CREXONT carbidopa and levodopa 52.5 mg; 210 mg Capsule, Extended Release, 120-count
🆔 Identity & classification
Where does this data come from?
🏷️ RxNorm drug class
This medicine belongs to the Aromatic Amino Acid Decarboxylation Inhibitor class.
Where does this data come from?
🏭 Manufacturer & labeler
Where does this data come from?
🩺 Clinical
Levodopa and carbidopa is used to treat the symptoms of Parkinson's disease and Parkinson's-like symptoms that may develop after encephalitis (swelling of the brain) or injury to the nervous system caused by carbon monoxide poisoning or manganese poisoning. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain (the natural substance that is low in Parkinson's and causes the symptoms of tremor, stiffness, and slowness of movement). Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preven...
Read the full MedlinePlus article ↗- Levodopa is the medicine that actually works in your brain — it crosses into the brain and gets converted into dopamine, the chemical that Parkinson's disease depletes. The problem...
- What exactly does levodopa and carbidopa do, and why do I need both?
- Generally yes, but the timing and content of your meals can matter. High-protein foods — like large servings of meat, eggs, or dairy — can compete with levodopa for absorption in y...
- Can I eat normally while taking this medication?
Patient education
Supplement & herbal interactions
Where does this data come from?
Ask a licensed pharmacist directly — free, answered by our team.
💊 What it looks like
Where does this data come from?
🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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UNII 3K9958V90M
A liquid solvent derived from fermentation or chemical synthesis. In medicines, alcohol dissolves active ingredients, helps preserve the product, and improves how the body absorbs certain drugs.
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UNII 5138Q19F1X
Ammonia is a colorless gas made from nitrogen and hydrogen. It's used in medicines as a pH buffer to maintain the correct acidity level and help keep the product stable.
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UNII 8PJ61P6TS3
Butyl alcohol is a clear liquid organic solvent derived from petroleum or natural sources. In medicines, it helps dissolve active ingredients and serves as a solvent in liquid formulations and some topical products.
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UNII 3J2P07GVB6
Cellulose acetate is a plant-derived polymer made by chemically modifying cellulose fibers. In medications, it serves as a film-coating material for tablets and capsules to protect the drug, control release, and improve appearance.
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UNII D9C330MD8B
Copovidone is a synthetic polymer made by combining two types of plastic-like molecules. It acts as a binder and film-former to help hold tablet ingredients together and improve how the medicine dissolves in your body.
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UNII M28OL1HH48
Croscarmellose sodium is a plant-based substance derived from cellulose. It acts as a disintegrant, helping tablets and capsules break down quickly in the digestive system so the medicine can be absorbed.
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UNII 905HNO1SIH
A synthetic polymer made from methacrylate compounds that forms a film coating on tablets or capsules. It helps control how quickly the medicine dissolves and releases its active ingredient in the digestive system.
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UNII H3R47K3TBD
FD&C Blue No. 1 is a synthetic blue dye approved for use in foods and medicines. It serves as a colorant to give the medication its distinctive appearance and help with product identification.
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UNII EX438O2MRT
Ferric oxide yellow is a naturally occurring iron compound used as a colorant in medications. It gives tablets, capsules, and other forms a yellow or golden hue for identification and appearance.
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UNII XM0M87F357
A dark iron oxide compound that gives medicines their black or dark color. It's used as a colorant in tablets and capsules to help identify the product and make it visually distinctive.
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UNII 2G86QN327L
Gelatin is a protein derived from animal collagen, commonly used in medicines as a gelling agent and capsule material. It helps create soft or hard capsule shells that hold and release medication, and can also thicken liquid formulations.
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UNII ND2M416302
Isopropyl alcohol is a clear liquid solvent derived from petroleum. In medicines, it dissolves active ingredients and other components, helps the product flow smoothly, and aids in sterilization during manufacturing.
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UNII 70097M6I30
Magnesium stearate is a salt made from magnesium and stearic acid, a fatty substance. It's used in tablets and capsules as a lubricant and glidant to help ingredients flow smoothly during manufacturing and prevent sticking.
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UNII 3OWL53L36A
A natural sugar alcohol derived from seaweed or synthesized in the lab. It's used as a filler to add bulk, a sweetener in sugar-free formulas, and a disintegrant to help tablets break apart in the stomach.
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UNII 74G4R6TH13
A synthetic polymer made by combining two plastic-like chemicals. It forms a coating on tablets or capsules that dissolves at a specific point in the digestive tract, controlling where and when the medicine releases.
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UNII OP1R32D61U
Microcrystalline cellulose is a purified form of cellulose, a natural fiber from plant sources. It acts as a binder and filler in tablets and capsules, helping hold ingredients together and give the medicine its shape and size.
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UNII FZ989GH94E
Povidone is a synthetic polymer made from a plastic-like material. It acts as a binder to hold tablet ingredients together and as a disintegrant to help the tablet break apart in your stomach so the medicine can be absorbed.
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UNII 6DC9Q167V3
Propylene glycol is a clear liquid derived from petroleum or vegetable sources. It acts as a solvent, humectant, and preservative in medicines, helping dissolve active ingredients and maintain product stability.
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UNII 46N107B71O
Shellac is a natural resin secreted by the lac beetle. It's used as a coating on tablets and capsules to control how quickly the medicine dissolves and to improve appearance and stability.
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UNII 55X04QC32I
A strong alkaline chemical used to adjust and maintain the pH balance of liquid medicines. It helps keep the medicine stable and ensures it stays effective during storage.
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UNII 368GB5141J
A detergent and foaming agent derived from coconut or palm oil. In medications, it helps break down and mix oil and water-based ingredients, aids in tablet disintegration, and improves how the drug dissolves and spreads in the mouth or digestive system.
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UNII 7SEV7J4R1U
A powder made from a naturally occurring mineral. In medicines, talc works as a glidant and anti-caking agent, helping tablets and capsules flow smoothly during manufacturing and preventing clumping.
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UNII 15FIX9V2JP
Titanium dioxide is a bright white mineral powder commonly used as a colorant and opacifying agent. It makes pills and tablets white or lighter in color and helps make coatings non-transparent.
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UNII 8Z96QXD6UM
Triethyl citrate is a clear liquid derived from citric acid. It acts as a plasticizer and solvent in tablet coatings and film formulations, helping the coating remain flexible and adhere properly to the medicine.
24 inactive ingredients listed in the exact product block matched to this NDC.
Where does this data come from?
ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
Why might an inactive ingredient be missing?
Can inactive ingredients matter?
💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| Medicare drug plans payPart D · Q2 2026 | $4.46 | $534.68 / 120 capsules |
Where does this data come from?
🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Crexont 52.5 mg/1; 210 mgthis 64896-0968-23 | Amneal | 120 capsules | — | — | FDA listed | — |
Where does this data come from?
⏳ Availability & generic status
We did not find an FDA-approved generic match for this exact strength, form and route. Patent/protection dates below may affect future generic timing.
Why the date isn’t exact: Generic timing can change because patents may be challenged, settled, licensed, added, removed, or worked around with a narrower label — and FDA approval does not always mean a pharmacy can get the generic today.
🛈 What do these terms mean?
- Patent
- Legal protection listed in the Orange Book that may delay generic approval or launch. Issued by the U.S. Patent & Trademark Office.
- Substance patent
- Covers the active drug molecule itself — the hardest to design around. A generic generally can’t launch until it expires.
- Formulation (product) patent
- Covers a specific formulation or dosage form. A generic can sometimes work around it with a different formulation.
- Method-of-use patent
- A patent covering one specific approved use of the drug — not necessarily the whole molecule. A generic can sometimes launch with a “skinny label” that carves out the protected use and keeps the others.
- Skinny label
- A generic label that omits a still-patented use when the FDA allows it — letting a generic reach the market for the unprotected uses.
- Exclusivity
- FDA-granted marketing protection, separate from patents — e.g. 5-yr new chemical entity, 7-yr orphan drug, or a +6-month pediatric extension.
- Paragraph IV
- A generic applicant’s formal challenge to a listed patent. It can potentially lead to earlier generic entry, but often involves litigation or a settlement.
- RLD / RS
- Reference Listed Drug — the brand product the FDA uses as the reference for generic applications. Reference Standard — the product the FDA expects generics to compare against in bioequivalence testing.
- TE / AB rating
- FDA therapeutic-equivalence rating. An AB rating generally means the FDA considers a generic therapeutically equivalent to — and substitutable for — the brand.
- LOE (loss of exclusivity)
- The latest patent or exclusivity currently listed — the loss-of-exclusivity / latest-listed-protection date shown on this page. Paragraph-IV challenges and settlements can move the real date earlier; FDA approval and a manufacturer’s decision to market can move it later.
Built from the FDA Orange Book. The bars above are scaled to each protection’s expiry; the red LOE marker is the last one to lapse.
| Patent | Type | Use code | Expires |
|---|---|---|---|
| US 12303482 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303482 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12295931 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12303481 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 11986449 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 11986449 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 11986449 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 11986449 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 11666538 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 11666538 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 11666538 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 11666538 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10987313 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10987313 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10987313 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10987313 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10973769 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10973769 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10973769 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10973769 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10688058 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10688058 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10688058 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10688058 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10292935 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10292935 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10292935 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10292935 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10098845 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10098845 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10098845 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 10098845 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12201596 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12201596 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12178919 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12178919 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12178919 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12178919 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12109185 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12109185 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12458616 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263148 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12263149 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12453710 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12447139 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12194150 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12194150 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12194150 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12194150 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-1649 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-219 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4004 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12370163 ↗ | Method of use | U-4005 | Dec 21, 2041 |
| US 12128141 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12128141 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12128141 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12128141 ↗ | Method of use | U-219 | Oct 7, 2034 |
| US 12491164 ↗ | Drug product | — | Oct 7, 2034 |
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| Code | What it grants | Expires |
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| NP | New Product | Aug 7, 2027 |
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| Package NDC | Description | Per unit | Per pack | Marketing start | Status |
|---|---|---|---|---|---|
| 64896-0968-16 | 1 BOTTLE in 1 CARTON (64896-968-16) / 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE | $4.58 / ea | $549.89 | 2024-08-09 | Active |
| 64896-0968-23 You're viewing this | 1 BOTTLE in 1 CARTON (64896-968-23) / 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE | — | — | 2024-08-09 | Active |
This pack shows little to no recent Medicaid volume — a different pack size carries most fills. See all packs ↓
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📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE CREXONT is indicated for the treatment of Parkinson's disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication in adults. CREXONT is a combination of carbidopa (an aromatic amino acid decarboxylation inhibitor) and levodopa (an aromatic amino acid) indicated for the treatment of Parkinson’s disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication in adults.
( 1 )
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION Evaluate vitamin B6 levels prior to starting treatment with carbidopa/levodopa therapies. ( 2.1 ) Levodopa-naïve patients: Starting dose is 35 mg carbidopa / 140 mg levodopa taken orally twice daily for the first 3 days; on the fourth day of treatment, dosage may be increased gradually as needed. ( 2.2 ) Patients converting from immediate-release carbidopa/levodopa: See Table 1 for instructions; dosages are not substitutable on a 1:1 basis.
( 2.3 ) The maximum recommended daily dosage of CREXONT is 525 mg carbidopa / 2100 mg levodopa. ( 2.2 , 2.3 ) CREXONT may be taken with or without food; do not chew, divide, or crush. ( 2.5 , 12.3 ) CREXONT should not be taken with alcohol.
( 2.5 , 12.3 )
2.1Management of Vitamin B6 Levels Evaluate vitamin B6 levels prior to initiating carbidopa/levodopa therapies, including CREXONT, periodically during treatment, and as clinically indicated [see Warnings and Precautions (5.7) ]. If vitamin B6 levels are low, supplement to sufficient levels per standard of care. Patients may initiate and continue treatment with CREXONT while supplementing vitamin B6.
2.2Dosage in Patients Naïve to Levodopa Therapy The recommended starting dosage of CREXONT in levodopa-naïve patients is 35 mg carbidopa / 140 mg levodopa taken orally twice daily for the first three days. Thereafter, dosage may be increased gradually as needed to a maximum daily dosage of 525 mg carbidopa / 2100 mg levodopa divided up to four times daily.
2.3Dosage in Patients Converting from Immediate-Release Carbidopa-Levodopa to CREXONT The dosages of immediate-release carbidopa-levodopa products are not substitutable on a 1:1 basis with the dosages of CREXONT. To convert patients from immediate-release carbidopa-levodopa to CREXONT, follow these steps: Step 1: Determine the patient’s total daily dosage of immediate-release levodopa. Step 2: Determine the patient’s most frequent single dose of immediate-release levodopa.
If more than one dose corresponds to the most frequent, use the highest of the doses. Step 3: Find the values from Step 1 and Step 2 in Table 1 (below) to determine the recommended starting CREXONT dosage of levodopa and dosing frequency. Step 4: After one to three days, adjust the dose or frequency as needed based on the patient’s clinical response and tolerability.
Dosage may be increased gradually as needed to a maximum daily dosage of 525 mg carbidopa / 2100 mg levodopa divided up to four times daily. Table 1: Conversion from Immediate-Release Carbidopa-Levodopa to CREXONT Total Daily Immediate-Release Levodopa Dosage Most Frequent Immediate-Release Levodopa Single Dose Recommended Starting CREXONT Dosage of Levodopa Less than 500 mg daily 100 mg 280 mg twice daily 150 mg 420 mg twice daily 200 mg 560 mg twice daily Equal to or greater than 500 mg daily 100 mg 280 mg three times daily 150 mg 420 mg three times daily 200 mg 560 mg three times daily Greater than 200 mg 700 mg three times daily For patients currently treated with carbidopa and levodopa plus a catechol-O-methyl transferase (COMT) inhibitor (e.g., entacapone or opicapone), the initial total daily dose of levodopa in CREXONT may need to be increased if the COMT inhibitor is discontinued.
Use of CREXONT in combination with other levodopa products has not been studied.
2.4Dosage for Patients Converting from Extended-Release Carbidopa-Levodopa (Rytary) to CREXONT For patients converting from RYTARY (extended-release carbidopa-levodopa), initiate CREXONT on an approximately 1:1 mg basis using the levodopa component for conversion.
2.5Administration Information Swallow CREXONT whole with or without food. CREXONT should not be taken with alcohol. A high-fat, high-calorie meal may delay the absorption of levodopa to reach the peak plasma concentration by about 2 hours [see Clinical Pharmacology (12.3) ]. Do not chew, divide, or crush CREXONT capsules. For patients who have difficulty swallowing intact capsules, administer CREXONT by…
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS CREXONT extended-release capsules contain white to off-white granules and pellets and are available in the following strengths: 35 mg carbidopa and 140 mg levodopa: Capsules with white opaque body and yellow opaque cap. Body imprinted with “140” in black ink and cap imprinted with “IPX203” in white ink. 52.5 mg carbidopa and 210 mg levodopa: Capsules with white opaque body and green opaque cap.
Body imprinted with “210” in black ink and cap imprinted with “IPX203” in white ink. 70 mg carbidopa and 280 mg levodopa: Capsules with white opaque body and purple opaque cap. Body imprinted with “280” in black ink and cap imprinted with “IPX203” in white ink.
87.5mg carbidopa and 350 mg levodopa: Capsules with white opaque body and medium orange opaque cap. Body imprinted with “350” in black ink and cap imprinted with “IPX203” in white ink. Extended-Release Capsules: Carbidopa and Levodopa 35 mg / 140 mg, 52.5 mg / 210 mg, 70 mg / 280 mg, 87.
5 mg / 350 mg ( 3 )
⛔ Contraindications ▾
4 CONTRAINDICATIONS CREXONT is contraindicated in patients currently taking a nonselective monoamine oxidase (MAO) inhibitor or have recently (within 2 weeks) taken a nonselective MAO inhibitor. Hypertension can occur if these drugs are used concurrently [see Drug Interactions (7.1) ] . Nonselective MAO inhibitors (4)
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS May cause falling asleep during activities of daily living. ( 5.1 ) Avoid sudden discontinuation or rapid dose reduction to reduce the risk of withdrawal-emergent hyperpyrexia and confusion. ( 5.2 ) Cardiovascular Events: Monitor patients with a history of cardiovascular disease.
( 5.3 ) Hallucinations/Psychosis may occur. ( 5.4 ) Impulse Control Disorders: Consider dose reduction or stopping CREXONT if occurs. ( 5.5 ) May cause or exacerbate dyskinesia: Consider dose reduction.
( 5.6 )
5.1Falling Asleep During Activities of Daily Living and Somnolence Patients treated with levodopa, a component of CREXONT, have reported falling asleep while engaged in activities of daily living, including the operation of motor vehicles, which sometimes resulted in accidents. Although many of these patients reported somnolence while on levodopa, some perceived that they had no warning signs, such as excessive drowsiness, and believed that they were alert immediately prior to the event (sleep attack). Some of these events have been reported more than 1 year after initiation of treatment.
Falling asleep while engaged in activities of daily living usually occurs in patients experiencing preexisting somnolence, although patients may not give such a history. For this reason, prescribers should reassess for drowsiness or sleepiness in CREXONT-treated patients, especially since some of the events occur well after the start of treatment. Prescribers should also be aware that patients may not acknowledge drowsiness or sleepiness until directly questioned about drowsiness or sleepiness during specific activities.
Before initiating treatment with CREXONT, advise patients of the potential to develop drowsiness and specifically ask about factors that may increase the risk for somnolence with CREXONT, such as concomitant sedating medications or the presence of a sleep disorder. Consider discontinuing CREXONT in patients who report significant daytime sleepiness or episodes of falling asleep during activities that require active participation (e.g., conversations, eating, etc.). If a decision is made to continue CREXONT, patients should be advised not to drive and to avoid other potentially dangerous activities that might result in harm if the patients become somnolent.
There is insufficient information to establish that dose reduction will eliminate episodes of falling asleep while engaged in activities of daily living.
5.2Withdrawal-Emergent Hyperpyrexia and Confusion A symptom complex that resembles neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability), with no other obvious etiology, has been reported in association with rapid dose reduction, withdrawal of, or changes in dopaminergic therapy. Avoid sudden discontinuation or rapid dose reduction in patients taking CREXONT. If the decision is made to discontinue CREXONT, the dose should be tapered to reduce the risk of hyperpyrexia and confusion [see Dosage and Administration (2.6) ] .
5.3Cardiovascular Ischemic Events Cardiovascular ischemic events have occurred in patients taking CREXONT. In Study 1 [see Clinical Studies (14) ], 4/589 (0.7%) of CREXONT-treated patients experienced cardiovascular ischemic adverse reactions compared to 2/630 (0.3%) of oral immediate-release carbidopa-levodopa-treated patients. These patients all had a previous history of ischemic heart disease or risk factors for ischemic heart disease.
In patients with a history of myocardial infarction who have residual atrial, nodal, or ventricular arrhythmias, cardiac function should be monitored in an intensive cardiac care facility during the period of initial dosage adjustment.
5.4Hallucinations/Psychosis There is an increased risk for hallucinations in patients taking CREXONT. In Study 1, 17/589 (3%) of CREXONT-treated patients reported hallucinations compared to 2/630 (0.3%) of oral immediate-release carbidopa-levo…
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS The following serious adverse reactions are discussed below and elsewhere in the labeling: Falling Asleep During Activities of Daily Living and Somnolence [see Warnings and Precautions (5.1) ] Withdrawal-Emergent Hyperpyrexia and Confusion [see Warnings and Precautions (5.2) ] Cardiovascular Ischemic Events [see Warnings and Precautions (5.3) ] Hallucinations/Psychosis [see Warnings and Precautions (5.4) ] Impulse Control/Compulsive Behaviors [see Warnings and Precautions (5.5) ] Dyskinesia [see Warnings and Precautions (5.6) ] Vitamin B6 Deficiency and Seizures [see Warnings and Precautions (5.7) ] P eptic Ulcer Disease [see Warnings and Precautions (5.8) ] Glaucoma [see Warnings and Precautions (5.9) ] The most common adverse reactions (incidence ≥ 3% and greater than immediate-release CD-LD) are nausea and anxiety.
( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Amneal Pharmaceuticals at 1-877-835-5472 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. The safety population consisted of 589 patients with Parkinson’s disease who received CREXONT for up to 76 weeks and had an average duration of exposure of 35 weeks. Study 1 in patients with Parkinson’s Disease consisted of a dose adjustment period of immediate-release carbidopa-levodopa treatment prior to a 4-week dose conversion period to CREXONT, which was then followed by a 13-week, double-blind, randomized period comparing CREXONT to immediate-release carbidopa-levodopa [see Clinical Studies (14) ].
In Study 1 , the most common adverse reactions (in at least 3% of patients treated with CREXONT and more frequently than with immediate-release carbidopa-levodopa) that occurred during the double-blind maintenance period were nausea and anxiety. Table 2 lists adverse reactions occurring in at least 2% of CREXONT-treated patients while converting from immediate-release carbidopa-levodopa and at a higher rate than immediate-release carbidopa-levodopa in the double-blind maintenance period. Table 2.
Adverse Reactions that Occurred in at Least 2% of Patients with Parkinson’s Disease who Received CREXONT and at a Higher Rate than Patients who Received Immediate-Release Carbidopa-Levodopa (Study 1) Adverse Reaction Dose Conversion Period Double-Blind Period CREXONT CREXONT Immediate-Release Carbidopa-Levodopa (N=589) % (N=256) % (N= 250) % Nausea 5 4 1 Anxiety 2 3 0 Dizziness 3 2 1 Dyskinesia 7 2
0.4 Constipation 2 2
0.4 Headache 2 1 0 Vomiting 2 1 0 Insomnia 2 1
0.4Adverse Reactions Leading to Discontinuation In Study 1, 6% of patients discontinued treatment because of adverse reactions during conversion to CREXONT. During the double-blind treatment period of Study 1, 5% of patients taking CREXONT and 1% of patients taking immediate-release carbidopa-levodopa discontinued treatment because of adverse events. The common adverse reactions leading to drug discontinuation during dose conversion were dyskinesia, dizziness, and nausea.
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS Iron salts and dopamine D2 antagonists, including metoclopramide, may reduce the effectiveness of CREXONT. ( 7.2 , 7.3 )
7.1Monoamine Oxidase (MAO) Inhibitors Nonselective MAO Inhibitors The use of nonselective MAO inhibitors (e.g., phenelzine and tranylcypromine) with CREXONT is contraindicated [see Contraindications (4) ] . Discontinue use of any nonselective MAO inhibitors at least two weeks prior to initiating CREXONT. Selective MAO Inhibitors The use of selective MAO-B inhibitors (e.g., rasagiline and selegiline) with CREXONT may be associated with orthostatic hypotension.
Monitor patients who are taking these drugs concurrently.
7.2Dopamine D2 Receptor Antagonists and Isoniazid Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone, metoclopramide) and isoniazid may reduce the effectiveness of levodopa. Monitor patients for worsening Parkinson’s symptoms.
7.3Iron Salts Iron salts or multivitamins containing iron salts can form chelates with levodopa and carbidopa and can cause a reduction in the bioavailability of CREXONT. If iron salts or multivitamins containing iron salts are co-administered with CREXONT, monitor patients for worsening Parkinson’s symptoms.
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS Pregnancy: Based on animal data, may cause fetal harm. (8.1)
8.1Pregnancy Risk Summary There are no adequate data on the developmental risk associated with the use of CREXONT (carbidopa and levodopa) in pregnant women. In animal studies, carbidopa-levodopa has been shown to be developmentally toxic (including teratogenic effects) at clinically relevant doses (see Data) . The estimated background risk of major birth defects and miscarriage in the indicated population is unknown.
In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Data Animal Data When administered to pregnant rabbits throughout organogenesis, carbidopa-levodopa caused both visceral and skeletal malformation in fetuses at all doses and ratios of carbidopa-levodopa tested. No teratogenic effects were observed when carbidopa-levodopa was administered to pregnant mice throughout organogenesis.
There was a decrease in the number of live pups delivered by rats receiving carbidopa-levodopa during organogenesis.
8.2Lactation Risk Summary CREXONT is a combination of carbidopa and levodopa. Carbidopa There are no adequate data on the presence of carbidopa in human milk, the effects on the breastfed infant, or the effects on milk production. Carbidopa is excreted in rat milk.
Levodopa Levodopa has been detected in human milk after administration of carbidopa-levodopa. Levodopa decreases secretion of prolactin in humans, which may inhibit lactation. There are no adequate data on the effects of levodopa on the breastfed infant.
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for CREXONT and any potential adverse effects on the breastfed infant from CREXONT or from the underlying maternal condition.
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established.
8.5Geriatric Use There were 282 (45%) patients 65 to less than 74 years of age and 112 (18%) patients 75 years of age and older treated with CREXONT in an active-controlled study for Parkinson’s disease (Study 1) [see Clinical Studies (14) ] . There were no differences in safety outcomes between patients less than 65 years of age, 65 to less than 75 years of age, or 75 years and older.
🤰 Pregnancy ▾
8.1Pregnancy Risk Summary There are no adequate data on the developmental risk associated with the use of CREXONT (carbidopa and levodopa) in pregnant women. In animal studies, carbidopa-levodopa has been shown to be developmentally toxic (including teratogenic effects) at clinically relevant doses (see Data) . The estimated background risk of major birth defects and miscarriage in the indicated population is unknown.
In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Data Animal Data When administered to pregnant rabbits throughout organogenesis, carbidopa-levodopa caused both visceral and skeletal malformation in fetuses at all doses and ratios of carbidopa-levodopa tested. No teratogenic effects were observed when carbidopa-levodopa was administered to pregnant mice throughout organogenesis.
There was a decrease in the number of live pups delivered by rats receiving carbidopa-levodopa during organogenesis.
🧒 Pediatric Use ▾
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established.
🧓 Geriatric Use ▾
8.5Geriatric Use There were 282 (45%) patients 65 to less than 74 years of age and 112 (18%) patients 75 years of age and older treated with CREXONT in an active-controlled study for Parkinson’s disease (Study 1) [see Clinical Studies (14) ] . There were no differences in safety outcomes between patients less than 65 years of age, 65 to less than 75 years of age, or 75 years and older.
🆘 Overdosage ▾
10 OVERDOSAGE Based on the limited available information, the acute symptoms of levodopa/carbidopa overdosage can be expected to arise from dopaminergic overstimulation. Doses of a few grams may result in CNS disturbances, with an increasing likelihood of cardiovascular disturbance (e.g., hypotension, tachycardia) and more severe psychiatric problems at higher doses. An isolated report of rhabdomyolysis and another of transient renal insufficiency suggest that levodopa overdosage may give rise to systemic complications, secondary to dopaminergic overstimulation.
In the event of CREXONT overdosage, monitor patients and provide supportive care. Patients should receive electrocardiographic monitoring for the development of arrhythmias; if needed, appropriate antiarrhythmic therapy should be given. The possibility that the patient may have taken other drugs, increasing the risk of drug interactions (especially catechol-structured drugs) should be taken into consideration.
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Carbidopa When levodopa is administered orally, it is rapidly decarboxylated to dopamine in extracerebral tissues so that only a small portion of a given dose is transported unchanged to the central nervous system. Carbidopa inhibits the decarboxylation of peripheral levodopa, making more levodopa available for delivery to the brain. Levodopa Levodopa is the metabolic precursor of dopamine, does cross the blood-brain barrier, and presumably is converted to dopamine in the brain.
This is thought to be the mechanism whereby levodopa treats symptoms of Parkinson's disease.
12.2Pharmacodynamics Because its decarboxylase inhibiting activity is limited to extracerebral tissues, administration of carbidopa with levodopa makes more levodopa available to the brain. The addition of carbidopa to levodopa reduces the peripheral effects (nausea, vomiting) due to decarboxylation of levodopa; however, carbidopa does not decrease the adverse reactions due to the central effects of levodopa. Patients treated with levodopa therapy for Parkinson's disease may develop motor fluctuations characterized by end-of-dose failure, peak dose dyskinesia, ‘on-off’ phenomenon, and akinesia.
Cardiac Electrophysiology At exposures corresponding to the maximum recommended dose of carbidopa in CREXONT, clinically significant QTc interval prolongation was not observed.
12.3Pharmacokinetics The pharmacokinetics of CREXONT were evaluated following single doses in healthy subjects and following single and multiple doses in patients with Parkinson’s disease. CREXONT shows dose proportional pharmacokinetics for both carbidopa and levodopa over the carbidopa/levodopa dosage strength range of 35 mg/140 mg to 87.5 mg/350 mg. Absorption Carbidopa Following oral dosing of CREXONT, the maximum concentration occurred at approximately 2.5 hours.
The bioavailability of carbidopa from CREXONT relative to immediate-release carbidopa-levodopa tablets was approximately 103% to 123%. Levodopa The bioavailability of levodopa from CREXONT was approximately 88% to 99% relative to immediate-release carbidopa-levodopa. For comparable doses, CREXONT results in a levodopa peak concentration (C max ) that is 38% that of immediate-release carbidopa-levodopa.
Following an initial peak at about one hour, plasma concentrations were maintained for about 6 to 7 hours before declining. In patients with Parkinson’s disease, multiple-dose pharmacokinetics was comparable to single-dose pharmacokinetics, i.e., there was minimal accumulation of levodopa. Variation in levodopa peak to trough plasma concentrations at steady-state defined as (C max -C min )/C avg was approximately 1.7 for CREXONT compared to approximately 2.7 for immediate-release carbidopa-levodopa.
Effect of Food Carbidopa In healthy adults, oral administration of CREXONT following a high-fat, high-calorie meal decreased carbidopa C max and AUC by approximately 64% and delayed carbidopa T max by approximately one hour compared to administration in the fasted state. Oral administration of CREXONT by sprinkling the capsule contents on applesauce decreased carbidopa C max and AUC by approximately 13% and 9%, respectively, compared to the intact capsule administered in the fasted state [see Dosage and Administration (2.5) ] .
Levodopa In healthy adults, oral administration of CREXONT following a high-fat, high-calorie meal increased levodopa C max and AUC by approximately 19% and 18%,, respectively, and delayed levodopa T max by approximately two hours compared to administration in the fasted state [see Dosage and Administration (2.5) ] . High protein meals may decrease the absorption of levodopa. Oral administration of CREXONT by sprinkling the capsule contents on applesauce did not significantly affect levodopa concentration time profiles compared to the intact capsule administered in the fasted state.
Distribution Approximately 36% of carbidopa binds to plasma proteins. Approximately…
🧬 Mechanism of Action ▾
12.1Mechanism of Action Carbidopa When levodopa is administered orally, it is rapidly decarboxylated to dopamine in extracerebral tissues so that only a small portion of a given dose is transported unchanged to the central nervous system. Carbidopa inhibits the decarboxylation of peripheral levodopa, making more levodopa available for delivery to the brain. Levodopa Levodopa is the metabolic precursor of dopamine, does cross the blood-brain barrier, and presumably is converted to dopamine in the brain.
This is thought to be the mechanism whereby levodopa treats symptoms of Parkinson's disease.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING
16.1How Supplied CREXONT capsules contain white to off-white granules and pellets and are available in bottles of 120 capsules as follows: Capsule Strength Description NDC Number 35 mg Carbidopa and 140 mg Levodopa Capsules with white opaque body and yellow opaque cap. Body imprinted with “140” in black ink and cap imprinted with “IPX203” in white ink. 64896-967-16 52.5 mg Carbidopa and 210 mg Levodopa Capsules with white opaque body and green opaque cap.
Body imprinted with “210” in black ink and cap imprinted with “IPX203” in white ink. 64896-968-16 70 mg Carbidopa and 280 mg Levodopa Capsules with white opaque body and purple opaque cap. Body imprinted with “280” in black ink and cap imprinted with “IPX203” in white ink.
64896-969-16 87.5 mg Carbidopa and 350 mg Levodopa Capsules with white opaque body and medium orange opaque cap. Body imprinted with “350” in black ink and cap imprinted with “IPX203” in white ink. 64896-970-16
16.2Storage and Handling Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]. Store in a tightly closed container, protected from light and moisture. Dispense in a tightly closed, light-resistant container.
📋 Description ▾
11 DESCRIPTION CREXONT is a combination of carbidopa, an inhibitor of aromatic amino acid decarboxylation, and levodopa, an aromatic amino acid, in extended-release capsules for oral use. CREXONT contains immediate-release granules consisting of carbidopa and levodopa and extended-release pellets consisting of levodopa. Carbidopa is a white to off-white powder, crystalline compound, slightly soluble in water, with a molecular weight of 244.24.
It is designated chemically as (–)-L-α-hydrazino-α-methyl-β-(3,4-dihydroxy-benzene) propanoic acid monohydrate. Its molecular formula is C 10 H 14 N 2 O 4 •H 2 O and its structural formula is: Capsule content is expressed in terms of anhydrous carbidopa, which has a molecular weight of 226.3. Levodopa is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2.
It is designated chemically as (–)-L-α-amino-β-(3,4-dihydroxy-benzene) propanoic acid. Its molecular formula is C 9 H 11 NO 4 and its structural formula is: Each CREXONT extended-release capsule contains 35 mg carbidopa and 140 mg levodopa, 52.5 mg carbidopa and 210 mg levodopa, 70 mg carbidopa and 280 mg levodopa, or 87.5 mg carbidopa and 350 mg levodopa. The inactive ingredients are amino methacrylate copolymer, cellulose acetate, copovidone, croscarmellose sodium, magnesium stearate, mannitol, methacrylic acid and methyl methacrylate copolymer, microcrystalline cellulose, povidone, sodium lauryl sulfate, talc, and triethyl citrate.
The 35mg/140 mg capsule shell contains D&C yellow #10, gelatin, Red Iron Oxide, and titanium dioxide. The 52.5 mg/210 mg capsule shell contains FD&C Blue #1, gelatin, titanium dioxide, and yellow iron oxide. The 70 mg/280 mg capsule shell contains FD&C Blue #1, FD&C Red #3, gelatin, and titanium dioxide.
The 87.5 mg/350 mg capsule shell contains gelatin, Red Iron Oxide, titanium dioxide, and yellow iron oxide. The black imprinting ink contains ammonium hydroxide, ethanol, ferrosoferric oxide/black iron oxide, isopropyl alcohol, n-butyl alcohol, propylene glycol, and shellac glaze. The white imprinting ink contains ethanol, isopropyl alcohol, n-butyl alcohol, povidone, propylene glycol, shellac glaze, sodium hydroxide, and titanium dioxide.
CD Structural Formula LD Structural Formula
💬 Information for Patients ▾
17 PATIENT COUNSELING INFORMATION Dosing Instructions Advise patients not to take other carbidopa-levodopa preparations with CREXONT without consulting their healthcare provider [see Dosage and Administration (2.2) ] . Advise patients to swallow CREXONT whole, without chewing, dividing, or crushing [see Dosage and Administration (2.5) ] . For patients with difficulty swallowing, inform them that the entire contents of CREXONT may be sprinkled on 1 to 2 tablespoons of applesauce and should be swallowed immediately without chewing [see Dosage and Administration (2.4) ] .
Instruct patients that CREXONT should not be taken with alcohol [see Dosage and Administration (2.4) and Clinical Pharmacology (12.3) ]. Inform patients that a high fat, high calorie meal may delay the absorption of levodopa and the onset of action by 2 to 5 hours. For this reason, consideration should be given to taking the first dose of the day about 1 to 2 hours before eating.
The patient should also be advised that a change in diet to foods that are high in protein may delay the absorption of levodopa and may reduce the amount taken up in the circulation [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3) ]. Advise patients to call their healthcare provider before stopping CREXONT. Discontinue CREXONT slowly.
Tell patients to call their healthcare provider if they develop withdrawal symptoms such as fever, confusion, or severe muscle stiffness [see Dosage and Administration (2.6) and Warnings and Precautions (5.2) ] . Falling Asleep During Activities of Daily Living and Somnolence Advise patients that certain side effects such as sleepiness and dizziness that have been reported with CREXONT may affect some patients’ ability to drive and operate machinery safely [see Warnings and Precautions (5.1) and Adverse Reactions (6.1) ] .
Suicidal Ideation and Suicidal Behavior Instruct patients, family members and caregivers to notify their healthcare provider if suicidal ideation and/or suicidal behavior are experienced by patients using CREXONT [see Warnings and Precautions (5.2) ] . Hallucinations and Psychosis Inform patients that hallucinations can occur with levodopa products [see Warnings and Precautions (5.4) ] . Impulse Control Disorder Inform patients of the potential for experiencing intense urges to gamble, increased sexual urges, and other intense urges and the inability to control these urges while taking one or more of the medications that increase central dopaminergic tone, that are generally used for the treatment of Parkinson’s disease [see Warnings and Precautions (5.5) ] .
Dyskinesia Instruct patients to notify their healthcare provider if abnormal involuntary movements appear or get worse during treatment with CREXONT [see Warnings and Precautions (5.6) ] . Vitamin B6 Deficiency and Seizures Inform patients that vitamin B6 deficiency may develop during treatment with carbidopa/levodopa therapies, including CREXONT. Tell patients to inform their healthcare provider if they develop symptoms such as depression, confusion, cheilosis, glossitis, dermatitis, anemia, neuropathy, and/or seizures [see Warnings and Precautions (5.7) ] .
Hypotension and Syncope Advise patients that they may develop orthostatic hypotension with or without symptoms such as dizziness, nausea, syncope, and sweating [see Adverse Reactions (6.1) ] . Advise patients to rise slowly after sitting or lying down, especially if they have been doing so for a prolonged period. Advise patients of the possible additive sedative effects when taking CNS depressants in combination with CREXONT.
Pregnancy and Breastfeeding Advise patients to notify their healthcare provider if they become pregnant or intend to become pregnant during carbidopa and levodopa extended-release capsule therapy [see Use in Specific Populations (8.1) ] . Instruct patients to notify their physicians if they intend to breast-feed or are breast-feeding an infant [see Use in Specific Populations (8.2) ] .…