{"id":55983,"date":"2024-02-07T05:48:23","date_gmt":"2024-02-07T05:48:23","guid":{"rendered":"https:\/\/medsname.com\/syndopa\/"},"modified":"2026-05-01T10:49:13","modified_gmt":"2026-05-01T10:49:13","slug":"syndopa","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/syndopa\/","title":{"rendered":"Syndopa"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Syndopa<\/strong> je tableta s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm kombinuj\u00edc\u00ed levodopa + karbidopa<\/strong> (110 mg (100\/10) a 275 mg (250\/25)) \u2014 z\u00e1kladn\u00ed l\u00e9\u010dba pro Parkinsonova choroba<\/strong>. Levodopa se v mozku p\u0159em\u011b\u0148uje na dopamin, aby nahradila to, co ji\u017e degeneruj\u00edc\u00ed nigr\u00e1ln\u00ed neurony nedok\u00e1\u017eou produkovat; karbidopa blokuje tuto p\u0159em\u011bnu mimo mozek, tak\u017ee v\u00edce levodopy se dostane do centr\u00e1ln\u00edho nervov\u00e9ho syst\u00e9mu s men\u0161\u00edmi perifern\u00edmi vedlej\u0161\u00edmi \u00fa\u010dinky (nevolnost, zvracen\u00ed, pokles krevn\u00edho tlaku). Dostupn\u00e9 ve dvou sil\u00e1ch: 110 mg<\/strong> = 100 mg levodopy + 10 mg karbidopy (n\u00edzk\u00e1 d\u00e1vka karbidopy), a 275 mg<\/strong> = 250 mg levodopy + 25 mg karbidopy. Verze s 25 mg karbidopy je preferov\u00e1na u v\u011bt\u0161iny pacient\u016f, proto\u017ee denn\u011b je pot\u0159eba 75\u2013100 mg karbidopy k pln\u00e9mu nasycen\u00ed perifern\u00ed dekarboxyl\u00e1zy \u2014 pod touto hladinou jsou b\u011b\u017en\u00e9 perifern\u00ed vedlej\u0161\u00ed \u00fa\u010dinky (nevolnost, hypotenze). Kritick\u00e9:<\/strong> nikdy nep\u0159eru\u0161ujte levodopu n\u00e1hle \u2014 riziko neuroleptick\u00e9ho malign\u00edho syndromu<\/em>. D\u00e1vkov\u00e1n\u00ed mus\u00ed b\u00fdt postupn\u011b sni\u017eov\u00e1no.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Co je Syndopa?<\/h2>\n

Syndopa je peror\u00e1ln\u00ed tableta obsahuj\u00edc\u00ed levodopa + karbidopa 110 mg (100\/10) a 275 mg (250\/25)<\/strong> v s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm<\/strong> formulace. Tato kombinace je z\u00e1kladem l\u00e9\u010dby Parkinsonovy choroby od 70. let 20. stolet\u00ed a z\u016fst\u00e1v\u00e1 nej\u00fa\u010dinn\u011bj\u0161\u00ed jednotlivou l\u00e9\u010dbou motorick\u00fdch p\u0159\u00edznak\u016f (bradykineze, rigidita, tremor). P\u016fvodn\u011b byla uv\u00e1d\u011bna na trh pod n\u00e1zvem Sinemet<\/strong>. Syndopa je vyr\u00e1b\u011bna ve v\u00fdrobn\u00edm z\u00e1vod\u011b certifikovan\u00e9m podle WHO-GMP a je bioekvivalentn\u00ed s origin\u00e1ln\u00ed zna\u010dkou ve stejn\u00e9 s\u00edle.<\/p>\n

Jak Syndopa funguje?<\/h2>\n

Parkinsonova choroba je d\u016fsledkem postupn\u00e9ho \u00fabytku neuron\u016f produkuj\u00edc\u00edch dopamin v substantia nigra<\/em>. Levodopa<\/strong> je bezprost\u0159edn\u00edm biochemick\u00fdm prekurzorem dopaminu; na rozd\u00edl od samotn\u00e9ho dopaminu p\u0159ekon\u00e1v\u00e1 hematoencefalickou bari\u00e9ru. Jakmile se dostane do mozku, p\u0159e\u017e\u00edvaj\u00edc\u00ed neurony jej dekarboxyluj\u00ed na dopamin, \u010d\u00edm\u017e obnovuj\u00ed synaptick\u00e9 hladiny dopaminu a zlep\u0161uj\u00ed motorickou kontrolu.<\/p>\n

Probl\u00e9m: kdy\u017e je levodopa pod\u00e1v\u00e1na samotn\u00e1, >95 % se p\u0159em\u011bn\u00ed na dopamin v perifern\u00edch tk\u00e1n\u00edch, ne\u017e dos\u00e1hne mozku \u2014 co\u017e zp\u016fsobuje silnou nevolnost, zvracen\u00ed a ortostatickou hypotenzi a nut\u00ed pou\u017eit\u00ed vysok\u00fdch d\u00e1vek. Carbidopa<\/strong> je perifern\u00ed inhibitor aromatick\u00fdch-aminokyselin dekarboxyl\u00e1zy. Sama nep\u0159ekon\u00e1v\u00e1 hematoencefalickou bari\u00e9ru, ale blokuje rozklad levodopy v perifern\u00edch tk\u00e1n\u00edch. V\u00fdsledek: 4\u20135kr\u00e1t ni\u017e\u0161\u00ed d\u00e1vka levodopy pot\u0159ebn\u00e1 pro stejn\u00fd \u00fa\u010dinek v mozku a mnohem m\u00e9n\u011b gastrointestin\u00e1ln\u00edch\/kardiovaskul\u00e1rn\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f.<\/p>\n

Pro koho je Syndopa ur\u010dena?<\/h2>\n

Syndopa je vhodn\u00e1 pro dosp\u011bl\u00e9 s idiopatickou Parkinsonovou chorobou, kte\u0159\u00ed pot\u0159ebuj\u00ed symptomatickou \u00falevu od motorick\u00fdch p\u0159\u00edznak\u016f, v\u010detn\u011b:<\/p>\n

    \n
  • Nov\u011b diagnostikovan\u00fdch pacient\u016f, u kter\u00fdch p\u0159\u00edznaky naru\u0161uj\u00ed ka\u017edodenn\u00ed fungov\u00e1n\u00ed (zejm\u00e9na star\u0161\u00edch pacient\u016f \u2014 u mlad\u0161\u00edch pacient\u016f neurologov\u00e9 \u010dasto za\u010d\u00ednaj\u00ed s dopaminov\u00fdm agonistou nebo inhibitorem MAO-B, aby odd\u00e1lili dyskineze souvisej\u00edc\u00ed s levodopou).<\/li>\n
  • Pacienti na agonistech dopaminu nebo inhibitory MAO-B, u kter\u00fdch do\u0161lo k progresi p\u0159\u00edznak\u016f a nyn\u00ed pot\u0159ebuj\u00ed dal\u0161\u00ed motorick\u00fd benefit.<\/li>\n
  • Pacienti vy\u017eaduj\u00edc\u00ed rychlou \u00falevu od p\u0159\u00edznak\u016f \u2014 levodopa s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm dosahuje maxim\u00e1ln\u00ed plazmatick\u00e9 koncentrace za 30\u201360 minut, ide\u00e1ln\u00ed pro rann\u00ed d\u00e1vku k p\u0159ekon\u00e1n\u00ed rann\u00ed akineze.<\/li>\n
  • Jako \u201cdopln\u011bk\u201d pro zvl\u00e1dnut\u00ed pr\u016flomov\u00fdch p\u0159\u00edznak\u016f u pacient\u016f jinak u\u017e\u00edvaj\u00edc\u00edch l\u00e9ky s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm.<\/li>\n
  • N\u011bkte\u0159\u00ed pacienti s parkinsonismem z jin\u00fdch p\u0159\u00ed\u010din (postencefalitick\u00fd, intoxikace manganem, n\u011bkter\u00e9 atypick\u00e9 syndromy) \u2014 pod odborn\u00fdm dohledem, s v\u011bdom\u00edm, \u017ee odpov\u011b\u010f je obvykle m\u00e9n\u011b v\u00fdrazn\u00e1 ne\u017e u idiopatick\u00e9 PD.<\/li>\n<\/ul>\n

    Nevhodn\u00e9 pro:<\/strong> pacienti s uzav\u0159en\u00fdm \u00fahlem glaukomu, podez\u0159en\u00edm na melanom nebo nediagnostikovanou ko\u017en\u00ed l\u00e9z\u00ed, t\u011b\u017ekou psychotickou poruchou nebo sou\u010dasn\u00fdm u\u017e\u00edv\u00e1n\u00edm neselektivn\u00edho inhibitoru MAO (do 14 dn\u016f).<\/p>\n

    D\u00e1vkov\u00e1n\u00ed a pod\u00e1v\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n\n
    F\u00e1ze<\/th>\nTypick\u00e9 d\u00e1vkov\u00e1n\u00ed<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    Zah\u00e1jen\u00ed<\/td>\nPolovina (nebo cel\u00e1) tableta 110 mg nebo 275 mg 3\u00d7 denn\u011b s j\u00eddlem<\/td>\nMen\u0161\u00ed d\u00e1vky u pacient\u016f n\u00e1chyln\u00fdch k nevolnosti nebo u star\u0161\u00edch osob<\/td>\n<\/tr>\n
    Titrace (t\u00fddenn\u00ed)<\/td>\nZvy\u0161ovat o p\u016fl tablety (nebo o celou 110 mg) ka\u017ed\u00e9 2\u20137 dn\u00ed<\/td>\nA\u017e do dosa\u017een\u00ed adekv\u00e1tn\u00ed kontroly p\u0159\u00edznak\u016f nebo v\u00fdskytu ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f<\/td>\n<\/tr>\n
    Typick\u00e1 udr\u017eovac\u00ed d\u00e1vka<\/td>\n300\u20131000 mg levodopy\/den v 3\u20135 d\u00edl\u010d\u00edch d\u00e1vk\u00e1ch<\/td>\nPlus minim\u00e1ln\u011b 75\u2013100 mg karbidopy\/den<\/td>\n<\/tr>\n
    Maxim\u00e1ln\u011b<\/td>\nPraktick\u00fd limit ~2000 mg levodopy\/den; z\u0159\u00eddka pot\u0159ebn\u00e9<\/td>\nVy\u0161\u0161\u00ed d\u00e1vky zp\u016fsobuj\u00ed dyskineze p\u0159i vrcholn\u00e9 d\u00e1vce<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Syndopa je s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm<\/strong> formulace. N\u00e1stup \u00fa\u010dinku do 30\u201360 minut; vrchol \u00fa\u010dinku za 1\u20131,5 hodiny; doba trv\u00e1n\u00ed 3\u20135 hodin na d\u00e1vku v ran\u00e9m st\u00e1diu onemocn\u011bn\u00ed, zkracuje se na 2\u20133 hodiny s postupem onemocn\u011bn\u00ed. Prvn\u00ed d\u00e1vka dne je obvykle nejd\u016fle\u017eit\u011bj\u0161\u00ed \u2014 mnoho pacient\u016f ji u\u017e\u00edv\u00e1 je\u0161t\u011b p\u0159ed t\u00edm, ne\u017e vstanou z postele (s malou sva\u010dinou, nap\u0159\u00edklad su\u0161enkou), aby p\u0159eru\u0161ili rann\u00ed akin\u00e9zu.<\/p>\n

    U\u017e\u00edvat s j\u00eddlem obsahuj\u00edc\u00edm b\u00edlkoviny nebo bez?<\/strong> Levodopa sout\u011b\u017e\u00ed o absorpci s dietn\u00edmi aminokyselinami (velk\u00e9 neutr\u00e1ln\u00ed aminokyseliny \u2014 LNAA \u2014 z b\u00edlkovinn\u00fdch j\u00eddel). U v\u011bt\u0161iny pacient\u016f v ran\u00fdch letech nen\u00ed tato konkurence v\u00fdznamn\u00e1; u\u017e\u00edvejte s j\u00eddlem, pokud je probl\u00e9m nevolnost. U pacient\u016f s motorick\u00fdmi fluktuacemi<\/strong>, u\u017e\u00edvejte levodopu 30 minut p\u0159ed<\/strong> j\u00eddlem obsahuj\u00edc\u00edm b\u00edlkoviny (nebo 1 hodinu po) pro maximalizaci absorpce. N\u011bkte\u0159\u00ed odborn\u00edci doporu\u010duj\u00ed sn\u00eddani\/ob\u011bd s n\u00edzk\u00fdm obsahem b\u00edlkovin a p\u0159esunout v\u011bt\u0161inu b\u00edlkovin na ve\u010de\u0159i.<\/div>\n

    Dlouhodob\u00e9 probl\u00e9my: Motorick\u00e9 fluktuace a dyskineze<\/h2>\n

    Po 5\u201310 letech l\u00e9\u010dby levodopou se u mnoha pacient\u016f rozvinou:<\/p>\n

      \n
    • Vymizen\u00ed \u00fa\u010dinku<\/strong> \u2014 ka\u017ed\u00e1 d\u00e1vka p\u016fsob\u00ed krat\u0161\u00ed dobu; p\u0159\u00edznaky se vracej\u00ed p\u0159ed dal\u0161\u00ed d\u00e1vkou. \u0158e\u0161\u00ed se krat\u0161\u00edmi intervaly mezi d\u00e1vkami, p\u0159id\u00e1n\u00edm inhibitoru COMT (entakapon) nebo inhibitoru MAO-B (rasagilin, safinamid).<\/li>\n
    • Fenom\u00e9n on\u2013off<\/strong> \u2014 n\u00e1hl\u00e9 nep\u0159edv\u00eddateln\u00e9 p\u0159echody mezi pohybliv\u00fdm (\u201con\u201d) a ztuhl\u00fdm (\u201coff\u201d) stavem.<\/li>\n
    • Dyskineze<\/strong> \u2014 mimovoln\u00ed kroutiv\u00e9 nebo krouciv\u00e9 pohyby p\u0159i maxim\u00e1ln\u00ed koncentraci levodopy. \u0158e\u0161\u00ed se sn\u00ed\u017een\u00edm jednotliv\u00fdch d\u00e1vek, p\u0159id\u00e1n\u00edm amantadinu nebo zm\u011bnou l\u00e9kov\u00e9 formy.<\/li>\n
    • Zamrznut\u00ed ch\u016fze<\/strong> \u2014 kr\u00e1tkodob\u00e1 neschopnost za\u010d\u00edt nebo pokra\u010dovat v ch\u016fzi. M\u00e9n\u011b citliv\u00e9 na medikaci; fyzioterapeutick\u00e9 strategie (vizu\u00e1ln\u00ed podn\u011bty, rytmick\u00e1 hudba) \u010dasto pom\u00e1haj\u00ed v\u00edce.<\/li>\n<\/ul>\n

      Tyto probl\u00e9my je snaz\u0161\u00ed odd\u00e1lit, ne\u017e je l\u00e9\u010dit, jakmile se objev\u00ed \u2014 jeden z d\u016fvod\u016f, pro\u010d se u mlad\u0161\u00edch pacient\u016f n\u011bkdy za\u010d\u00edn\u00e1 s dopaminov\u00fdmi agonisty nebo inhibitory MAO-B.<\/p>\n

      B\u011b\u017en\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n

      Na za\u010d\u00e1tku l\u00e9\u010dby:<\/strong> nevolnost, zvracen\u00ed, nechutenstv\u00ed, ortostatick\u00e1 hypotenze, z\u00e1vrat\u011b, sucho v \u00fastech. V\u011bt\u0161ina p\u0159\u00edznak\u016f ustoup\u00ed do 2\u20134 t\u00fddn\u016f. U\u017e\u00edv\u00e1n\u00ed s j\u00eddlem nebo domperidonem pom\u00e1h\u00e1.<\/p>\n

      P\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed:<\/strong> dyskineze (mimovoln\u00ed pohyby p\u0159i maxim\u00e1ln\u00ed d\u00e1vce), motorick\u00e9 fluktuace (vymizen\u00ed \u00fa\u010dinku, fenom\u00e9n on\u2013off), halucinace, \u017eiv\u00e9 sny, poruchy impulzivn\u00ed kontroly (m\u00e9n\u011b \u010dast\u00e9 ne\u017e u dopaminov\u00fdch agonist\u016f), nespavost, n\u00e1hl\u00fd n\u00e1stup sp\u00e1nku, ne\u0161kodn\u00e9 \u010dervenohn\u011bd\u00e9 zabarven\u00ed mo\u010di a potu.<\/p>\n

      M\u00e9n\u011b \u010dast\u00e9:<\/strong> zmatenost, paranoia, deprese, m\u00e1nie, gambling\/hypersexualita, neuroleptick\u00fd malign\u00ed syndrom p\u0159i n\u00e1hl\u00e9m vysazen\u00ed.<\/p>\n

      \u26a0 Nikdy nevysazujte levodopu n\u00e1hle<\/strong> N\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat neuroleptick\u00fd malign\u00ed syndrom<\/em>: vysokou hore\u010dku, svalovou rigiditu, autonomn\u00ed nestabilitu, zv\u00fd\u0161enou hladinu CK a poruchu v\u011bdom\u00ed. Jedn\u00e1 se o l\u00e9ka\u0159skou pohotovost. Pokud mus\u00edte levodopa vysadit \u2014 kv\u016fli operaci, hospitalizaci, v\u00e1\u017en\u00e9mu onemocn\u011bn\u00ed \u2014 m\u011blo by to b\u00fdt pl\u00e1nov\u00e1no a postupn\u011b sni\u017eov\u00e1no ve spolupr\u00e1ci s neurologem. Pokud jej nem\u016f\u017eete z jak\u00e9hokoli d\u016fvodu u\u017e\u00edvat peror\u00e1ln\u011b, okam\u017eit\u011b kontaktujte sv\u016fj t\u00fdm ohledn\u011b transderm\u00e1ln\u00edho rotigotinu nebo apomorfinov\u00e9ho m\u016fstku.<\/div>\n

      Interakce s l\u00e9ky a potravinami<\/h2>\n