Another Commonly Used Drug Faces Nationwide Shortage, Unable to Resume Normal Supply Within the Year

(Yaoyao.com, April 24) Another commonly used drug is out of stock nationwide and will not be normally supplied within this year.

 

Recently, patients across China have reported being unable to purchase Sinemet (carbidopa/levodopa controlled-release tablets).

 

As one of the primary medications for treating Parkinson’s disease, Sinemet has once again faced a “drug shortage” following widespread stockouts across China in 2016. Since shortages began earlier this year, online posts seeking access to Sinemet have rapidly proliferated, with requests visible on social media platforms such as Weibo and various forums.

 

　　

(Source: Sina Weibo, Baidu Tieba)

 

 

Sinemet is one of the primary medications for alleviating and treating Parkinson's disease symptoms. It is a combination formulation of levodopa and carbidopa, regarded by patients as a long-term medication.

 

Clinicians have stated that Sinemet is essentially in the same drug class as Madopar (levodopa/benserazide tablets), which is used to treat Parkinson's disease. However, Sinemet is a controlled-release formulation; although its onset of action is not as rapid as that of Madopar, it has a longer duration of effect. Consequently, Sinemet demonstrates superior efficacy compared with Madopar in improving end-of-dose phenomena and on-off phenomena in Parkinson’s disease.

 

This medication undergoes slow disintegration in the stomach, followed by prolonged release of its active ingredients over a period of 4–6 hours. It has a delayed onset of action but provides sustained therapeutic effects. It is indicated for patients experiencing end-of-dose wearing-off phenomena (loss of efficacy between doses), difficulty turning over in bed at night, and morning stiffness with impaired mobility.

 

 

Currently, there are manyHospitalIt has already been stated that this medication is unavailable, with stockouts occurring in many cities.

 

According to the official WeChat account of the Parkinson’s Disease Patient Association, a supply statement for Sinemet provided by the manufacturer, MSD, indicates that the current shortage is due to issues at the production facility, affecting the global supply of Sinemet. It is expected that the Chinese market will not receive normal supplies within the next year (2019).

 

 

Regarding the shortage of Sinemet, experts advise against excessive panic; instead, patients should address the situation rationally, follow their physicians’ recommendations, and switch to alternative therapeutic regimens.

 

Wu Xi, Associate Chief Physician in the Department of Neurosurgery, and Hou Miaomiao, Attending Physician in the Department of Neurology, at Shanghai Changhai Hospital, stated in a publication that there are multiple options for medication regimen adjustments:

 

1. It can be directly replaced with Madopar. The equivalent dose conversion between the two is: 1 tablet of Sinemet = 3/4 tablet of Madopar. For patients who have never used Madopar, caution dictates that treatment should still begin with a low dose to avoid side effects, particularly gastrointestinal reactions and orthostatic hypotension.

 

2. For patients already receiving concomitant Madopar therapy, individualized considerations should be made based on specific clinical circumstances. For instance, if the previous dose of Madopar per administration was relatively low and the patient does not exhibit significant dyskinesia, an increase in the Madopar dose per administration may be considered.

 

If the dose of Madopar per meal is already relatively high, consideration can be given to switching to Stalevo (a triple combination formulation of levodopa, carbidopa, and entacapone), or adding other anti-Parkinson’s medications, such as dopamine receptor agonists (Trastal, Sifrol, etc.), monoamine oxidase B inhibitors (Selegiline, Rasagiline), or entacapone (Comtan).

 

For patients with Parkinson's disease, there are still significant differences in individual medication regimens. The specific choice of drug substitution depends not only on the medications previously used but also, more importantly, on the clinical issues that need to be addressed. Any adjustment involving drug substitution must be carried out under the guidance of the attending physician; patients should never make arbitrary adjustments on their own.

 

Currently, the number of Parkinson’s disease patients in China has exceeded 2 million, creating a substantial therapeutic demand for Sinemet. We look forward to the resumption of normal supply of “Sinemet” at an early date, thereby urgently addressing the critical needs of a vast patient population.