hi all

At 15:43 1999/10/29 -0700, joe wrote:
>Sinemet CR vs regular
>
>The subject of Sinemet CR vs regular comes up fairly often
>here, and since it's important to many PD newcomers, I'll
>re-plow the terrain; no new data, but perhaps a more easily-
>grasped explanation:
>
>Although Sinemet (even the regular kind) is absorbed rather
>slowly, its levodopa dissipates quickly. You might adjust for
>that by taking bigger doses, but you know that too much in the
>body at once causes dyskinesia, while too little causes the
>familiar "end-of dose" cramps and dystonia. So it's desirable
>to keep the body level of levodopa as constant as possible. You
>might do that by taking tiny doses very often, but that's a
>pain, what you want is the longest interval between doses.
>
>All the regular Sinemet tablets are scored so you can take a
>half tablet at a time, but Dupont Pharma, makers of Sinemet,
>also offer Sinemet CR (Controlled Release), which comes in
>a bigger tablet that dissolves more slowly, and therefore
>lasts longer. The 50/200CRs are scored, so they may be taken
>whole or as the equivalent of two (not scored) 25/100CRs.
>
>The rate of dissolving for either type of Sinemet is proportional
>to the remaining surface area of the tablet, so it is highest at
>first, and then declines as the tablet becomes smaller. But
>slower dissolving makes the effect of the CRs last 2 or 3
>times as long as the equivalent amount of regular Sinemet,
>and the peak concentration, about 2 hours vice 1/2 hour after
>taking, is only about 35% of that from regular Sinemet. So
>you can get away with the bigger (50/200CR) tablet, taken
>half as often as the regular 25/100 tablets.
>
>The slow dissolving rate and prolonged sojourn of Sinemet CR
>also means more time for the levodopa to be degraded before
>it reaches the brain, therefore the total effect is only about
>3/4 as great as regular Sinemet. But, I believe,the total dosage
>may be safely increased to compensate, as the excess merely goes
>to waste. Most patients find they can reduce their total dosage.
>
>One final warning: Don't tinker with Sinemet dosage without the
>supervision, or at least the full trust and confidence, of your
>neurologist. The levodopa component of Sinemet is one of several
>drugs whose abrupt withdrawal or dosage change has, on very rare
>occasion, led to a life-threatening condition similar to
>neuroleptic malignant syndrome. Among the prominent symptoms are
>very high fever and mental changes. Cheers,
>Joe

hey joe

this is a great summary,  thank you!

i have been on sinemet since 1998 with quite wonderful success
in dealing with my major symptoms muscle rigidity and bradykinesia

as time has marched on
i have had to learn more 'finesse' in
managing the doseage level and timing of sinemet
[with my doctor's knowledge and approval]
for 'smooth' coverage' of my pd symptoms

during that 11 year period
once in awhile i would give sinemet cr a try
looking for the magical and sometimes elusive longer 'on' period

but my reaction to CR
was always extreme dyspepsia
as well as fairly extreme dyskinesia
not a pretty sight!

in the past few months i have discovered that
'melting' sinemet CR 25/100 tablets or portions thereof, in my mouth,
[taking maybe 10 to 15 minutes to dissolve an entire tablet]
has given me good 'smoother' results
with no
i said
no
dyspepsia or dyskinesia

who knew?

there is always something new to learn


janet

ps
the usual disclaimer

each one of us is unique with a unique bio-chemical make-up
what works for me may/may not work for you

irregardless,
always consult your doctor
and always go for low and slow titration

brain chemistry is us

janet paterson
52 now / 41 dx / 37 onset
613 256 8340 po box 171 almonte ontario canada K0A 1A0
a new voice: <http://www.geocities.com/SoHo/Village/6263/>
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