Good morning Patricia, In a 4 year period from 1993-1997 i had 5 back surgerys and a pallidotomy. When I was on anything that seemed related to helping my back, it brought on a reduction in the effectiveness of my sinemet(I am taking 7-8 siunemet 50/200cr every 24 hrs.) It seemed to apply particularly to any kind of steroid. hope this helps--take care-----pete