What's in ER C/L vs. IR C/L?

[Jockboy17]

We have tried using 25/100 ER in combo with 25/100 IR in an effort to increase time between doses and it consistently leads to negative symptoms that don't occur when I'm just taking the IR. Symtoms are mild headache, mild nausea, fatigue, my brain feels swollen and anxiety. It reminds me when I was prescribed Comtan early on in combo with sinemet that caused similar symptoms. Is there something in the ER that's not in the IR? thanks

[park_bear]

There are many different generic versions each with its own label. List at this link: dailymed.nlm.nih.gov/dailym...

Best to check ingredients for your particular manufacturer. Here is a comparison of a pair of IR versus ER examples chosen at random.

IR: dailymed.nlm.nih.gov/dailym...

Inactive Ingredients

Ingredient Name

STARCH, CORN (UNII: O8232NY3SJ)

MAGNESIUM STEARATE (UNII: 70097M6I30)

CELLULOSE, MICROCRYSTALLINE (UNII: OP1R32D61U)

FD&C BLUE NO. 2--ALUMINUM LAKE (UNII: 4AQJ3LG584)

------------------------------------

ER:

dailymed.nlm.nih.gov/dailym...

Inactive Ingredients

Ingredient Name

CELLULOSE, MICROCRYSTALLINE (UNII: OP1R32D61U)

SILICON DIOXIDE (UNII: ETJ7Z6XBU4)

HYDROXYPROPYL CELLULOSE (1600000 WAMW) (UNII: RFW2ET671P)

FERRIC OXIDE RED (UNII: 1K09F3G675)

D&C YELLOW NO. 10 (UNII: 35SW5USQ3G)

HYPROMELLOSE 2208 (100 MPA.S) (UNII: B1QE5P712K)

MAGNESIUM STEARATE (UNII: 70097M6I30)

[Jockboy17 in reply to park_bear]

Thanks PB, googling all of them doesn't reveal anything significant side effect wise.

[Juliegrace]

I don’t respond well to mixing the two, either. When I have I felt slower and sort of bogged down.

[Jockboy17 in reply to Juliegrace]

Thanks Juliegrace, what does work well for you to extend if any?

[Bunny622023]

Have you thought of using the 200/50 ER with the Comtan instead to lengthen without the use of an IR. Just a thought.

[Gigi_12]

I have had a terrible time with lightheaded spells. I take 1 1/2 tablets of 25/100 5 times a day that is IR and the Dr added 3 tablets of 50/200 ER. I'm thinking it has to be the ER as my family Dr has adjusted my blood pressure meds and other meds. The ER has helped the muscle strength and restless legs so I wish I could figure out a combo. It takes forever to get a response from the neurologist so I thought I would drop 1 dose of the ER. Any suggestions?

[gesundheight]

I believe the ER and CR versions release more Levadopa, so that the total levadopa released into the plasma per dose is more, but the Levadopa measured in the plasma at any point of would be 250.

[rebtar]

the combo worked for me, until it didn’t give me enough ON time and food interfered too much. Now trialling Rytary, which I’m still on the fence about…definitely more ON time, but tricky to keep from interfering with sleep, and some other differences I’m trying to adjust to/figure out…

[jackritchie47]

The ER stands for Extended Release and can also be listed as CR (Controlled Release). The IR stands for Immediate Release. This is usually determined by the amount and type of cellulose-related ingredients in the tablet. This will effect the breakdown and absorption of the dose. For example, IR tablets may be dosed 3 to 4 times a day whereas ER tablets may be dosed 2 to 3 times a day. Everyone is different as far as their absorption, distribution, metabolism and elimination so you will see different strengths and directions being prescribed.