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Nancy and Don, I am glad Don and you enjoyed your Hawaii trip. You said: >We used to be so careful about taking the meds either 1 hour before a meal >or 1 hour after a meal, but the doctor at the Mayo Clinic said not to worry >about it since he was using the CR. It sure made life easier!! I hope you will forgive me if, purely with only Don's best interests in mind, I am controversial and challenge your Mayo doctor's advice on Sinemet not being affected by food. It is simply not true. Who am I, with no medical qualifications at all, to challenge a doctor at Mayo? Well, this list has proved many times that Doctor's advice has not always been right, that is certain. My reasons for what I say, besides feedback from the group are: 1. I travel 200 miles to London to see one of our top PD Neurologists and he insists Sinemet CR is best taken at least 45 mins before food. 2. This was clearly stated yet again at the PD conference in Leeds a couple of weeks ago. 3. I have been on Sinemet CR for 3.7 years and a very detailed diary on food and Sinemet timings show the effects of meals and timings very clearly indeed. Nancy, because the CR formulation is designed to release over a 4 -6 hour period (most find the useful release period is around 4 hours) it may not be entirely blocked by the food, but it most definitely is affected. If food/Sinemet timing is ignored it can lead to erratic supply of the drug into the blood plasma at best - total blocking at worst. As for taking it one hour AFTER a meal, this can be disastrous. The Sinemet cannot work until it leaves the stomach and reaches the intestine. Depending on the type and quantity of the meal Don has eaten (fatty foods take longer to leave the stomach) it can be some considerable time before the Sinemet gets through. You could even get the situation where one dose is so delayed in getting through, that the next dose is following close upon the previous one leading to overdosing. I suspect that, because 2 Sinemet CR 50/200 is a highish dose, your doctor is relying on the scatter gun approach of "something will get through". Nancy, if Don is suffering dyskinesias, then smooth flow rate is very important. By taking food into account rather than ignoring it you will most certainly achieve a better flow rate. There are enough variables in PD without adding stomach emptying time to them. When first starting Sinemet it is advised taken with food, but only to minimise nausea. People taking Sinemet with food and doing well are almost certainly taking a slightly higher dosage than their current requirement and therefore coping with the "waste". I hope that you do not mind me saying all this but, this group is formed to help PDERS and I could not let it go through without comment if there was the slightest chance that I could help. Your doctor says not to worry about meals, well please do not WORRY about meals, but do take the timing I have mentioned into consideration. It IS inconvenient, but I am sure you will find it worthwhile. Good Luck, Ernie. 54/3.7 At 17:24 06/07/97 -0400, you wrote: >It's been almost two weeks, since we got home from our trip to Hawaii. Had >a wonderful time and met two other PDP. One from Australia and one from >Hawaii. I didn't cancel the PD Digest cause I didn't want to miss anything >important. Came home to 53 copies of the Digest. Still trying to get >through all of them. While we were gone we had more time to monitor Don's >medications. Since last October the Mayo doctor told him to take 2 Simemet >CR 50/200 every four hours. He said he was under medicated. We cut back to >1 1/2 and the Dyskinesia and tremors seemed to get better although he said >he felt weaker. Can't decide if it helped because we were a much more >relaxed and less streeful situation or because of another alternative we are >trying. He has stayed on the 1 1/2 dosage since we have been home. > >We used to be so careful about taking the meds either 1 hour before a meal >or 1 hour after a meal, but the doctor at the Mayo Clinic said not to worry >about it since he was using the CR. It sure made life easier!! > >Its great to be back and to get my electronic fix a couple times a day! >Love all of your messages. > >Nancy B cg for Don 63/13 > > Ernie Peters <[log in to unmask]>