Hi

My husband has been given a " probably is " diagnosis of PD and has been given Sinemet Plus to see if he gets some improvement, the thought being that if he does improve then it is PD

My question is when to take it. When we saw the neurologist he said to take 1 a day at breakfast for week one adding one at teatime the 2nd week and one at lunch time the third week. I then see in the enclosed information leaflet it is not a good idea to take after a heavy meal. I have spoken to a today and she says that although it is better not to take after a heavy meal, it is important to take at the same time and not to forget and this is easier with meals. Can anyone tell me how they takes theirs

Thanks

Hi, birding, welcome to the forum. I was introduced to Neupro patches, then Sinemet+, and Selegiline, in that order, much as you describe.
You will find the advice on the Forum very helpful and supportive.
Generally, the experience of PWPs is that it is best not to take meds within 30 mins of a meal, 90 minutes if the meal has much protein, because it competes with the sinemet for the enzymes which break it down. I take my first dose 30 mins before I get up, to get me going, and I don't need food at this stage, but as all PWPs are different, you will find that others will need a couple of digestives, or the equivalent with the tabs.
The improvement may take a week or two to be visible, so observe the symptoms closely over the next few weeks. Chin up and all the best, wrinklygran

is there a difference between sinemet and sinemet plus.

Hi birding,

Welcome to the forum.

When first taking sinemet it normally says on the dispensed label-should be taken with food. This is because when first starting treatment with this type of medication it can cause nausea but once the body's adjusted to the medication you can then start to take the medication at times that benefit controlling the parkinson's. This is where the role of protein in diet comes in. In some people protein which is found in meat, fish, eggs, cheese, beans and pulse, seem to interfere with the absorption of the sinemet from the gut. This can make the drug less effective if it's taken with protein rich meals. Therefore it may benefit taking levadopa about 45 minutes before or after meals, a cracker or a biscuit can help stop upsetting the stomach. Some people prefer to eat the majority of their daily protein in the evening. This can help the sinemet to be more effective in the day time when you're more likely to need it.

Drug timings are down to the individual. No two people are the same in the way they respond to treatment. I find the best way to tailor the drugs to your needs is to keep a drugs diary. Make notes of when medication is taken, how you are mentally and physically through out the day, food intake and timings and sleep patterns. When you next go to see your pd specialist take this with you and it will help him to tailor the drugs to your needs. It may be the dosage needs adjusting Some people notice end of dose deteariation by this i mean their pd symptoms start to return. This can be helped by adjusting the drug timing, bring it slightly forward. It is best to speak to your pd specialist about the best way of taking the medication because they will along with you keeping a drugs diary be able to monitor the response to treatment and advice on timings.

If your husband begins to respond well to treatment this is normally a good indication that the right diagnosis has been made.

If you go to the home page of this site and click onto publications you'll find some very good information sheets and booklets one of which is 'keeping a drugs diary'. Please take time to look, you'll find it of great use and interest.

Best wishes
Cutiepie

sorry wrinklygran didnt realize you'd answered.

QT

hi ali j

The difference between sinemet and sinemet plus is the strength. The following table explains the different types of strengths and dosages that can be used to treat pd symptoms. Your pd specialist will decide which one he thinks is best to suit your symptoms


Sinemet ®-62.5: 50mg levodopa and carbidopa equivalent to 12.5mg anhydrous carbidopa
Sinemet ®-110: 100mg levodopa and carbidopa equivalent to 10mg anhydrous carbidopa
Sinemet ®-Plus: 100mg levodopa and carbidopa equivalent to 25mg anhydrous carbidopa
Sinemet ®-275: 250mg levodopa and carbidopa equivalent to 25mg anhydrous carbidopa


QT

thankyou cutipiex.

hi

i take sinemet plus three times a day, i start at 8am and have a piece of toast about half an hour later, then i have my next one at 12.30pm and have lunch 30 mins later but no protein in my meal, then i have one at 5pm and wait 45 mins before i have tea i do have protein in my meal at this point, i take a sinemet cr at 9pm.

it works for me, i have tried several different ways and this is what i came up with that actually works for me.
good luck

goldi...

HI I am a fairly new PDS and started Sinemet Plus in November 2008 at 3 a day, now worked up to 6 a day. I found I couldn't sleep if I took the tablets too late in the evening and after I read in the forum about the affects of protein (thanks for that info everyone) I now start the day with 2 tablets, then cereal breakfast up to an hour later, 2 more before lunch - probably a sandwich - then 2 late in the afternoon, at least an hour before I eat dinner, thus avoiding protein. I have to say my appetite is not good, but I don't seem to be losing weight.
I don't think the tablets are doing much good either as my symptoms are loss of use of my left side, especially my hand, and this doesn't seem to have changed. I know it's early days, but I imagine the process is going to be trial and error, until I find the right drug for me. Is this the case for most people? Pat

hi pat

are you on anything else apart from the sinemet, i wasn't sleeping very well either so they gave a sinemet cr to take in the evening to help sleep.

you seem to be doing well with the food aspect.if you have a pd nurse ring them up and see if they can come up with something to help you.
don't suffer in silence, you may need your meds tweeking.

good luck goldi....