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On Sat 05 Jul, Diane Lucas wrote:
> Dear Brian
>
> My mum has taken Sinnemet for nearly 2 years.
>
> She takes 5 125mg per day
>
> At 10am when she has her breakfast
>
> 12.30pm with her lunch
>
> 3.00pm with a biscuit
>
> 5.30pm with dinner
>
> 8.00pm with a biscuit
>
> Is this info enough
>
> Thanks a lot
>
> Diane
>
>
Hello Diane,  I think I can explain what is wrong about your mum's tablet
schedule: Has anybody given your mum advice about when to take her tablets,
relative to meals? I suspect that someone has, probably when you were
introduced to Sinemet. In a small number of people, some nausea is encountered
when patients begin taking Sinemet, and they are advised to take the tablets
with meals, because that reduces the nausea. Well, it certainly does that,
but it accomplishes it by a reaction with the protein; the protein in the
food breaking down the levodopa, so that you get less nausea because you get
less Sinemet!!

The schedule which you sent indicates that only the 3:00pm and 8:00pm tablets
are taken without meals, from which I conclude that your mum's basic levodopa
requirement is actually less than that delivwred by a Sinemet Plus (Known to
our friends in the USA as Sinemet25/100). This fact is masked most of the
time by the meals, but this is a very imprecise way to do it, because of the
problem of knowing how much Protein is in the meal. The easiest way of avoiding this interaction is by taking your tablet some 20 to 30 mins BEFORE your meals.
This should give you the full effect of the tablets, BUT, we know that that is
too much, so the problem is how to find the new optimum levodopa flow rate.
This is where I offer to use a computer program of mine to help find this
target levodopa flow rate. If you want to have a go at it, take a look at Simon Coles' Web site: The URL is as follows

   http://james.parkinsons.org.co.uk

Look for my name at the bottom of the home page and click on that. You should
find a couple of notes describing the way to generate data for the program.
If you want to ask questions, please do so, otherwise call me when you feel
that you are ready to go.

By the way, where do you live in the uk?

Regards,
--
Brian Collins  <[log in to unmask]>