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Hey Brian and Fellow List-family Don't forget to factor in the difference between taking Sinemet with a sweet beverage as such as fruit juice or soda pop as opposed to taking it with water or maybe coffee.... For those who don't know, Sinemet works faster, smoother AND generally a bit better, with "better" being different in each PWP, as a rule). Sooo.... no matter what dosage of Sinemet you're scarfing down each day, the OUTCOME can be noticeably and fairly consistantly bettered by WHAT you drink when you take your daily Sinemet. Another thin gyou might not be aware of is that if you're starting to go into an "off" mode, you MAY be able to forstall the "off" or lessen it's immediate impact for a while by eating a few teaspoons of ice cream or drinking a sweet beverage - even eating a cookie - 'cause apparently sugar or honey is a "Sinemet booster" or possibly a buffer. This "sweet phenomana" isn't just a figment of imagination for a few "On the fringe crackpots" (NOT that any of YOU are an "on the fringe crackpot!! <wee smirk>. Rather, it's a bona fide benefit that many Parkies AND physicians stumble on (Heck - many of US stumble at the drop of a hat as it is!) <GROAN> by accident. Barb Mallut [log in to unmask] al Message----- From: Brian Collins <[log in to unmask]> To: [log in to unmask] <[log in to unmask]> Date: Tuesday, January 25, 2000 8:07 AM Subject: Re: Sinemet >On Tue 25 Jan, William A. Parrette wrote: >> Hi all, >> >> On Mon, 24 Jan 2000, the digest contained: >> >> > ... >> > Date: Mon, 24 Jan 2000 11:01:27 -0500 >> > From: "Hawkins, Darwin" <[log in to unmask]> >> > Subject: Re: Sinemet >> > >> > Would taking one 25/100 every 3 hours be closer to approximating the desired >> > effect of one 50/200 every 6 hours? Seems to me it would smooth things out. >> > ... >> >> First, let me say (as has been said before) everybody's physi- >> ology is different and different medications rarely have the same >> effect on two different people. This is especially true with PW- >> Ps and Sinemet. >> >> That being said: >> >> 25 mg. Carbidopa/100 mg. Levodopa x 8 (every 3 hours) = >> 200 mg. Carbidopa/800 mg. Levodopa a day >> >> 50 mg. Carbidopa/200 mg. Levodopa x 4 (every 6 hours) = >> 200 mg. Carbidopa/800 mg. Levodopa a day >> >> And, although apparently the same levels of each ingredient is >> being used, the regular Sinemet delivery would have "spikes" in >> its delivery-graph and effectiveness. Where the CR (controlled >> release) version's delivery-graph would be smoother. In theory, >> the delivery of the CR is spread out more evenly over its effec- >> tive period which results in a more even control of the tremors; >> where the non-CR version would result in more control soon after >> the dose was taken and less control toward the end of its effec- >> tive period. >> >> If I remember correctly, the delivery-graphs for both products >> are available at: >> >> http://www.sinemetcr.com/ >> >> But, then again, all us PWPs is different ... :-) > > > >I must write a few words to try and bring a degree of consistency to the >discussion about Sinemet tablets, in particular the CR200/50, CR100/25 and >plain Sinemet 100/25. > >The first thing to understand is that the effective duration of any of the >types of tablet mentioned here is totally outside the control of the PWP. > >The effective duration of these tablets is controlled for the most part by >the particular characteristics ofthe PWP's digestive system, with >contributions from the lower intestine, the blood system, and the >blood/Brain barrier. In addition, a newly-diagnosed PWP will tend to get >a longer period of effectiveness than a long-term PWP. As you will see, >none of those variables can be altered by us, to suit some drug schedule >which we have dreamed-up. I would estimate that at least half the drug >schedules that I see fail to recognise this single, fundamental fact. >For example; Sinemet 100/25 has (for me) an effective duration of 2 hours. >If I was told to take one tablet every 4 hours and did so, I would get >a situation in which I got the full dose of levodopa over the first 2 >hours, and then 2 hours of NOTHING until the next tablet is taken. >This is just about the worst thing to do to a system trying to stay 'ON' >without the worry of dyskinesias: You will get the dyskinesias during the >first 2 hours, but suffer from a total 'OFF' during the second 2 hours. > >So what can you do? It is quite simple really, you experiment on yourself. >Yes, here we go again- it is dangerous to fiddle with your drugs etc. etc. >so alright, ask your neuro to administer the tests - you may both learn >something. All you want to know is what is your 'Magic Number' - the time >interval which, if you take one Sinemet 100/25 at that rate, will give you >a constant, uninterrupted flow of effectiveness. Only then, can you think >about tailoring the size of the dose. > >For the CR tablets, the principle is exactly the same, except that the >CR200 (in my tests) had an effective life of 4 hours, giving an excellent >50 mg/hour flow rate. When I did these tests (about 7 or 8 years ago), >there were no CR100 tablets available from Sinemet. There were some >Madopar CR100/25 however, so I tried those and was impressed to see that >the CR100 lasted the same time - 4 hours, and at all points delivered >exactly half the amounr of levadopa as the Sinemet CR200/50. I wouldn't be >at all surprised to find that the new Sinemet CR100/25 was the same, in >which case you can simply take two CR100s and get exactly the same result >as if you took 1 CR200. > >Since that answers the original question, I will stop there. Further >reading can be found on Simon Cole's Web site >Regards, > > http://james.parkinsons.org.uk/brian.htm >-- >Brian Collins <[log in to unmask]> (59/39/34)