 |
 |
I was trying to get by without writing to the list for a few days, so that I could get some serious work done, but I could not resist the crop of Sinemet CR messages: So- here's my view of Sinemet CR. I took Sinemet CR for several years, until my ability to tolerate its output forced me to take a different approach. My experience is : 1/ Like all sinemet, it is most effective if taken 20 to 30 minutes before a meal. If you take it WITH a meal you will get an erratic and reduced effect: I do not recommend it. 2/ By taking the tablet ahead of food I suspect that the CR gets a chance to 'grab' a good location against the wall. It then holds that position and uses it to transfer its contents through the wall of the small intestine relatively free of interference by the meal. I found that the tablet lasted 4 hours by which time the meal was mostly digested, and I could safely take the next tablet. 3/ If you are unfortunate enough to suffer nausea caused by Sinemet, you have a problem. The nausea can in almost every case be overcome, and you would be well-advised to make the effort. I would not like to contemplate the later stages of PD without Sinemet or Madopar. The Dopamine agonists make great helpers when combined with Sinemet, but none of them can directly replace Sinemet in the later stages. 4/ If all else fails, there is a drug available which can simply block the signals to the vomit centre and force the body to accept the Sinemet. I understand that in most cases, after a few weeks, this drug ( Called Motillium or Domperidone) can be slowly reduced, leaving an acceptable Sinemet tolerance. 5/ Breaking a Sinemet CR. The thing which the CR tablets have been designed to do is to deliver the contents at a controlled rate, and that rate should be slower than the 'Uncontrolled rate' of say the Sinemet25/100. Now if you break a CR tablet in half, and swallow both halves, it is easy to see that two new faces have been added, and the tablet will dissolve more rapidly, in the process reaching a higher peak flow rate, which is contrary to the original intent of the tablet. This debate is largely academic since I understand that Sinemet is now made in a form called 'Half Sinemet CR'. whch, contrary to its name is in fact a whole tablet, containing half the normal quantity of levodopa. This then makes it comparable with the Madopar CR, which is available in 100mg form already. Regards, -- Brian Collins <[log in to unmask]>