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Brian Collins, I tried to open the Simon Coles' Web site and got "Internet Explorer cannot open ...Make sure the address is correct and try again." Tried twice. Is it correct? Thanks. I just recently switched my intake of Sinement to 30-60 minutes before meals and minimal protein until supper, as was suggested by a number of folks on this List and it definitely seems to help my bradykensia. (And I also found a Movement Disorder specialist who presumably would have mentioned this to me sooner - since my current neurologist had no clue - and since I hadn't been paying attention here! Couldn't get an appt until Sept 8 though, but I don't feel quite as desperate now so that doesn't matter.) I haven't quite figured out yet when it's best to take the Permax, however. So I take it with the meals. Bruce Anderson (51/2.5) ---------- > From: Brian Collins <[log in to unmask]> > 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]>