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Ivan, Thanks for your inputs below. I am not sure what cutting up the Tasmar pills is doing for you. I presume the idea to approximate a flat response function with time rather than a sawtooth response one would get over the successive six hour time intervals the literature says a Tasmar pill lasts. In your case,you easily detect on/off cycles and sense improvements. In Aliza's case,her on/off processes are more subtle, so improvements are not easily discerned. Aliza was taking 200mg Tasmar with her first Sinemet CR half pill dose of the day at 7:00am and then at six hour intervals as recommended by Roche. Earlier on ,she took one Tasmar 100mg pill each time she took the Sinemet at 3,7,12,17,22.Come to think of it,with that routine,she did not have sharp BP drops,and did not feel tired.But the Tasmar showed no improvement ,so she went to the Roche-recommended routine. Yesterday,she stopped the Tasmar,and still feels tired,weak,and shaky and at this am had another steep BP drop.So,either she is suffering from withdrawal from the Tasmar, or these side-effects are caused by something else such as her cardiac insufficiency which we thought was under control,or from one or more of the 11 medications she is taking each day. Meanwhile,she is continuing to lose weight and is down to 88lb. This is evidence that her body is not properly utilizing the food she eats.Her appetite is good and she eats well but small portions.Meeting with Dietition tomorrow evening.See what she suggests.Your remark about slow digestive processes hits home here. Warm regards. Gil ---------------------------------- Date: Sun, 23 Aug 1998 12:02:53 -0400 From: Ivan M Suzman <[log in to unmask]> Subject: Re: Tasmar is not for every PWP/take less? Hi Gil and Aliza, and Art-- You could be taking both not enought Sinemet, or too much Tasnar! I use 225 mg per day. With the aid of a pill-cutter, I take 25mg, 50, 50, 50 and 50 mg. These five doses are spread out from mid-morning to midnight. We cut up 100 mg tablets. I can get tired after these much lesser dosages, but in general they extend my Sinemet significantly. My Sinemet is down to 750-800 -was 1500 mg / day. Yesterday I was on without an off-period for SIX hours-triple the expected Sinemet on-off cycle. Unfortunately, my food digestion is so slow that my pill pieces may get blocked from being useful. At those times, I have to lie down and wait for a long time, or sit quietly, and sip water or orange juice, unless I sleep. I also do NOT take Tasmar until my 2nd dose of the day. Otherwise, I will get very tired, and hear a buzzing sound that bothers me and distracts me. All in all, Tasmar (tolcapone) has nonetheless been a wonderful drug for me-and has prevented me from thinking about pallidotomy. Ivan 48/12 ^^^^^^WARM GREETINGS FROM^^^^^^^^^^^^^^^^^ Ivan Suzman 48/12 [log in to unmask] Portland, Maine Land of lighthouses 74 deg. F ******************************************************************** On Sun, 23 Aug 1998 15:51:23 +0300 Gil Lieberman <[log in to unmask]> writes: >Art, >This is in response to your message below. >My wife Aliza is on the same PD meds as you and is experiencing the >same Tasmar side-effect of being very tired.After about six weeks >of Tasmar and about two weeks of 200mgx3,we have concluded that Tasmar >is not helping her PD and is producing the following side-effects: >1.Extreme tiredness >2.Increased tremor. >3.Shakiness >4.Sharp drops in blood pressure. > >Gil,CG for Aliza,PD 2/95 >--------------------------------- >Date: Fri, 21 Aug 1998 09:30:24 EDT >From: Art D'Isabel <[log in to unmask]> >Subject: Re: Tasmar > >Shortly after taking a 200mg tablet of Tasmar, I get so tired that I >find it >difficult to stay awake. I take 200 mg of Tasmar three times a day, >as well >as my regular dose of sinemet and caridopa/levodapa. Does anyone else >who is >on Tasmar experience the same side effect? > ------------------------------