diagnosed 9 years ago:

I take meds 4 x a day
--Morning: amantadine, dynacirc (for hyper tension but may help with PD) mirapex .25 , stalevo 150, azilect, lexapro 100, chinese herbal supplements
--Noonish: amantadine, mirapex .25 , stalevo 150, Chinese herbal supplements
--Around 4:00pm: mirapex .25 , stalevo 150, Chinese herbal supplements
--Around 8:00pm: mirapex .25 , stalevo 150, Chinese herbal supplements, dynacirc

The chinese herbal supplements I take are mentioned in this thread: http://neurotalk.psychcentral.com/sh...ight=cogane%3F

Jean

Hi Arin,
Well spotted! I take entacapone alone, because it allows me to tailor my sinemet intake.

Arin
Sorry for not oops! Lost my post - trying again.

Arin - sorry for not replying earlier. And lindy, pay attention, because I have something for you in this reply.

Entacapone (Comtan)is a COMT inhibitor ( catechol-O-methyltransferase) and must be used in adjunct with carbidopa-levodopa (Sinemet) for it to do anything. I have had Parkin's for 18 years and have taken Comtan since it was U.S. approved. Before that, I took Tasmar (Comtan's brother drug which is a bit stronger. It was pulled from the market not too long ago, due to death-related incidence, but has since been cleared and is bac k on the market. Each of the pills I take are 200 mg, so T 3X a day WITH Sinemet of 25/100, so that is 600 mg a day.

Lindy, if you are taking Comtan alone, you are not getting its benefit.
For the record, Stalevo is simply Sinemet and Comtan combined.
http://www.rxlist.com/comtan-drug/pa...de-effects.htm

Hi Peggy,
Was answering to Arin, who I think was using the word alone to mean as a single medication rather than a combination. I am of course taking a does of sinemet with an entacapone tablet at the same time, when possible,same swallow. But you are right, my PD nurse says she has patients who spread their tablets out over the day some with their breakfast and some with a snack, nobody ever really explained things and they and don't take entacapone properly. It is a drug that has made a huge difference to me, I never got the full benefit of the sinemet I was taking until I went onto it, and regained the ability to smile, along with quite a lot more.

It does of course have some less mentionable very orange side-effects.

Thanks Peg!

Lindy

Hi,Arin.
I'm into my twelfth year post-diagnosis. I have taken only generic sinemet and amantadine as PD meds. I started with 25/100 quick-release 3X per day with 100mg amantadine with the first dose.
I have gradually increased the sinemet and incorporated (generic) controlled-release as per my neurologists directions.
My current daily regimen is still 100 mg amantadine followed with one 25/100 QR sinemet and one 50/200 CR every 4-5 hours. I also take another 50/200 CR about 4 hrs after the last combo dose. Sometimes I substitute a 25/100 QR for the last 50/200 CR.
That makes a total of 1000 or 1100 mg levodopa each day currently.
My "extra" med is dextromethorphan, 4 mg at bedtime each night. Check numerous posts by me and others on the reason and sources for the dex. This regimen provides me with reliable 75% "on" time with some fading toward the end of each dosing and in the evening.
I am still quite active for an almost 74 yo person, daily walking the dog a mile and weekly mowing a fair-sized yard and maintaining flower beds and other chores around the house. My PD is bradykinetic, rigidity, postural instability dominant with almost no tremors.

Arin, if eighty people were to post in this thread, it is likely that there would be 80 different regimines that differ in type, frequency and amounts taken to relieve the same diagnosed disease, and then we would , of course, have to add your dad and make it 81. Don't get me wrong, Arin, there is nothing wrong with gaining knowledge.Knowledge is a great tool. Let's look at your dad and try to adjust his meds according to his needs. It is good that you are taking your time and energy to do this for your dad.

First, each individual with parkinson's is different. Our cells, tissues, organs and systems differ in efficiency for a myriad of reasons ( eg. genetics, previous and current disease status, exercise levels, diet, stress factors, amount of sleep...and the list goes on and on and on).

Second, Thie disease itself presents itself differently in different people. While there might be one among us who only exhibits tremor, there might be others who exhibit everything but tremor, while others might exhibit all of the primary symptoms and up to ten or more secondary symptoms, some of which seemingly do not abide by any rules whatsoever.

Third, Sinemet, regardless of what you might have heard about it, works on practically every one who takes it to temporarily relieve parkinson's symptoms, therefore, we can say :

Fourth, if your dad is not responding to sinemet, then he probably does not have parkinson's or something is blocking the absorption. There are several things that you and your dad can try to discover whichis the case. There ar e several questions that need answering. How old is your dad, and does he have any circulatory problems, endocrine problems, respiratory problems, digestive problems, excretory problems, etc. that would affect the delivery of L-dopa?

Please, before you pay any attenton to what I am telling you speak to your dad's neurologist. I am just a patient, I AM NOT A DOCTOR. Here are some personal, anectdotal examples. I developed absorption problems and sinemet no longeer worked for me. I found that regular sinemet can be dissolved in a glass of orange juice, thereby increasing t he rate of absorption. I also found that sinemet CR requires light exercise n order to be effectively delivered through the lymph system. I also found that a clean bowel is very benficial to delivery. None of this is profound information, but it all works together.

michael