Guidance for People with Parkinsons and their doctors resulting from the recent notice of the pending Sinemet® product shortage

MSD the pharmaceutical company who produce Sinemet® products notified the Irish medicine regulatory body, the HPRA, that there will be a temporary shortage in two of their Sinemet® products from October. The shortage duration is anticipated to last a number of months with the expected return to medication availability Spring 2019. The shortage is temporary, global and described by MSD as due to manufacturing constraints at a global level.

What medicines will be affected?

Only the 2 medicines - Sinemet Plus® (25/100) and Sinemet®25/250 are affected in the first instance.

Supply of all other medicines for People with Parkinson’s is unaffected.

When will the medicines shortage start? How long will it last?

The shortage is likely to come into effect during October this year.

Information supplied by MSD suggests a normal return to medicines availability in Spring 2019.

We recommend that over the next few months you fill your Sinemet® prescription about a week before it runs out to allow a satisfactory alternative to be sourced.

What alternatives are available?

As things currently stand, the medication substitution options for patients established on Sinemet products are:

  1. Multiple dosings of Sinemet® 12.5/50 for Sinemet® 25/100

  1. Substituting Sinemet® 10/100 for Sinemet® 25/100 (the ‘10’ rather than ‘25’ of carbidopa may cause some nausea in some patients)

  1. Substituting Sinemet® CR 50/200 for Sinemet®25/200

  1. Generic co-careldopa at equivalent levodopa dose

  1. Madopar® - co-beneldopa – capsules at equivalent levodopa dose

  1. Stalevo® - likely at equivalent levodopa dose or ‘consider small dose reduction’

Will I notice any difference on the new medication?

The basic active agent in Sinemet® and the alternatives above is levodopa so you should be optimistic that your Parkinson’s can be controlled close to current levels with the Sinemet® alternatives.  In the event that your PD control worsens then other therapy options can be explored directly with your prescriber/specialist.

How do I get more information?

Your local pharmacist can help around what alternatives are readily available and to ensure that they don’t interaction with other medications you may be on.

Your GP can help with the prescription of alternatives.

Your Parkinson’s Nurse specialist and PD doctor can also advise on alternatives.

When information around return of normal medicines becomes available to us we will quickly let the advocacy groups – Parkinson’s Association of Ireland and Move 4Parkinson’s know so that they can help share the information. We will also inform General Practitioners through their College, the ICGP.


Dr. Graham Hughes - Geriatrician St. Vincent’s University Hospital

Professor Tim Lynch - Neurologist Mater Misericordiae University DublinHospital, Dublin


Follow Us