Hi Arin,
I am 9 years from dx and take sinemet 100/25 tablets + entacapone as follows:

On waking (whatever time that might be)
2 x 100/25 sinemet tablet + 1 200 entacapone tablet

After approx. 3.5-4.5 hours I take the same dose again.

My third dose of the day is:
1.5 x 100/25 sinemet tablet + 1 200 entacapone tablet

If I have had a long day I take a half of a 100/25 sinemet before bed.

I am currently thinking about splitting my second and third doses and bringing them closer together, maybe around 3 hours.

I do experience 'wearing off' of medication, which is more noticeable if I am being physically active. If I am absorbed in doing something sedentary I may not notice it until my body 'tells' me.

I have worked very hard to maintain this low dosage, currently an absolute maximum of 600 per day, choosing to go against initial advice to take more if I got 'wearing off'' issues. Instead I lowered slightly and divided doses, as I had been prescribed 200/50 sinemet 3 tid. The addition of entacapone three/four years ago allowed me to lower my intake by 150. Since then I have increased by about half a tablet every 18 months.

Somebody on this forum years ago suggested splitting doses instead of increasing intake of sinemet - on the basis that the tablets contain far more active ingredient than we uptake, and that sinemet has a short half life in the body. It has worked with me, with the proviso that entacapone improved uptake immensely for me. I know this does not happen for everyone.

We all respond to medication in different ways, it is a very problematic thing for doctors and patients. Whereas formerly doctors would increase sinemet intake to much higher levels than I have ever taken (8 per day max. around 3 years into dx) they now prefer to see patients on much lower levels of levodopa, as time and better awareness have revealed some of the problems of long term use.

Some patients do get an increasingly lower level of relief and therefore need to take more. The reasons for this are unclear. It is always a balancing act. This is also why there are many other PD medications that can be used to mitigate some of the problems.