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On Sun 25 Jul, M Potter wrote: > Hi all, > > This may seem like a silly question but I'm trying to learn all I can. > So, who better to ask than you, the experts! My mother just recently > began taking Sinemet, I wrote to you asking about the nausea problem > before. She is taking the 50/200 dosage, she asked her doctor about > cutting the pill in half and he said "no" that it isn't the dosage of > the med making her sick but just the "nature" of the medicine. The silly > part of the question is can a controlled release pill be cut in half > (someone told her that you shouldn't) and if you do cut it in half does > it become the 25/100 dosage? > > What she would like to do is start out gradually with this medication. > She has been managing on Segeline alone for years but there is no doubt > it's time to begin the Sinemet. The trembling and stiffness is becoming > worse and balance was starting to become affected. So, we aren't arguing > about that. But, since it is questionable how long you can use this > medication, shouldn't you start out with the lowest dose possible? Half > a pill does ease her symptoms but it really doesn't have much of an > effect on the nausea and just an overall "not right" feeling. Still, she > would feel more comfortable taking the least amount possible. > > One more thing, what is a Movement Disorder Specialist, is it different > than a neurologist? Thanks again and best wishes to all, Marcia > > > Hello Marcia, you have been given a lot of good advice about Sinemet, and hopefully you will have read my 'Living with Levodopa' article on the web. I will take a few lines to explain some details, because I think it is always easier if you understand the basic facts behind a subject. The important parameter when dealing with Sinemet is the rate of flow of the levodopa (that is the active ingredient) into the brain. For most people, a tablet of Sinemet 25/100 (100 mg of levodopa) lasts about 2 hours; a nominal rate of flow of 50 mg per hour. In the CR version of the Sinemet, the body of the tablet is designed to disolve at a slower rate. Typically a CR tablet will disolve in 4 hours, giving a nominal flow rate of - 50 mg/hour, just like the other tablet! However, it lasts twice as long, which is more convenient. Now consider what happens if you break the tablet along that tempting weak spot across the centre of the tablet: You open up two more surfaces of (at a guess) an extra 20% of surface area. giving a faster rate of erosion of the tablet. The net result is that although you set out to produce two CR tablets each giving 100 mg at a rate of 25 mg/hour, you end up with two tablets, lasting about 3 hours and 12 minutes, and giving a higher dosage than you intended, at a rate of 60 mg/hour which is a more powerful dose for a shorter time. Neurology covers a very wide spectrum of illneses - you may well be suspiscious of advice from a neurologist who specialises in Motor Neurone Disease, or Alzheimer's Disease (I have in the past 'benefitted' from such advice.) The person most qualified is one who has covered 'movement disorders' as a speciality. Regards, -- Brian Collins <[log in to unmask]>