Levodopa ER before bed?

[Zardoz]

I recently met with a new neurologist who reviewed my meds. Previous prescription was (1) entacapone and (2 1/2) 25/100 levodopa three times a day. Total levodopa was 750mg/ day.

New prescription is (1) ER 25/100 levodopa before bed, (1) entacapone & (1) 25/250 levodopa upon rising, (1) entacapone & (1) 25/100 levodopa at 11am, (1) 25/100 levodopa at 2pm, and (1) entacapone & (1) 25/100 levodopa at 5pm. Total levodopa is now 650mg/day.

Question is whether 100mg of levodopa while sleeping is a waste of the meds.

[park_bear]

I take ER 25/100 levodopa before bed and I do not regard it as a waste. I typically sleep less than eight hours and it is usually still working for me when I arise. Also good to have it on board in the case of middle of the night bathroom visits.

[johntPM]

"Question is whether 100mg of levodopa while sleeping is a waste of the meds."

My answer is, it depends on whether it gives you any benefit.

Some PwP find nights troublesome and getting up difficult. They might benefit. Other PwP have few problems, their existing endogenous dopamine production being adequate to build up some reserves overnight. They might not benefit. I am still, 17 years post diagnosis, in the latter category.

Try it and see.

[marcet]

for me it’s not, without it i can’t sleep

[LAJ12345]

too much at night can make you restless and give you insomnia. Too little and it’s hard to roll over and get into bed, or out if you need the toilet. It depends on how much you make of your own overnight as the natural cycle peaks at midnight and is at a low at mid day.

If you wake up pretty mobile and function for a while before you need to take your first dose of the day you might not need it. If you struggle to get into the bed at night you might. Why not try 1/2 a tablet and see if you feel better or worse.

[hercules957 in reply to LAJ12345]

It is not recommended to split CR tablets.

[ryzlot in reply to hercules957]

My dosage is 1 and 1/2 tabs at specified times so I split for every dose. Ny tabs are scored and split easily

JR

[LAJ12345 in reply to hercules957]

The IR tablets are ok to split. But not the capsules. I'm not sure what ER ones are . Oh, extended release? So is that the same as CR?. Then they can't be cut.

[hercules957 in reply to LAJ12345]

CR is controlled release and should not be cut

[LAJ12345 in reply to hercules957]

yes, it is the IR tablet I am suggesting to cut, not the capsules.

[Annieartist]

I recently started taking a CR madopar 100/25at night-I took it for over 2 weeks (this did coincide with colder weather that tends to make me feel bad). Normally I take 100/25 3 times daily 7.30am, 12pm and 4.30pm) and I confessed to my PD nurse I often self medicate an additional dose in the evening if I have a social engagement or work to do. I slept badly and every day -late afternoon - I was SO shaky and yet my upper arms felt like they were paralysed. This feeling has worn off since I stopped taking the CR. Anyone had anything similar? I also got CUE1 about the same time but don't think it was that.

[Annieartist in reply to Annieartist]

Thats why she suggested a night dose (especially as I said my sleep was deteriorating)

[LAJ12345 in reply to Annieartist]

Yes, this is what happened to my husband on the CR too . He went back to the IR and just takes an extra 1/2 at night instead now and went from seeming like he was dying to back to his normal prechange self

[Daisies22 in reply to Annieartist]

Hello, I've just read your post from a year ago and was wondering if you still have the feeling of being paralysed when taking CR. I have the same experience with all Madopar preparations, every time I take a dose (currently 7 Immediate-Release and one CR).Have you been able to resolve this problem and if yes, how?

Thank you in advance.

D.

[Annieartist in reply to Daisies22]

I haven’t tried again but I am thinking about doing so - I’ll let you know -I am struggling with my medication right now

[Jalia in reply to Annieartist]

May I ask how you are getting on with the Cue1 which I've just noticed you mentioned a year ago please !

[SGlass]

For me I had RLS during night. This night dose resolved it.

[hercules957]

I take 1 sinemet CR 100/25 at 23:15 and another one just before bedtime (around 00:15). It really helps me sleep.

[BeedieBird]

I take one 25/100 one hour before bedtime and then at bedtime 1 Rytary (extended release). Sleep all night now with no waking in the middle of the night.