Doctor insights on:
Madopar Vs Sinemet
Very safe: This medicine has been out for forty years and has been a miracle drug for pd patients. There are potential issues for people who have been on it for a long time or at high doses (ie fluctuations, dyskinesias), but nearly every pd patient who goes on it feels better. It will not damage your liver, kidneys or any other organ. Because of the above issues, it may not be the first med used in pd. ...Read moreSee 1 more doctor answer
What is the protocol for switching a Parkinson’s patient from regular Sinemet (carbidopa and levodopa) to Sinemet (carbidopa and levodopa) CR?
Slow increase: Sinemet (carbidopa and levodopa) CR is a 2x/day treatment vs Sinemet (carbidopa and levodopa) at 4x/day, so to get to twice the daily dose you need to increase dosing slowly over several days, up to a week. I suggest you talk to your doctor, who can nap out a plan to do this safely ...Read more
What is the difference between Parkinson's drug sinemet and stalevo (carbidopa and levodopa and entacapone)?
COMT inhibitor: Entacaptone is a selective catecholamine-o methyl transferase (comt) inhibitor that increases the bioavailabilty of dopamine. Like Carbidopa in sinemet it does not cross the blood brain barrier. Stalevo (carbidopa and levodopa and entacapone) is a combination of l dopa, Carbidopa and entacaptone. Sinemet is a combination of Carbidopa and l-dopa. ...Read more
Is Stalevo (carbidopa and levodopa and entacapone) superior to Sinemet for Parkinson’s? Is one better than the other?
Superiority?: All of the drugs in this class attempt to increase the levels of circulating dopamine. Sinemet is a combination of 2 drugs whereas Stalevo (carbidopa and levodopa and entacapone) is a combination of 3. There is currently an ongoing study at the Mayo Clinic to answer this question - but right now - there isn't any data to demonstrate if one is 'better' than the other. The best treatment is the one that works for you. Hope that helps! ...Read more
Better for what???: Opioids may be all that a person needs for acute pain (broken bone, sprained ankle) but is NEVER the primary treatment of ANY chronic pain. Each of these drugs has a different half-life, side effect and safety profile, and some are better for some people, and some are more dangerous in some people. Methadone is the most dangerous, particularly when given by doctors with less experience using it. ...Read more
Neither: Generic drugs are held to standards where the manufacturer must prove "bioequivalence" to the branded drug. The molecules must be structurally the same, and the same standard of quality and purity must be met. The pills and the packaging themselves may look different, but the active ingredient is the same. It can be thought of as the difference between clorox bleach and safeway brand bleach. ...Read more
MAO-B inhibitors: Both selegiline (eldepryl) and Rasagiline (azilect) are mao-b inhibitors, with a couple important differences. Azilect (rasagiline) is much more specific for mao-b, meaning no risk of serotonergic crisis when used alongside ssri antidepressants (celexa, lexapro, etc). Azilect (rasagiline) is also the only neuroprotective drug for parkinson's. Take care! ...Read moreSee 2 more doctor answers
Should sinemet and requip (ropinirole) taken together or take requip (ropinirole) in between doses of sinemet to be more effective? Underwent dbs 2 months ago for Parkinson's
Parkinson patient for 7 years currently taking sinemet & requip (ropinirole). Only sinemet seems to releive systoms. Is there any risks of stoping requip (ropinirole)?
See neurologist: The Requip (ropinirole) may not be playing much of a role at this point, and could be tapered off over a few days. There really is no substantial withdrawal issue usually, and unlikely to experience any challenges. Discuss with your doctor, and revamp your medications, as dbs will certainly change your med needs. ...Read more
DBS and medications: DBS is not a replacement for medication and vice versa. Many DBS patients are place on Azilect (rasagiline) before and some after surgery. This drug can block the destruction of Dopamine in the brain. These allows more Dopamine to be available for action. This may induce dyskinesias in some patients but DBS to the GPI can help that side effect ...Read moreSee 1 more doctor answer
It depends: Because of cost considerations its worth trying it for a while. Watch for peak dose dyskinesis and dose failures or wearing off. ...Read more
69yo, parkinson disease underwent madopar125 assessment.Taken 1 tablet, vomit&sweats after 1hr.Concluded-take seasick tablet with madopar as a solution?
Parkinson disease: You need to report this event to your doctor to get advice on how to proceed. ...Read more
High sinemet (carbidopa and levodopa) doses without Parkinson's how do I get off sinemet (carbidopa and levodopa). No doctor at present.?
That depends: upon the reason that you are taking Sinemet, (carbidopa and levodopa) the dose you are taking, and the duration that you have been taking it. Discontinuing medication is usually safer and better tolerated if it is done in a slow stepwise manner. That is my slowly reducing the dosage. ...Read moreSee 1 more doctor answer
Either: The one that works the best for you. ...Read more
How many mgs of protien Parkinson patient who takes Sinemet (carbidopa and levodopa) should consume per day?
Eat protein at night: The active ingredient of Sinemet (carbidopa and levodopa) is Levodopa, which is absorbed by the same channels in the gut which absorb amino acids from protein in your diet, so Sinemet (carbidopa and levodopa) is poorly absorbed when you have eaten protein. Try to avoid heavy protein meals during the day, when you need to absorb Sinemet (carbidopa and levodopa). At night, your Sinemet (carbidopa and levodopa) absorption is not as critical, so shift protein intake to the night or evening. ...Read more