytary, refer to this article.)
Peptic ulcer disease. Rytary may increase the risk of bleeding in the stomach or intestines in people who’ve had peptic ulcer disease. If you have or have had a peptic ulcer, tell your doctor. They’ll help determine whether Rytary is right for you.
Psychotic disorders. Rytary can worsen psychosis associated with some mental health conditions, such as schizophrenia. Due to this risk, doctors typically won’t prescribe Rytary to people who’ve experienced psychosis. Also, medications that treat psychosis may stop Rytary from working as intended. If you have or have ever had psychotic episodes, be sure to tell your doctor.
Sleep disorders. If you have a sleep disorder and take Rytary, you may be more likely to fall asleep during daily activities. Before starting Rytary, tell your doctor if you have a sleep disorder or take medications that make you sleepy. They’ll advise whether Rytary is right for you.
Alcohol with Rytary
There isn’t a known interaction between alcohol and Rytary. However, alcohol can worsen many of the side effects Rytary can cause. These include dizziness, headache, and nausea. Alcohol may also cause problems with blood pressure, thinking, and movement.
If you drink alcohol, talk with your doctor. They can advise what amount, if any, is safe to consume while taking Rytary. To learn more about alcohol and Parkinson’s disease medications, see this article.
Pregnancy and breastfeeding while taking Rytary
It isn’t known whether Rytary is safe to take during pregnancy or while breastfeeding. Animal studies found that Rytary was harmful to developing offspring. However, there haven’t been clinical trials of Rytary in pregnant people.
Levodopa (one of the active drugs in Rytary) passes into breast milk. It isn’t known whether carbidopa (the other active drug in Rytary) passes into breast milk. The possible effect of either drug on a child who’s breastfed isn’t known.
If you become pregnant while taking Rytary, tell your doctor right away. If you’re breastfeeding or planning on doing so, your doctor can advise whether Rytary is safe to take.
Rytary has some common side effects that are typically mild. However, serious side effects are possible. If you’d like to learn more about Rytary, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.
Besides talking with your doctor, you can do some research on your own. These articles might help:
- More information about Rytary. For details about other aspects of Rytary, refer to this article.
- Dosage. For information about the dosage of Rytary, view this article.
- A look at Parkinson’s disease. For details about Parkinson’s disease and parkinsonism, see our Parkinson’s disease hub.
Disclaimer: Medical News Today 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.