Doctor insights on:
Sinemet Cr Medication
Carbidopa/levodopa: Sinemet (carbidopa and levodopa) is a combination drug that contains Carbidopa and levodopa. It is most commonly prescribed for parkinson's disease but may also be prescribed for other conditions including restless legs syndrome. ...Read more
Dosages: Dosages are adjusted for the specific needs of each patient - there is no standard dose for any specific time period. Sinemet (carbidopa and levodopa) comes in carbadopa-levodopa doses of 10-100, 25-250, and 25-100. These can be combined and given at various times throughout the day to best relieve the symptoms of parkinson's disease. If you are not sure of your dose or the dose of someone you are caring for, you need to call the doctor that prescribed the medication to clarify. Good luck! ...Read more
Is it safe to take fluoxetine with Parkinson's medications such as sinemet and requip (ropinirole)?
Mild interaction: There is no severe interaction although if the fluoxetine were to be sedating to you then you may feel somewhat sedated. Additionally, the selective serotonin reuptake inhibitors that include fluoxetine have been known to produce mild extrapyramidal effects through obscure mechanisms. This would translate into a potential for mild motoric phenomena that would be only a nuisance. Stay safe! ...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
My mom, Safia, 60 years old, resident of Pakistan has drug induced parkinsonism, which is bothering a lot & worsening. Sinemet (carbidopa and levodopa) 25/250 every 4.5 hours?
Tachyphylaxis.: Dosing of Sinemet (carbidopa and levodopa) is a little strange, requiring front loading in the day and a long gap at night without dosing. If taken like most other medications, on a more regular dosing interval, tachyphylaxis develops, which essentially means the efficacy of the medication reduces. ...Read more
Is it safe to take clonazepam for sleep with sinemet (carbidopa and levodopa) for Parkinsons patient? Are there any drug interactions?
Probably safe...: ...but not especially the best choice! Although medications in that class (benzodiazepines) allay anxiety and can relax muscle spasm, they also interfere with normal sleep architecture and increase the risk of falling. I would certainly advise that you discuss this with your neurologist or a psychiatrist trained in sleep disorders or with additional training in geropsychiatry. ...Read more
Can a parkinson patient who takes sinemet&requip take sudafed for congestion & robotussin to losen mucus together? It says not to take with maoi drugs
Sinemet-CR: This has to be determined by careful titration thru your doctor. Initial dose is usually 50-200. Consult your Neurologist. ...Read more
See below: Sinemet® (carbidopa-levodopa) is a combination of Carbidopa and Levodopa for the treatment of parkinson's disease and syndrome. Sinemet® cr (carbidopa-levodopa) is a sustained-release combination of Carbidopa and Levodopa for the treatment of parkinson's disease and syndrome. ...Read more
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
When switching from regular Sinemet (carbidopa and levodopa) to CR, do you need to add little more CR to achieve the same dose of the regular Sinemet (carbidopa and levodopa)?
Not usually: You can usually use the same dose of Sinemet (carbidopa and levodopa) CR as you had of the regular Sinemet (carbidopa and levodopa). You may not feel it "kick in" as strongly but it should work just as effectively and hopefully last longer for you. Good luck. ...Read more
Parkinsons - Is it true that the bioequivalent dose of Sinement CR is 75-80% of the regular Sinemet (carbidopa and levodopa)?
The bioequivalent dose actually depends on the dose that is needed, your metabolism, what other medicines you use, an your experience with these medicines.
The ratio of sinemet (carbidopa and levodopa) CR to regular sinemet (carbidopa and levodopa) may vary from 50% to 100% of the regular dose. Your number (75%) is right inbetween.
For 600 mg regular sinemet (carbidopa and levodopa), most would start with 300 mg sinemet (carbidopa and levodopa) CR. ...Read more
Why is Sinemet (carbidopa and levodopa) CR is inferior to regular Sinement in terms of strength even though they carry the same mg in terms of dose for Parkinsons?
Different timing: CR is sustained release. Regular lasts only a few hours and tends to have more peaks and troughs. One can use both. Regular is given 3 to 4 times a day. ...Read more
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
Sinemet (carbidopa and levodopa): Not sure what milligram each, but if that's what your doctor prescribed & your symptoms are under control & you are tolerating the medication well, then you should be ok. ...Read more
Variable, but: In my experience, the maximum Sinemet (carbidopa and levodopa) dosing is the 25/250 tab four times daily, and if this seems to wear off, one can add Comtan (entacapone). Problem with going too high with L-DOPA is incidence of dyskinesias. ...Read more
Yes: But the GI side effects would make it intolerable. ...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
On sinemet (carbidopa and levodopa) 2 times per day 62.5. I want off this to try other alternatives first how do I safely do this. I do not agree with my diagnosis of pd.?
See your doctor: If you can't find any common ground then it's best to part ways and find a physician you feel mors comfortable with. That said, you should negotiate a time period during which you can try alternatives before resuming orthodox therapy. Your doctor will help wean you. ...Read more
Slowly: Depends on dosing/schedule, but its very important to taper very slowly. It would be best to call your prescribing doctor and have them give you a clear tapering schedule. ...Read more
Before I take Stalevo, (carbidopa and levodopa and entacapone) I'm on but shortly after, I suddenly go off. What's causing this?
See a physician: Your questions is not very clear, but is important to see your doctor for accurate reason for your symptoms ...Read more
Slow taper: If sinemet (carbidopa and levodopa) needs to be stopped, depending on the amount and indication for the medication, the most desire able way is to taper the medication. Parkinson's patients can have severe side effects if sinemet (carbidopa and levodopa) is abruptly stopped. ...Read more
Probably not bad: I had to look up rhodiola as that was one I had never heard of. There are no reasons, at least theoretically, that the two should be a problem. I did a literature search and there are no articles in the medical literature looking at rhodiola and sinemet (carbidopa and levodopa). There are some laboratory papers that suggest rhodiola should be helpful in pd, but I could not find any clinical studies in people. ...Read more
Depends...: Regretfully, there is no typical Sinemet (carbidopa and levodopa) dose following DBS, given that each patient is different and their need for treatment varies. Discuss this with your neurologist. ...Read more
Typical- Misnomer...: Quite honestly, as a neurologist I've found LESS AND LESS TYPICAL starting doses of any of the anit-parkinsonian medications as I get farther into my career. Oh, sure there are textbook numbers but when the actual DIAGNOSIS of PD cannot be firmly made at times for years after presentation should there really be such as a thing as a TYPICAL starting dose of Sinemet (carbidopa and levodopa)? Commonly seen is 25/100 3x/day. ...Read more