Rytary and Sinemet together

[Mogul1]

Has anyone tried Sinemet and Rytary together? If so, what are your observations of these two Parkinson’s meds that aren’t generic?

[PDGal4]

I take 2 x 95 Rytary 4 x day. Because it wears off, I supplement with 1/2 C/L (generic) 3 x day. What were you wanting to know? Works well for me.

[shelly9 in reply to PDGal4]

Wondering if anybody is successful mixing at higher doses ?

[Mogul1 in reply to PDGal4]

Thank you for your reply. I have been struggling with Rytary for over a year.

Began taking 12/day. Too much. Lots of experimenting. Got down to 7/day.

Taking 48.75-195mg. Dramatic changes when it wore off. At day’s end stacking occurred. That is unreleased that should have released all going off at once. Changed my personality. No, not for the better!

Needed to smooth things out. What you are doing is what I was thinking!

Grateful for your reply. Will talk to my neurologist about gameplay.

Thank you!

[Mogul1 in reply to PDGal4]

Do you mind if I ask what your med schedule is? ie: what do you take, quantity, and when?

[PDGal4 in reply to Mogul1]

Not at all.

I take 2 x 95 mg Rytary 4 x day.

First dose, 7.30 am.

Second dose, 11.30-ish.

Third dose 4.30-ish.

Last dose 9.00-9.30 pm

I supplement with 1/2 25/100 C/L about 1.5-2.5 hours after first three Rytary doses (9.00-9.30 am, 2.30-3.00 pm, 6.00-6.45 pm), otherwise wears off. Especially in am when exercise burns through my dopamine. My neurologist is okay with this gameplan. He just stresses consistency. The supplemental 1/2 C/L was supposed to be 'as needed' but I pretty much always need. I was up to 2 x 145 mg (4 x a day,) then took 1 x (145 + 95) mg (4 x a day), then reduced to current 2 x 95 mg (4 x a day). Trying to control dyskinesias. Also I sometimes feel buzzed on higher dosages.

I think I metabolize meds fairly quickly. I also take Azilect in the mornings and use 4 mg Neupro patch. I was diagnosed 7 years ago.

You Wrote: At day’s end stacking occurred. That is unreleased that should have released all going off at once.

What does that mean??

[Mogul1]

Well, exactly the same Rytary schedule as mine. I also take Azilect in the morning.

I found that around 6pm when I got off work my voice changed slightly, my enunciation deteriorated, I was easily aggravated, edgy, and drove home rocking out with the volume cranked and driving too fast. I was doing a classic Jekyl/Hyde personality change. My wife was in shock. I was buzzed. It was crazy.

When I started analyzing what was going on, I felt like the Rytary was stock piling an unspecified amount of the fast release portion and somehow knowing to release at the end of the day and I would get”launched!”

When I described this to my neurologist he said that stock piling was actually known as Stacking. Since there is a medical term for it, I realized it was not uncommon. It also opened my eyes to the inefficiency of the constant release and fast release aspects of Rytary.

I would guess that the times that you have felt buzzed were towards the end of the day. If so, that is stacking. It is my opinion that this is from the fast release aspect of Rytary. I would suggest that you ask your neurologist about it. He can give you a better description.

Because of the problems caused by stacking, I eliminated the 9:30 dose and reduced the 4:30 dose to 1 capsule or maybe 2 depending on how I feel and whether we have plans for the evening.

This is excellent info for me because I have been changing my dose and meds in search of that ideal med that let’s me transition from one dose to the next smoothly.

I was diagnosed in March of 2012.

I live in the USA also.

[Fishaholic in reply to Mogul1]

Hey , I had same thing happened to me aggravated,edgy, and driving home. I just went into house chewed my pet African Gray ass out, and turn on some loud music and laying in bed doing the Dyskinesia Disco. I think it was most painful night I have had on Rytary. I don’t know how many calories I burned up. What really makes me feel bad screaming at my Parrot.What has Rytary done to myself.

[Mogul1]

The Rytary I take is 48.75mg/195mg. Do you have a similar description for yours?

Apologies for the slow reply. Working on my own new recipe!

This is tremendous info. Very similar.

Thank you.

[PDGal4]

I take 2 x 23.75/95 mg, which comes out to around the same dosage. Neuro offered to write on 195mg, but I prefer the two smaller capsules. Take two of those four times a day.

I don't think I experience stacking as you describe, and my buzzed feelings were when the dose first hit, about an hour after taking. I am still not 100% sure about Rytary; it's so new. Recently I had some issues with chest pain and the ER said EKG showed an irregularity having to do with ischemia (narrowing of arteries so heart doesn't get enough blood) but follow-up with cardiologist, he doesn't think there are any heart issues. Doing another test to be sure. But my concern was I read online 2.5% of people taking Rytary had ischemic episodes. Cardiologist doesn't think so for me as I have very few risk factors (like high BP, overweight, etc.) and neuro says I am on a low Rytary dose.

I was diagnosed April 2012 by internist, confirmed May 2012 by neuro.

[Mogul1 in reply to PDGal4]

Thank you for the reply. This is very helpful. I have switched from Rytary to Sinemet and although t is smoother, it drops off quickly. Seems like I am constantly taking pills. A “toned down” version of Rytary makes sense. I have had trouble with the higher strength Rytary for some time, but I am told it is the Ferrari is

[Hidden]

Very similar responses to my own. Was also having problem with very low blood pressure when taking rytary with Azilect. Reduced Azilect to .5 and take it at bedtime instead of the morning and I sleep better. I only take rytary in the late afternoon and bedtime. The rest of the day I use generic form of Sinemet. I have to be very careful with when and what I eat. Too much fat and it doesn’t work for me or too much sugar and it burns through me. I try to use music to slow me down when I am stacked. Also found that wearing off and stacking both seem to make me hyper aware of sounds and light. I just read an article about new recommendations on dosing advanced Parkinson’s. Also, more attention is being paid to dosing by body weight. Good luck and thank you for your thoughts.