I have pd for 10 years and take levadopa 100/25 tablets 4 tablets daily.My doctor wants to increase my dose by switching t0 Stalevo.The new drug is much more expensive.Wonder if its worth the difference.

For me it was..I had no choice, nothing else was working, and was unpredictable

Stalevo is notorious for dysknesia, some people get it worse than others..I get it when it is kicking in or wearing off

Stalevo has been consistantly predictable for me

The other option is to take the two component drugs in Stalevo separately, sinemet and entacapone (Comtan/Comtess). I do this as it is easier to tailor the dosage to my needs.

Dear Lindy
Adding anything new is so scary, as even small adjustments can feel so life-threatening. What change can I expect will be necessary to my Sinemet dose and timeing when adding Comtan?

PD diagnosed from 2007. From 2010 I started with Madopar. but from about six months I have changed a neurologist, and he told me to take Stalevo, like Sinemet, but there is also entacapone, which is to last longer, the levels of l-dopa in the blood. In any case I prefer Madopar, because I can adjust the dose in a better way (as written by lindylanka above). Moreover, Stalevo does pee fluorescent!? However, until now, no side effects, it seems. Still honeymoon.
By the way, how long on average for honeymoon ?

Hi, Atma Namaste,

I was aware before I started taking Comtan that more l-dopa would be getting to my brain, so was prepared to make adjustments to my daily dose. My initial few days were really good, I was more flexible and I got back a proper smile, rather than exaggerating a smile-like facial gesture! Following on from that I sometimes noticed that movement would be a little out of control, and felt that I was teetering off the pd tightrope, so adjusted down with sinemet till I felt I was doing well. It took about two and half months to get it right, because I waited and watched between changes, but eventually I was on a quarter less l-dopa than previous, and was considerably better medicated than before. I remain on a low-ish dose though I have slightly increased my morning dose, and if I have a very long day take an extra dose at night to avoid sleep problems and inability to move in the morning. I can't really advise more on this except to say that comtan does get ldopa doing it's job, and you are likely to have to very gradually reduce your l-dopa till it is optimized to your needs. I reduced first from the end of the day dose, then middle, and then early, because I have done well on having a good dose to start the day.

Good luck with it if you decide to add it to your meds, and remember to give it time. It can be really helpful if you persevere.

PS (Also be prepared for the inevitable orange stain to your urine )

Thanks --- did you continue to take the meds at the same time of day, and just reduce the dosage, or do you now take the L-dopa doses farther apart? Did you start out with 200mg of Comtan with every dose of L-dopa, or did you start off gradually --- I read a suggestion to start off taking Comtan with every other dose, and work up ... ?

I kept with my original timings, three a day, and added entacapone to one dose for a week at a time, starting with the last dose of the day, then the middle, then the morning. By the end of the third week it was clear I was a bit over medicated so started to reduce down in the same way. All in all it took a couple of months of slow changes..... I do take the doses around 4 and a half hours apart - with sinemet alone the had been getting very close together, and had just added a 4th dose to the day on my neuro's advice. My PD nurse differed as she thought I still looked under-medicated and thought maybe the extra l-dopa was of no benefit if it was not getting to where it was needed.

I went on Stalevo 3 mos ago and it has been a wild ride,it takes an hour to kick in and meantime you have tremors ,sometimes it has taken 2hrs. The past two days one dose did not seem to take effect a tall and pain was intense so took anther dose on 2hr time. I am on Stalevo 125 5 or 6 doses a day. Not everyone appears to get this problem,I went from 5 Sinemet 25/100 to Stalevo, shoould maybe have done sinemet and Comtan first.I was dx in11/2008 going on 77 so maybe age has something to do with it.
Another Pder male 59 takes it no rigid schedule lots of exercise aand does not have a problem, lucky him
Hope you are lucky
Joyce

[QUOTE=trubrit4;912610]I went on Stalevo 3 mos ago and it has been a wild ride,it takes an hour to kick in and meantime you have tremors ,sometimes it has taken 2hrs. The past two days one dose did not seem to take effect a tall and pain was intense so took anther dose on 2hr time. I am on Stalevo 125 5 or 6 doses a day. Not everyone appears to get this problem,I went from 5 Sinemet 25/100 to Stalevo, shoould maybe have done sinemet and Comtan first.I was dx in11/2008 going on 77 so maybe age has something to do with it.
Another Pder male 59 takes it no rigid schedule lots of exercise aand does not have a problem, lucky him
Hope you are lucky
[UPDATE 11/25/12
Note: September added Gabbapentin 300 mg it is marvelous no symptoms walking shopping and living normally. Only thing is Stalevo cost , I am in medicare gap and it is 300 for 30 day supp;y. Plan pays $535.so next yer will be in Gap by May.considering options , going to Sinemet and Comtan