From Mr C. M. Roome, MRPharmS
SIR,-A question posed in your "Credit for Learning" feature on neurology is whether breaking a Sinemet CR tablet is recommended. I recall reading in the article by Dr Burn (PJ, March 25, p476) that he stated that breaking the tablet disrupts the slow release mechanism. However, in previous personal communication with the manufacturer I have been advised that breaking the tablet has no effect on the slow release mechanism. It is important to clarify the position as I see patients who break a Sinemet CR tablet and appear well controlled.
For the benefit of all pharmacists could I ask, through your columns, that the precise position on the acceptability or otherwise of breaking Sinemet CR is clarified.
Chris Roome
Clinical Pharmacist, Royal Devon and Exeter Healthcare NHS Trust, Exeter
We have contacted Du Pont Pharmaceuticals, the manufacturer of Sinemet CR, to clarify the position. It has confirmed that it does not recommend breaking CR tablets in half because, as Dr Burn pointed out in his article, this affects the slow-release mechanism. Du Pont says that this is mentioned in the summary of product characteristics and reinforced by a pharmacokinetic study, which showed a 20 per cent increase in bioavailability from halved tablets. The company suggests that patients requiring a lower dose of Sinemet CR should be given Half Sinemet CR.-EDITOR.