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hi all At 15:43 1999/10/29 -0700, joe wrote: >Sinemet CR vs regular > >The subject of Sinemet CR vs regular comes up fairly often >here, and since it's important to many PD newcomers, I'll >re-plow the terrain; no new data, but perhaps a more easily- >grasped explanation: > >Although Sinemet (even the regular kind) is absorbed rather >slowly, its levodopa dissipates quickly. You might adjust for >that by taking bigger doses, but you know that too much in the >body at once causes dyskinesia, while too little causes the >familiar "end-of dose" cramps and dystonia. So it's desirable >to keep the body level of levodopa as constant as possible. You >might do that by taking tiny doses very often, but that's a >pain, what you want is the longest interval between doses. > >All the regular Sinemet tablets are scored so you can take a >half tablet at a time, but Dupont Pharma, makers of Sinemet, >also offer Sinemet CR (Controlled Release), which comes in >a bigger tablet that dissolves more slowly, and therefore >lasts longer. The 50/200CRs are scored, so they may be taken >whole or as the equivalent of two (not scored) 25/100CRs. > >The rate of dissolving for either type of Sinemet is proportional >to the remaining surface area of the tablet, so it is highest at >first, and then declines as the tablet becomes smaller. But >slower dissolving makes the effect of the CRs last 2 or 3 >times as long as the equivalent amount of regular Sinemet, >and the peak concentration, about 2 hours vice 1/2 hour after >taking, is only about 35% of that from regular Sinemet. So >you can get away with the bigger (50/200CR) tablet, taken >half as often as the regular 25/100 tablets. > >The slow dissolving rate and prolonged sojourn of Sinemet CR >also means more time for the levodopa to be degraded before >it reaches the brain, therefore the total effect is only about >3/4 as great as regular Sinemet. But, I believe,the total dosage >may be safely increased to compensate, as the excess merely goes >to waste. Most patients find they can reduce their total dosage. > >One final warning: Don't tinker with Sinemet dosage without the >supervision, or at least the full trust and confidence, of your >neurologist. The levodopa component of Sinemet is one of several >drugs whose abrupt withdrawal or dosage change has, on very rare >occasion, led to a life-threatening condition similar to >neuroleptic malignant syndrome. Among the prominent symptoms are >very high fever and mental changes. Cheers, >Joe hey joe this is a great summary, thank you! i have been on sinemet since 1998 with quite wonderful success in dealing with my major symptoms muscle rigidity and bradykinesia as time has marched on i have had to learn more 'finesse' in managing the doseage level and timing of sinemet [with my doctor's knowledge and approval] for 'smooth' coverage' of my pd symptoms during that 11 year period once in awhile i would give sinemet cr a try looking for the magical and sometimes elusive longer 'on' period but my reaction to CR was always extreme dyspepsia as well as fairly extreme dyskinesia not a pretty sight! in the past few months i have discovered that 'melting' sinemet CR 25/100 tablets or portions thereof, in my mouth, [taking maybe 10 to 15 minutes to dissolve an entire tablet] has given me good 'smoother' results with no i said no dyspepsia or dyskinesia who knew? there is always something new to learn janet ps the usual disclaimer each one of us is unique with a unique bio-chemical make-up what works for me may/may not work for you irregardless, always consult your doctor and always go for low and slow titration brain chemistry is us janet paterson 52 now / 41 dx / 37 onset 613 256 8340 po box 171 almonte ontario canada K0A 1A0 a new voice: <http://www.geocities.com/SoHo/Village/6263/> <[log in to unmask]>