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This is a subject which irritates me from time to time, because to me it indicates a lack of understanding on the part of some doctors of what they are doing: The most important drug which we take is undoubtedly levodopa: All the others are really accessories to the levodopa, so it merits a treatment om its own. Sinemet and Madopar come packaged in tablets or capsules, in units of 50, 100, and 250 mg (or 100 and 200mg Controlled release). Unfortunately, people do not come conveniently calibrated in similar values. Everyone happily acknowleges that PWPs are all different, and this certainly applies to the amount of levodopa required, so why do so many doctors insist on using 'one tablet here, one there, and if that doesn't work try doubling the dose.' The reason why they get away with it is that in the earlier stages of the disease the remaining dopamine-producing cells compensate for any over or underdose, but when you get to the sharp end, when there are effectively no remaining dopamine-producing cells left, the match must be exact. I have found, for example that my requirement is for 37 mg per hour, and the range that I can accept is no more than plus or minus 1/4 of a madopar dispersible (or +/- 12 mg). I achieve this by taking 1 and 1/2 Madopar dispersibles every two hours. (This is because a madopar lasts for 2 hours.) It may sound too much trouble, but this philosophy has kept me going through 18 years of levodopa, (and I haven't finished yet.) The plain fact is that no-one is going to go to such trouble on your account. Everyone is different, and it is up to each of us who wants to extract the best from the drugs, to undertake a modest amount of experimentation (If you are lucky, you may find a doctor who is prepared to help) I know that many people prefer to leave it all to their doctor or specialist, but I have doubts whether anyone who is not directly experiencing the effects can define requirements such as these. Does anyone else work to close tolerances like this? Regards, -- Brian Collins <[log in to unmask]>