It has been suggested to me that I am taking my Sinemet at too big an interval and there is some "off-time". During this time I am worse than before. I think it works for about 4 hours.

How long does Sinemet work for you?

Has anyone noticed a difference with the slow release Sinemet CR?

What protocol do you follow?

Hi.

I take Sinemet (in Stalevo 100 form, which includes Entacapone) every 2 hours during the day from 8am to 8pm (= 7 tabs), and still get the "off" periods before the end of the 2 hours.

At 11pm I take Sinemet CR (250mg), which is much more gentle and predictable and lasts 4-5 hours. This of course contains no Entacapone, the usefulness of which I have my doubts about. You can feel the CR wearing off, but you get plenty of notice. I take another CR between 3.30am and 4am - I'm always awake around then, to this is no problem.

That 2nd CR lasts me through to 8am, when the whole cycle starts again.

I've tried several versions of Sinemet, but swear by the CR. For me it's more effective, gentler and predictable.


I also take a 1mg Azilect once a day at 8am, and Madopar 50 dispersible for a quick boost if necessary. I probably use this about twice a day on average.


Good luck!

Ray.

Ta Ray

So for you it only lasts a couple of hours. I think it's a bit longer for me, maybe 4 hours, but the symptoms are so vague and come back so slowly, I'm not sure.

Thanks for your help

Anyone else

Chris

4-5 hours for the Sinemet CR, which I prefer, but for some reason they won't prescribe CR all the time, round the clock.

I take sinemet plus 3 times a day as 6 tablets. The time they last is variable and i dont know if symptoms are PD, pills or general welfare.... I take 2 x 62.5 every 4 hrs as a rule. The dose as two tablets allows me flexibility to take smaller doses spread out a bit more. (My doc knows about this). However I usually try a regular 2 tablets every 4 hrs. I wait for 4 hrs even if I feel he signs I need a dose. signs are often very vague (shivery arms, feeling lack of well being). I find a very regular dose works best.

I'm very irregular - always forgetting to take my pills at the right time and getting confused. Not sure how much that affects the drugs' efficacy.

Hi, like Ray I take Stalevo during the day but I take 150mg every 3 hours. I also take a sinemet cr with an entacapone at bedtime. I don't often wake during the night but I usually don't go to bed much before 1am.

The above regime seems ok for me at this point in time, but who knows how long that will last...

Glenchass

Sorry, I meant to add that I use an alarm system to tell me when I'm due to take my meds. I know if I didn't I would forget.

Glenchass

Intuitively taking a smaller dose more frequently seems like a good idea, Thoughts?

heres an interesting quote

Sustained-release formulations in theory could reduce dyskinesias, as they are released slowly throughout the day. In practice, however, they tend to prolong the duration of dyskinesias and increase the severity of dyskinesias in the late afternoon or early evening. Patients who have dyskinesias and are on sustained-release levodopa formulations may benefit from switching to immediate-release levodopa.

I have a hunch Rays neuro is trying to avoid dyskinesia, but its extraordinary that he (?) wouldnt say why. Surely communication with the patient is central to all treatments?

Spam, I read somewhere, but cant find it, that taking too many small doses increase the 'pulses' of peak dopamine and it is the change from peak to trough that leads to dyskinesia - the ideal being a smooth continuous supply.
Not sure if this is generally accepted.