Hi Trixiedee,
I am in the uk too and got two different branded boxes of sinemet this week. One is working differently from the other. I had been getting branded in a transparent bubble pack for a few months, sometimes from different sources (spain, france). It worked great. This month I have one box MSD all labeled in english, and I was achy and tired all the time on it. The other box has dark navy blue stripes, is a different batch number completely, and seems fine. The ones that are not so good seem harder and shinier than the others.I had a batch like this early last year, luckily had some accumulated from when I was able to reduce my dosage, and did not have to carry on with them. Despite whatever the drug companies say not all sinemet is equal. In the US they have changed the way the pills are shaped and coloured, and maybe the formulation is slightly different too, people have noticed a difference, and the pills are not scored making it difficult to take a half dose.

If your medication is wearing off and not working so well perhaps the addition of entacapone (Comtess in the UK) would help. It has made a huge difference to me. I have the two separately so that I can fine tune sinemet to my needs, so I did not have to increase meds by 100 at a time. This has worked very well for me, though the two are available in a combination drug called Stalevo, which works well for some. You really have to learn what is best for you. Increasing doses is not always the right way to go. It can be that you are just not having enough ldopa get to your brain. Another drug that many people I have met in the UK seem to be doing ok on is Requip XL, an agonist, but seems to be better to tolerate for some. Ask your neuro or PD nurse about these. AS you can see from this I have had a different experience from Steve, and there is no one way that is right, it is all about getting it right for you. I have not tried Zandopa, would like to, though as it too provides ldopa have my reservations when I read about it wearing off fast. Keeping meds low and smooth seems to work best for me. As the side effects of these drugs are so similar to the symptoms of PD I have always erred on the side of caution. I have to admit I have never wanted to be on agonists either, but this does not mean they are not useful for some.

Any kind of infection can result in the way you are feeling, and could be a factor. Any UTI type problem especially. In MS they are well known to trigger relapses. Because we do not go into acute phases in the same way this is only anecdotal, but lots of people say that infection and/or inflammation have made them feel worse. Though usually I avoid antibiotics, for this I would take one, though it can be hard to convince the GP that I need one.... it usually helps a lot. In this warmer time of year make sure you drink enough too......