 |
 |
Jennifer, The FDA requires the Drug companies to report to them any reports the get of anything abnormal that they SUSPECT may be related to a drug which is being tested or marketed. This tends to leavd to an overinclusiveness in the Package insert or including things tht may have occured ideosyncratically or even spontaneously in a few patients. It is the philosophy that it is better to forewarned which is fine for MD's but it can scare the hell out of patients who read the inserts without knowledge of the common side effects. I think that Dr. Lieberman is probably means that he never heard of it which in his case would make the side effect rare if existant at all. Dr. Lieberman is an experienced PD specialist and the fact he hasn't run into it is significant considering the number of diabetic patients he must see. I wonder what other people's experience has been with sinemet and changing blood sugars. I haven't heard of it either but it is possible. For reference, The statement reads: "Patients with diabetes mellitus should be monitored during levodopa; carbidopa therapy. Alterations in blood glucose may occur in some individuals as a result of the sympathomimetic effects of levodopa. The medication combination can also produce false-positive reactions with various urinary ketone and urinary glucose test reagents." [The second is a false lab result while the first is likely a thoeretical finding or an unusual finding. ] Other statements grouped with it include: "... Levodopa can worsen malignant melanoma, so the drug is contraindicated in patients with a history of melanoma or in patients with undiagnosed pigmented lesions." [This is according to my neurologist untrue and based on a theoretical consideration not clinical evidence.] "Concomitant use of monoamine oxidase inhibitors (MAOIs) with levodopa; carbidopa combinations can result in hypertensive crisis, and simultaneous use of these agents is contraindicated. MAOIs should be discontinued 2-4 weeks before initiation of levodopa-carbidopa combination therapy (see Drug Interactions)." [This is partially true with some agents but not with selegiline which is an MAOI commonly prescribed for PD] ----- Original Message ----- From: Jennifer Siegel <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, November 22, 1999 12:14 PM Subject: Re: Sinemet & blood sugar questions > Dear Bonnie, > My package insert for regular sinemet has a paragraph about > "abnormal" lab reports, which include elevated glucose levels. > Do you know what that could mean? > Sincerely, Jennifer > > -----Original Message----- > From: Bonnie Cunningham <[log in to unmask]> > To: [log in to unmask] <[log in to unmask]> > Date: Monday, November 22, 1999 11:13 AM > Subject: Re: Sinemet & blood sugar questions > > > Dear Jennifer: > > As I had never heard that Sinemet can cause an elevation with the blood > sugar levels, I asked Dr. Lieberman about it. He said that Sinemet does NOT > cause an elevation of glucose levels. > > To answer your second question, some people, particularly early on in their > illness, can get by with little or no Sinemet. Some can benefit from one of > the agonist and some can feel the benefit of taking amantadine to control > symptoms. Unfortunately, there is no other drug like Sinemet, which helps > replace the lost chemical of dopamine. Most PWP will need Sinemet, sooner > or later, to control the symptoms of PD. > > Regards, > > Bonnie Cunningham, R.N. > Patient Services Director > NPF > > > -----Original Message----- > From: Jennifer Siegel <[log in to unmask]> > To: [log in to unmask] <[log in to unmask]> > Date: Saturday, November 20, 1999 5:56 PM > Subject: Sinemet & blood sugar questions > > > I have received so much helpful information from the group, that I am > wondering if anyone can help me with these 2 questions. > 1. Since elevated blood sugar "can happen" when one takes sinemet, does > anyone know if the "elevated blood sugar" reading is a true reading and > indicates diabetes, or if it is a false reading of the blood sugar due to > the sinemet? > 2. Also, since sinemet loses its efficacy & has its own side effects, has > anyone tried (& what) taking no, or less sinemet and doing something else to > manage the PD?? > Jennifer