Madopar CR v Rytary

[jeeves19]

Morning all. Just trying to get my head around the difference between these two? Also, Neurologist has me on Madopar CR during the night and immediate release during the day. I’m trying to work out what the purpose of immediate release is? Why not CR twice a day?

Thanks guys 💊😀

[johntPM]

Rytary contains levodopa and carbidopa.

Madopar contains levodopa and benserazide.

The carbidopa and benserazide are taken to get more of the levodopa into the brain, where it can do some good. They are similarly effective.

Apart from the active ingredients in a dose, pharmacists can play around with coatings, which help to control the release of the drug, CR. Rytary uses three different types of beads to give a longer lasting, smoother effect.

At first sight it seems good to have a CR pill with a longer lasting effect. The problem is that the longer the pill is in the stomach, the less accurately that the pill follows your needs. The immediate release, IR, pill is effective faster and more reliable.

[jeeves19 in reply to johntPM]

Thanks very much John. Much appreciated buddy 😀

[jeeves19 in reply to johntPM]

whilst you’re here, would you explain what the COMT class of drugs are and comment on your perceived efficacy or value?

[buzbyc in reply to johntPM]

I've also heard, even by neurologists, the CR being referred to as standing for cr*ppy reliability due to the slow absorption problems. I had about 7yrs use of only CR until it became too unreliable. IR is now much better but off periods are more obvious, although this could obviously just be progression.

[Smittybear7 in reply to buzbyc]

 how do you deal with the off periods

[jeeves19 in reply to Smittybear7]

I dot think we do do we? Everyone asks for a solution and I don’t think that there is one . That’s why it’s such a *hit disease. Apomorphine pen

[JJAJJ in reply to jeeves19]

It’s all very complicated...the more I know the less I know. Have you tried taking Madopar with lemon juice to improve bioavailability ? CDP-choline can make medication more effective, I haven’t tried CDP on my husband I tend to stick to natural foodstuffs such as fresh lemon in this case and starve him of food (especially proteins) for two hours before/after Madopar. x

[buzbyc in reply to Smittybear7]

Doses nearly every 3 hours to make sure there’s a bit of overlap. Can sometimes stretch it a bit longer if the stars align (mainly relating to a good nights sleep)

[Smittybear7 in reply to buzbyc]

 I'm only on three pills a day. Would you suggest cutting them in half and taking them4 hours instead of every eight? Thanks for your help

[buzbyc in reply to Smittybear7]

You could try, as long as they're not the controlled release version which shouldn't be cut. It may give you a more even release of levodopa

[Sydney75 in reply to johntPM]

Interesting my HWP never did well on C/L immediate release 2 years of trying different doses etc. Switched to Rytary 3 mos ago. Overall much better. Everyone with PD can have different experience

[park_bear]

I use the generic version of C/L CR only and it works very well for me. The difference between CR and Rytary is the latter is even longer acting.

[Smittybear7 in reply to park_bear]

 do you experience any side effects

[Smittybear7 in reply to park_bear]

 what is difference between the two

[jeeves19 in reply to park_bear]

Thanks PB

[LAJ12345]

my hubby was put on the cr madopar and it nearly killed him as he kept wanting to kill himself. Also it made his throat constrict and muscles spasm.

[jeeves19 in reply to LAJ12345]

Blimey! 😳

[LAJ12345 in reply to jeeves19]

yeah so if you have started feeling worse since being on it you could try going onto the ir ones only and see if you feel any better. He now takes the madopar tablets. He used to take the capsules but I think the tablets are better as they can be cut. And I am deeply suspicious about him ingesting so much blue given we are eliminating all additives in food!

[JeanieBeanie]

Can we get Rytary in UK?

[jeeves19 in reply to JeanieBeanie]

Don’t know. Don’t think so. It’s never been offered to me.

[JeanieBeanie]

I read at least 2 years ago that it was going to be called Numient here but has not been licensed in Europe yet.

[rebtar]

i have successfully combined IR C/L with CR for a while now . I take 1.25 IR with 1 CR every four hours. I was having more wearing off due to food disorganization, i tried two IR instead, but the combo seems to work better ( if i am more organized with food). I do get a bit of dyskinesia in the evening - but not bothersome at this point.

[rebtar in reply to rebtar]

from what i understand, Rytary lasts longer than CR, but some people find it more sensitive to food, and not as effective as IR. It can also build up iver the day resulting in dyskinesia, and can take a while to get the dosage right.

[jeeves19 in reply to rebtar]

Thanks Rebtar

[Esperanto]

Herewith visualized the longer duration of effect of Rytary compared to the standard Sinemet IR and CR. Probably the levels of Madopar and Sinemet will be about the same. Although the pictures are from the Rytary website, they give a good idea of the principle.

Medication levels Rytary compared with Sinemet and Stalevo