Hi, Here is part 3 of Living with Levodopa 4.3 Sinemet CR (125 and 250) , Madopar CR (125). The CR in these formulations stands for Controlled Release. In the Sinemet tablet, the surface of the tablet is designed to dissolve at a pre-determined rate, thus releasing the levodopa at a certain rate. What rate is actually achieved will depend on the efficiency of the individual's digestive s ystem. In my case, the tablet took 4 hours to dissolve, so with a total load of 200 mg of levodopa, The rate was 50mg/hour. The intention behind the design of these tablets is excellent, because the control of the system is a matter of dealing with varying rates of flow. Unfortunately, with only one rate of flow to play with, it is not possible to fine-tune the system. Nevertheless, while you can tolerate the flow rate, these tablets are effective and do not subject the system to large unwanted excursions. The Madopar CR comes in the form of a capsule containing numerous little balls having different release rates. They only come in one size,(100mg levodopa) but the larger Sinemet CR (200 mg) can be emulated simply by taking two capsules of Madopar at the same time. The dissolve rate of the Madopar CR is effectively the same as the Sinemet CR. 4.4 Madopar Dispersible tablets are designed to dissolve in water. This seems to speed-up the transfer of the drug into the blood stream, and makes the Dispersible formulation one of the fastest ways of getting from 'off'to'on' (see Liquid Sinemet). There are two sizes; 62.5 and 125 (containing 50 and 100 mg of levodopa). Another minor point about these tablets is that they are laced with Citric Acid, which makes them quite pleasant to suck and dissolve in the mouth. When you take one or more tablets every two hours, as I do, access to a drink of water is often not available. I actually take all of my levodopa in the Madopar Dispersible form, and take them all by sucking them in my mouth. 4.5 I cannot over-emphasize the fact that although the tablets containing 100 mg of levodopa are apparently the most popular, they represent an extremely blunt implement when trying to follow the path of minimum levodopa use. To this end, I use the 62.5 Madopar Dispersible tablets because they allow more precise control of the levodopa. Where necessary, I break the tablet into half and even quarters. (Try slicing a 12.5 mg piece off a 200mg tablet!) My particular optimum rate of consumption of levodopa is 37.5 mg perhour. I get that flow rate by taking 1 and 1/2 tablets every 2 hours. 5.0 Countries in which Madopar is available. (I assume that Sinemet is universally available) Madopar is known to be available in the following countries:- Country Local name Australia Madopar Austria Madopar Belgium Prolopa Canada Prolopa Denmark Madopar Finland Madopar France Madopar Germany Madopar Greece Madopar Holland Madopar Ireland Madopar Italy Madopar Luxemburg Prolopa Norway Madopar Portugal Madopar Spain Madopar Sweden Madopark Switzerland Madopar Taiwan Madopar Turkey Madopar UK Madopar New Zealand Madopar 6.0 Speed of Action. It can be very frustrating , waiting for the first dose of the day to take effect. The speed with which this happens is a very personal thing, because to a large degree it willl depend on your ability to transfer the levodopa into the blood stream and from there into the brain. You should be aware that if you are aiming for the 'minimum useage' philosophy which I advise, the time to come 'on line' is increased, because there is a rounding-off if the correct value has been taken. 6.1 Liquid Sinemet. This is a descriptive name given to a solution of ground-up Sinemet disolved in Orange Juice. The reasons why this mixture should be so fast are not totally clear, but there is no doubt that it is fast! Also, it is a neat way to set up a system to produce any 'Designer Rate of flow' that you choose, in terms of milligrams per 100 ml of Orange Juice. There is one snag, and it is a side-effect of the speed of operation. Remember that we are always trying to maintain a constant rate of input of levodopa to the brain: The Liquid Sinemet characteristic is in contrast a case of fast in, dump the load, and fast out, which is precisely what we do not want. On balance, I have decided not to use it myself, but it can be useful for experimenation. -- Brian Collins <[log in to unmask]>