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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 -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013