According to the NIH CL ER has less bioavailibility (which I found also to be true) requiring a higher dose for the same effectivity.
SINEMET CR is less systemically bioavailable than SINEMET and may require increased daily doses to achieve the same level of symptomatic relief as provided by SINEMET. link
http://dailymed.nlm.nih.gov/dailymed...6-2520ef505cb0
If you have trouble with high doses (as you say your doc does) then ER would perhaps not be as good as the regular. I don't have PD, as it turns out, but thought I did at the time. I noticed I needed more to remain asymptomatic or "on" with ER. As I tried to get off sinemet I found ER was much less predictable and produced very erratic on off cycles over three hours that differed from day to day and hour to hour. I got much more predicable and stable effects that allowed me to better predict and reduce my dosing.
The mechanism for extended release in this drug appear to be inexact according to clinical data (measured elimination levels in urine).
PS I had more trouble with hallucinations and bad dreams with ER. I think due to it's less stable or predictable bioavailabilty/decay profile. The more sameness I had from day to day the less issue I had with side effects. Anytime you mess with the levels on a short periodic basis I tend to have more audio and visual hallucinations and horrid nightmares.
Quote:
Originally Posted by ashleyk
Is anyone taking sinemet ER or CR (is there a difference?) during the day instead of regular sinemet or stalevo? How much good time do you get with er/cr compared to regular sinemet? It is my understanding that regular sinemet has a half life of 1 hr, stalevo 2 hrs and the er's 4 hrs? (if you don't eat).
My wife takes one or two 100/25 er during the night and 4 stalevo 75mg, 4 stalevo 100mg during the day. That's about 900mg of l-dopa a day. Her neuro does not want her to exceed more than 800mg/day and to take only one er at bedtime. My wife has a lot of off time swings and tends to have bad, disturbing hallucinations into the evening. Stalevo is probably a contributor to the psychosis. Does it make sense to replace the stalevo with sinemet ER? Or, what is the down side to ER/CR?
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