Hi,  Here is part 3 of Living with Levodopa


   4.3   Sinemet CR (125 and 250) , Madopar CR (125).    The CR in these
formulations stands for Controlled Release.  In the Sinemet tablet, the
surface of the tablet is designed to dissolve at a pre-determined rate,
thus releasing the levodopa at a certain rate.  What rate is actually
achieved will depend on the efficiency of the individual's digestive s
ystem. In my case, the tablet took 4 hours to dissolve, so with a total
load of 200 mg of levodopa, The rate was 50mg/hour. The intention behind
the design of these tablets is excellent, because the control of the
system is a matter of dealing  with varying rates of flow.  Unfortunately,
with only one rate of flow to play with, it is not possible to fine-tune
the system.  Nevertheless, while you can tolerate the flow rate, these
tablets are effective and do not subject the system to large unwanted
excursions.  The Madopar CR comes in the form of a capsule containing
numerous little balls  having different release rates. They only come in
one size,(100mg  levodopa) but the larger Sinemet CR (200 mg) can be
emulated simply by taking two capsules of Madopar at the same time. The
dissolve rate of the Madopar CR is effectively the same as the Sinemet CR.

   4.4   Madopar Dispersible tablets are designed to dissolve in water.
This seems to speed-up the transfer of the drug into the blood stream,
and makes the Dispersible formulation one of the fastest ways of getting
from 'off'to'on' (see Liquid Sinemet). There are two sizes; 62.5 and 125
(containing 50 and 100 mg of levodopa).  Another minor point about these
tablets is that they are laced with Citric Acid, which makes them quite
pleasant to suck and dissolve in the mouth.  When you take one or more
tablets every two hours, as I do, access to a drink of water is often not
available. I actually take all of my levodopa in the Madopar Dispersible
form, and take them all by sucking them in my mouth.

  4.5  I cannot over-emphasize the fact that although the tablets
containing 100 mg of levodopa are apparently the most popular, they
represent an extremely blunt implement when trying to follow the path of
minimum levodopa use.  To this end, I use the 62.5 Madopar Dispersible
tablets because they allow more precise control of the levodopa. Where
necessary, I break the tablet into half and even quarters.  (Try slicing
a 12.5 mg piece off a 200mg tablet!)  My particular optimum rate of
consumption of levodopa is 37.5 mg perhour. I get that flow rate by taking
1 and 1/2 tablets every 2 hours.

  5.0  Countries in which Madopar is available.
 (I assume that Sinemet is universally available)  Madopar is known to be
 available in the following countries:-

            Country         Local name

         Australia          Madopar
         Austria            Madopar
         Belgium            Prolopa
         Canada             Prolopa
         Denmark            Madopar
         Finland            Madopar
         France             Madopar
         Germany            Madopar
         Greece             Madopar
         Holland            Madopar
         Ireland            Madopar
         Italy              Madopar
         Luxemburg          Prolopa
         Norway             Madopar
         Portugal           Madopar
         Spain              Madopar
         Sweden             Madopark
         Switzerland        Madopar
         Taiwan             Madopar
         Turkey             Madopar
         UK                 Madopar
         New Zealand        Madopar


   6.0  Speed of Action.  It can be very frustrating , waiting for the first
dose of the day to take effect.  The speed with which this happens is a very
personal thing, because to a large degree it willl depend on your ability to
transfer the levodopa into the blood stream and from there into the brain.
You should be aware that if you are aiming for the  'minimum useage'
philosophy which I advise, the time to come 'on line' is increased, because
there is a rounding-off if the correct value has been taken.


     6.1  Liquid Sinemet.  This is a descriptive name given to a solution of
ground-up Sinemet disolved in Orange Juice.  The reasons why this mixture
should be so fast are not totally clear, but there is no doubt that it is
fast!  Also, it is a neat way to set up a system to produce any 'Designer
Rate of flow' that you choose, in terms of milligrams per 100 ml of Orange
Juice. There is one snag, and it is a side-effect of the speed of operation.
Remember that we are always trying to maintain a constant rate of input of
levodopa  to the brain: The Liquid Sinemet characteristic is in contrast a
case of fast in, dump the load, and fast out, which is precisely what we do
not want. On balance, I  have decided not to use it myself, but it can be
useful for experimenation.
--
Brian Collins  <[log in to unmask]>