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On Thu 11 Jun, Gil Lieberman wrote: > Ronald, > Thanks for your reply below to my question. > > Aliza is using 25/100 CR pills. > How does this affect your sugggestion below? > I did not know that regular pills are 1/3 more effective than > CR pills.Previously,Aliza was taking half pills of 25/250 or 12.5/125 > which using 1/3 reduction corresponds to about 67mg of levadopa with > the 25/100 CR pills.This is almost a 50 percent reduction in levadopa > as compared with the regular pills.This may account for her increased > symptoms with the CR.Is my reasoning correct? > > Gil > ----------------------------------------------- Hello Gil. I am not sure that you have quite absorbed the role of Carbidopa (or Benserazide in Madopar tablets). I will just list the main points to try and clarify the setup. 1. Carbidopa's job is to protect the levodopa from attack while it is in the stomach/blood stream. It is largely successful in this role, with a quantity of about 75 mg/day. 2. Since you can't improve on 100%, more Carbidopa has no direct effect, but rattles round the body causing the secondary problems as defined earlier, until it is itself absorbed and broken down. 3. The Carbidopa cannot cross the blood/Brain barrier, and so cannot affect the brain directly. (Insufficient Carbidopa can bring about a reduction in levodopa, thus can indirectly cause a problem. 4. The theory about Controlled release tablets is that they spend longer in the blood stream, and thus are exposed for a longer period of time to attack. I have never seen the proof of how much this affects the levodopa getting to the brain - My instinct is to believe a loss of 5% rather than the quoted 30%. Regards, -- Brian Collins <[log in to unmask]>