Sinemet Shortage Update: What Patients Need to Know in 2026

If you depend on Sinemet or generic carbidopa/levodopa for Parkinson's disease management, you deserve a clear, current picture of the supply situation. Here is what we know as of early 2026.

Current Status: Which Formulations Are in Shortage?

The shortage does not affect all formulations equally. Here is the current breakdown:

Immediate-release (IR) tablets — Relatively stable. Multiple manufacturers (Teva, Amneal, Sun Pharma, and others) produce IR tablets in the 10/100 mg, 25/100 mg, and 25/250 mg strengths. Spot shortages occur at individual pharmacies, but overall supply is more reliable than other formulations.

Extended-release (ER/CR) tablets — Active shortage. As of early 2026, carbidopa/levodopa extended-release tablets remain on the American Society of Health-System Pharmacists (ASHP) shortage list. Accord Healthcare discontinued the 25/100 mg ER strength; only the 50/200 mg ER remains from Accord. Availability of the 25/100 mg ER varies by region and pharmacy.

Orally disintegrating tablets (ODT) — Discontinued. Sun Pharma stopped making carbidopa/levodopa ODT in December 2022. Viatris (Mylan) discontinued them in 2021. There are currently no generic ODT manufacturers actively supplying the market.

Brand ER capsules (Rytary, Crexont) — Available. These brand-name extended-release formulations are not in shortage. However, they are significantly more expensive than generic tablets and typically require prior authorization from insurance.

A Brief History of the Sinemet Shortage

Intermittent shortages of carbidopa/levodopa have been reported to the ASHP and FDA since the early 2010s. The problem intensified significantly when Merck announced in 2019 that it would discontinue Sinemet CR (the extended-release brand version). This announcement caused supply-chain disruption as the market shifted entirely to generic manufacturers—and there weren't enough of them to absorb the demand reliably.

Subsequent manufacturer exits—including Viatris and Sun Pharma dropping ODT formulations and Accord discontinuing the 25/100 mg ER strength—further narrowed the supply base. Each exit leaves fewer redundant sources, making the entire supply more fragile.

What the FDA Is Doing

The FDA is aware of the extended-release tablet shortage and has been in contact with manufacturers to expedite production. The agency has also communicated to patients and providers that IR tablets remain available as a therapeutic substitute for most patients. However, no confirmed resolution date has been announced for the ER tablet shortage.

In March 2026, the FDA also issued a MedWatch safety warning requiring updated labeling for all carbidopa/levodopa products regarding vitamin B6 (pyridoxine) deficiency. Long-term use of carbidopa/levodopa can deplete vitamin B6 levels, potentially causing seizures. Patients taking these medications should ask their doctor about monitoring B6 levels.

What Patients Should Do Right Now

Do not wait until you run out. Start searching for your refill 10–14 days before you need it. Contact your prescriber if you anticipate a problem—they can sometimes call pharmacies directly or authorize an early refill.

Use a pharmacy-finding service. medfinder will call pharmacies near you to check current stock of your exact dose and formulation, saving you hours of phone calls.

Ask about a 90-day supply. If your insurance allows it, filling 90 days at once reduces the frequency of this search and gives you a buffer. Mail-order pharmacies often have better access to generics.

Talk to your neurologist about alternatives. If ER tablets remain unavailable, your doctor can convert you to immediate-release tablets or discuss brand ER capsules (Rytary, Crexont) as a temporary or permanent alternative.

Ask your doctor about vitamin B6 monitoring. In response to the new FDA warning, your doctor may want to check your B6 levels, especially if you have been on carbidopa/levodopa for a long time.

Will the Shortage End in 2026?

There is cautious reason for optimism. Additional generic manufacturers may enter the extended-release market, which would help ease the shortage. Crexont, approved by the FDA in 2024, offers an alternative ER option. But FDA approval timelines for new generics are unpredictable, and no specific resolution date has been announced for the current ER tablet shortage.

For more detail on supply chain causes, see why Sinemet is so hard to find in 2026. And if you need to discuss alternatives with your doctor, our guide on alternatives to Sinemet provides a full comparison.