Mike, I'=92ll try to answer as many of your questions as I can, but I don=92t hav= e all=20 the answers. Perhaps others were also reluctant to try to answer so many at= =20 once. > Is a total of one CR 25/100 tablet a day enough ? It doesn't seem so, > based on my reading....or is this a good starting point ? It=92s a good starting point, but the dosage should be gradually increased = over=20 a period of a couple of weeks until an effective level is reached. The=20 effective level depends on a variety of factors and there is no way it can = be=20 predicted. > When is the best time to take the medicine and how long between doses ? I > started her with half a tablet early in the AM and the other half around > noon. Is this good ? What is the useful time range for half a 25/100 for = a >=20 > smaller women.? Again, the answers can only be found by trial and error. Once you find the= =20 effective level the medication should be spaced equally throughout the day.= =20 When I first started on Sinemet I took one 25/100 three times a day: mornin= g,=20 noon, and evening, and one dose lasted about six hours. Now I take one 25/2= 50=20 three times a day and one dose by itself lasts only 1-2 hours (however, I a= m=20 also taking Pramipexole and that increases the effective time to about four= =20 hours). > Is Nausea really a problem if the Sinemet is taken well before a meal ? > Can the lodosyn be reduced after the startup period ?....(relying on the > carbidopa in the CR 25/100 combination pill to hold down nausea ?) Nausea is the most common side-effect of Sinemet and usually the first one= =20 encountered (my first dose made me so sick I had to go to bed!), but you=20 eventually get used to it. For the first 6 months I was taking Sinemet I=20 experienced nausea at least once a week, but during the past year I=92ve=20 experienced it only two or three times. Taking the Sinemet with a meal does= =20 help control the nausea but reduces the absorption rate of the medication. > What's the real issue with milk and dairy products ? I have read that Lom= a > Linda recommends against it...yet others seem to say "no problem". Do mil= k > or dairy products have this wide a range of effect on different individua= ls? All I know about dairy products is that they slow down the absorption rate.= In=20 fact several people in my support group who are on high doses of Sinemet an= d=20 who frequently suffer from dyskinesia take dairy products (usually milk and= /or=20 ice cream) to counteract it. > she must get normal protein levels to maintain weight and body strength b= ut=20 > how restrictive does one have to be, if the medicines are to be useful ? Various studies that have been conducted suggest that a 1:7 ratio between= =20 protein and carbohydrates is the most effective for PD patients. The only= =20 effect of eating a lot of protein is that it is in competition with Ldopa f= or=20 the enzyme that converts Ldopa to dopamine. Personally, I don=92t pay that = much=20 attention to it. > What side effects does Sinemet have ? It seems I've read that it causes > sleep problems ?? This is a listing from my Drug Reference Guide: Sinemet-25/250 (Carbidopa/Levodopa) 25/250 Tablet=20 LEVODOPA WITH CARBIDOPA - ORAL=20 (Prescription medication.)=20 Uses:=20 This medication is used to treat symptoms of Parkinson's disease. Carbidopa= is=20 used to make levodopa more effective. Carbidopa has no effect when given=20 alone. =20 How to Use This Medication:=20 Take with food or milk to prevent stomach upset, unless your doctor directs= =20 you otherwise. Take this drug as directed. It may take a few weeks before t= he=20 full benefits of this medication are observed. =20 Side Effects:=20 May cause drowsiness, dizziness, headache, loss of appetite, stomach upset,= =20 vision changes, unusual body odor or trembling of the hands. These should= =20 subside as your body adjusts to the medication. If these symptoms persist o= r=20 become bothersome, inform your doctor. Notify your doctor if you develop=20 vomiting, difficulty swallowing, difficulty urinating, uncontrollable=20 movements, chest pain, rapid heart rate, skin rash or mood or mental change= s=20 while taking this medication. May cause darkening of the urine or sweat. Th= is=20 is not harmful and will disappear when the medication is stopped. May cause= =20 dizziness especially when rising quickly from a seated or lying position.= =20 Change positions slowly and be careful on stairs. =20 Precautions:=20 This drug should be used during pregnancy only if clearly needed. Discuss t= he=20 risks and benefits with your doctor. Levodopa appears in breast milk. Consu= lt=20 with your doctor before breast-feeding. This medication can cause false=20 results in urine glucose testing in diabetes. TesTape should be used to tes= t=20 urine for accurate results. =20 Interactions:=20 If you are presently taking: MAO inhibitors or medicine to treat depression= or=20 anxiety ("anti-depressants" or Valium-like) drugs, phenytoin (Dilantin), ir= on=20 vitamins or other drugs to treat Parkinson's disease, tell your doctor as t= he=20 dose of your new medicine may need to be adjusted or changed. Persons takin= g=20 levodopa alone should not take vitamin B6 (pyridoxine) since this vitamin c= an=20 reduce levodopa's effects. Persons taking levodopa with carbidopa do not ne= ed=20 to observe this precaution. =20 Drug Tips:=20 Be sure your doctor knows your complete medical history and the medications= =20 you are taking. =20 Missed Dose:=20 If you miss a dose, take as soon as remembered unless the next scheduled do= se=20 is within 2 hours. If so, skip the missed dose and resume your usual dosing= =20 schedule. Do not "double-up" the dose to catch up. =20 Storage:=20 Store at room temperature away from sunlight and moisture. Do not store in = the=20 bathroom. =20 Hope this helps. Bruce ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Bruce G. Warr "Experience is what enables us to recognize Healthcare Informatics Lab a mistake the next time we make it." Information Systems Dept. University of Maryland Baltimore County http://umbc.edu/~warr/ (V) (410)455-3206 (F) (410)455-1073 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ =20