[rd42]

http://journals.lww.com/clinicalneur...inetics.4.aspx

Conclusions: There is a slower absorption rate of levodopa during nighttime, probably related to delayed gastric emptying. However, the extent of absorption and bioavailability were unaffected. As the effect of posture on plasma PK was less than the effect of nighttime, this study suggests that the circadian rhythm has a pronounced effect on gastric emptying and absorption rate. Nevertheless, body position may also be an important factor, and it can be recommended that levodopa tablets be taken in upright position that probably should be sustained for at least 30 minutes.

My meds get less effective through out the day. I have to wait quite sometime after lunch to take my next dose or it just won't work, and if I don't eat dinner with in 1/5 hours of the last dose, it doesn't ever seem to kick in.

My schedule:
7 AM 1 x 25/250 Sinemet (works awesome)
8 AM eat
9 AM 1/2 x 25/250 Sinemet (not to noticeable)
11 AM 1 x 25/250 Sinemet (works almost as good as morning)
2:30 - 3 PM 1 x 25/150 Sinemet (don't really notice till next dose)
4:30 - 6 1 x 25/150 Sinemet (works great if I get 30 min mild aerobic type exercise, raking, and then eat. otherwise not much relief)

I 'm interested in other strategies. This is sort of an up and down schedule, but I do get nearly four distinct on times and the dyskinesias are minimal compared to when I tried 5 x 25/250 /day for a month or so. That didn't work all that well.

[kenki]

After a year of struggling to find the right dosage and frequency of Sinemet Plus (25/100) - I came across this book:

"The Parkinson's Disease Treatment Book" by Prof.J.Eric Ahlskog - a PD specialist Neurologist at Mayo Clinic USA.

I recomend check your local library to borrow or buy. Very very detailed -includes almost all known PD medications and instructions on how to find the right protocol for you. I wish I could quote from it, but there is no online version. It helped me enormously.

Good luck

Kenki