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On Thu 07 Oct, Chris van der Linden wrote: > In Belgium and other parts of Europe we have a disperible form of levodopa > (Madopar or Prolopa HBS). You dilute this in a little water and drink it; > after about 15-30 minutes there is an immediate effect; it is very helpful > in patients who frequently freeze and at night when the PD patient wakes up > and cannot get out of bed to go to the restroom. > It is NOT the same as diluting a regular Sinemet in water, the dispersible > tablet works faster and more powerful. > Does a similar form of Sinemet exist in the USA? > > One other note, in Europe you can get both Sinemet and Madopar, in the USA > only Sinemet, yet there are differences in response; so if one of my > patients does not respond to Sinemet I can switch to Madopar and sometimes > see a far better response. Can anybody tell me why Madopar is not available > in the USA? Do the two companies have some kind of an agreement (Roche vs > Merck Sharp and Dohm)? As a patientgroup I would really pressure the > companies to have Madopar released in the USA, because some patients can be > helped!! > > Greetings, > > Chris > > > Hello Chris, I posted an article on Sinemet/Madopar - a summary of practical advice which I have learned the hard way - 21 years with PD. In that I make the same points that you raised (although I confess that although I tried them back-to-back, I couldn't distinguish any difference in response. The faster response on the journey from mouth to brain I certainly did notice, and since then I have always used Madopar. I can confirm that Madopar is not available in the USA, nor is there a soluble form of Sinemet. (I suspect that it was a deal between the drug companies). There is one other aspect which favours Madopar a little, and that is the adverse effect of too much Carbidopa:- PWPs on high levels of Sinemet are advised to use the Sinemet 10/100 formulation to keep their intake of Carbidopa within certain limits, e.g. between 75 and 300 mg/day. It is not critical, but can cause some unpleasant effects above 300mg. Madopar, with Benserazide does not seem to have this problem. Living with Levodopa <http://james.parkinsons.org.uk/brian/> Regards, -- Brian Collins <[log in to unmask]>