Hi, I'm RJ, I'm new here, male in my 50s, had PD for 7 years. I joined because I have been wabting to increase my PD knowledge base, help others when I can, and occasionally ask questions when I'm clueless!
My Movement Disorder doctor is on vacation and I noticed that I only have 1 Carbidopa/Levodopa Extended Release 50 mg/200 mg tablet left. For many years I have always taken 1 such pill before bed to get me through the night since it's extended release. Since I also take C/L immediate release 25/100 during the day, can I take 2 of those before bed to substitute for the missing C/L Ext Rel 50/200 tablet until I get my refill for the c/l ext rel 50/200? Any help or response would be appreciated, thank you!
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RJworldTour
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I would say no to taking that much IR at once unless you have done it before and know how you will respond. The ER releases gradually. If it were me and I couldn’t refill my prescription, I would take one IR and set an alarm to take the second one.
RJworldTour I second Juliegrace 's suggestion. In fact, I would go to one step further and take half of an IR tablet, and take another half a little later. Keep the other two halves for later on in the night if required or if you set an alarm.
CR acts rather quickly and depending on your absorption rate, you might have some discomfort if it is too quick. If you call your pharmacy during the day, they might be willing to give you a 5 day supply until your doctor has a chance to send in a script.
Hi RJ. I am a physician with Parkinson’s and just want to add how I take my medication. I realised that when I take nothing during the night it works quite well if I have‘ not eaten something with protein for dinner. This is because the aminoacids of the proteins interact with l-dopa for resorption via the blood brain barrier into the brain. Because I get stomache pain when taking the slow release tablets I don‘t take them. This was an interesting experience that in fact I do not need them during the night if I avoid dinner with protein. If I have an invitation for dinner with meat or fish I take L-Dopa/ Benserazid 30 min before eating. During the day I start my medication around 6-7 am when i wake up. Then I wait till my tremor comes and then I take the next pill. This is not to repeat for everyone because I have to live with around 30 min of tremors and pain. But by following this procedure I found out what I can tolerate. I react when I sit more than one hour in front of the laptop or when i have a stressful situation or when I eat food rich in proteins. This is bad for my Parkinson’s. I am still experiencing with my need for l-Dopa and different activities/situations. Currently I try to find out if gluten is bad for me. Hope you have a good sleep.....oh I just realized that I should put the answer in this field instead into the individual response .... Gisela
As you have heard many times before, Parkinson's disease is an individual disease as it interferes with our lives and our physiology differently. For example, Gisel stated that she has problems with protein competing with absorption of levodopa. In my case it does not matter what I eat, the absorption is even. One interesting fact that I remember reading a while ago. Is that the formulation of extended release and control released levodopa can only be absorbed at about 75%. 25% is lost for most people. Therefore, if you need 200 mg of CR, you might want to try 150 mg of immediate release and I would be careful to not take it all in one shot. For me a cycle is every 3 and 1/2 hours.
I too have questions. I was diagnosed in 2019. I have been on rytary 195 mg for two years. I have been taking carbadopa-levodopa 25-100 cut in half to offset my off periods. I know that for everyone the absorption of this medication is different and over time a person builds up a tolerancefor c-l causing one to take more c-l more often. I have also realized how stress makes my symptoms worse and how fast it starts my off periods. It's really frustrating when I can't move and I am waiting for my meds to kick in. Is anyone else on Rytary? I know my medication needs to be adjusted but that is difficult when I don't have an appointment but every 3 months with my neurologist or one of his pa's.Any thoughts?
I switched from Sinemet to Rytary last fall (3x195mg) @ 5a, 10a, 3p,8p, and 1.5 Sinemet 50/200 @ 10pm to get me through the night. I was taking 1/2 of a 25/100 1 hr before my next dose for a while, but my MDS thought that was limiting my freedom. I got a sample bottle of the 95mg Rytary and only use one after a vigorous exercise class at the Y with my 10am dose. Seems to be working out pretty well as my average tremor time is just over 1 hour/ day. If you can send a message to your neurologist, they might have a suggestion for you.
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