Originally Posted by SmittyZ3M

Hi Lindy,

Thanks for the reply, and I apologize for the confusion in the medication. I have been reading so many other posts and people mention the medication "Sinemet" that I simply assumed that my mother was using it also.

To clarify, I just read and wrote down the names and dosages of the medications my mother is currently on:

1. Carbidopa / Levodopa 25/100 (which is a substitution for Sinement 25/100)

2. Carbidopa / Levodopa ER 25-100 (which is a substitution for Sinemet CR 25/100)

Sounds like the two meds you describe above are generics. There have been some reports from people on the forum that these work differently than branded medication, and that the amount of available levodopa differs too, due to differences in the way they are ingested. My personal experience is that I did not do well on generics, though in hindsight I think that is probably due to th difference in how much levodopa was actually getting through.


She takes one each of the above, three times daily :: breakfast, lunch, dinner. So, a total of 6 pills per day.

I read the above directly from the bottles.

With this in mind, I have a few questions:

1. Is there a true difference between the Sinemet and the Carbidopa / Levodopa, as I interpret from your post that there may be?
As I described above, the active ingredient is not different at all, but the availability may be.


2. Is it safe to assume that ER = Extended Release and CR = Controlled Release, and that Extended Release means the exact same thing as Controlled Release?

In terms of the description, yes, they mean exactly the same, though it is unsure whether the matrix is the same in both

3. Is it safe to assume that "25/100" is the exact same thing as "25-100", the only difference being the "forward slash" versus the "dash" between the "25" and the "100"?
Yes


4. When I read other posts and see the term "l-dopa", is it safe to assume that "l-dopa" is the same thing as "Levodopa"?
L-dopa, levo-dopa, levodopa, dopa, and even sinemet are often used by patients almost interchangeably!

After being with her this weekend, I still honestly feel that she was doing better and showing more improvements while she was on ONLY number one (1) listed above in the medications. Her voice has gone back to sounding as weak as it did before she started any PD medication. The personality in her face and general being has, in my opinion, decreased since she has been on BOTH number one (1) and number two (2) above. She has been taking both number one (1) and number two (2) above for seven (7) full days as of today.

Might I be jumping the gun in forming conclusions that my gut instinct tells me that she is on too much medication at this point in time?
If both you and she feel that this is a possibility you should discuss this with the neuro

Is it frowned upon to experiment and stop taking number two (2) above to see what happens, or should this only be done at the recommendation of the neuro? Is it considered acceptable to call the neuro and ask my previous question as opposed to continuing the take both medications and wait until the next neuro appointment, which is the first or second week of April?
If the gains she has made are being lost on the new regime I suggest that you contact the neuro and discuss the possibility of going back to the original regime and maybe adding just one tablet per day initially, and gradually adding more until she gets maximum benefit. The one tablet could even be added as a half tablet twice a day, the neuro should be able to guide you through the best way to do things, and be willing to discuss it too. The key to this is getting a dialogue going with the neuro so that he/she is helping you to get the best results from the medication.

Hope this helps,
Lindy

Thanks,

Matthew