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On Tue 06 Jan, EDIELUT wrote: > I've been having stiffness and slowness near the end of dose. I have been > taking > one mg. of Mirapex three times a day with one 50/200 Sinemet CR four times a > day > > About three days ago, I decided to play doctor by cutting the one mg. Mirapex > in half and taking them every four hours, instead of every eight hours. It > may be all in my head, but I seem to feel better.Of course, my neurologist may > not approve. I am going to give it another week or two and see what happens. > Edie 63/l8. > > Hello Edie, I note your condition as 18 yrs since diagnosis - I am almost the same, at 18 (soon to be 19 years) from diagnosis, so I know how careful we must be about changes. I found that for any tablet containing levodopa and specially for the CR tablets, the effective duration decreases as we get older and taking the correct dosage becomes more vital. The result is, if you continue to take your CR tablets at the same time each day, you will run out of levodopa before the time for the next dose comes round. By cutting up your Mirapex, and taking it every 4 hours, you were probably bolstering the emerging gap in the levodopa schedule. However, that is not really the best way to do it. What you should do is to 'shuffle-up' the times at which you take the CR tablets, until the gap is filled-in. (When you say you take your CR tablet 4 times a day, does that mean one every 6 hours through the night? or something different?) Assuming that you take your first tablet at 7:00am, let's consider what may happen: Let's suppose you find that you need to take your tablets every four house, you will take a tablet at 11:00am , 3:00 pm , and 7:00 pm. That leaves a potential problem at 11:00pm when the next tablet would be due. If I take a full dose at bedtime, I find that my mind does not want to go to sleep. A half-strength tablet is needed . Madopar do one, ang I think Sinemet also recently made a Sinemet100/25CR available. So far, I have just talked about the Sinemet, the bedrock on which we will build the required amount of agonist. Based on your previous figures this looks like 3 mg of Mirapex spread out uniformly. I do not know the claimed half-life of Mirapex, and you should refer to that in sorting out your agonist dosages. Can you break the tablets? (Is there any need?). The great thing about this set-up is that about every 6 months, I review the situation, and if I have been struggling a bit to survive on the margin between Underdosed and overdosed, I add another 500 microgrammes of Permax. to my daily schedule. I have been doing this for about 5 years, and it is by far the best method that I have tried. Please note the following points: You must only attempt this with the agreement of your neurologist. The numbers which I have used are for illustration only, and finally, I think this approach is best suited for PWPs who have come to the end of the 'gravy train' (say 8 to 9 years with PD Well Edie, you just mention cutting a Mirapex in half, and find yourself buried under a whole new schedule!!. I'm sorry about that, but I thought you and maybe others might be interested. Regards -- Brian Collins <[log in to unmask]>