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Ghassan Abbas wrote to the List on April 21 asking about Sinemet. Belatedly here is some information that might be informative to others too so I have sent it along to the list. I am sorry that it has taken me so long to reply to your questions about Sinemet. I was doing some other things and had no time to respond to items on the PD List. Sinemet is a combination drug. It contains carbidopa and levodopa. Levodopa is effective if it reaches the brain where it is then converted to dopamine. There are enzymes within the body external to the brain tissues that metabolize lovodopa to dopamine. Dopamine outside of the brain causes many unpleasant side-effects, particulary nausea and dizziness. Carbidopa is an inhibitor of the enzymes capable of metabolizing levodopa to dopamine. Carbidopa itself never reaches the brain. Hence the combination of the two drugs to meet the requirements of providing dopamine to the brain of PD patients who suffer from the loss of the ability to produce adequate supplies of their own doapamine. Sinemet is adsorbed very quickly when taken and provides a "surge" of levodopa to the brain within 15-30 minutes after being taken. Sinemet CR is a sustained or controlled release preparation of the same two medicines, carbidopa and levodopa. As the words imply, the CR formulation releases the drugs slowly over time and thereby provides the patient with a smoother exposure to levodopa and carbidopa over a longer period of time. Different patients at different stages of their disease require varied amounts of carbidopa and levodopa. Some patients need the standard preparation while others do well on the CR preparation. The amount required by any individual will vary and should be worked out with their physician. Best regards, Joe Irr - Worldwide Product Manager - The Sinemet Brand DuPont Pharma ([log in to unmask])