[MorningGlory]

Hello everyone. I am wondering if anyone can explain how the CR works. I am taking 50/200 CR 4xs a day, along with the 20/100 in doses of 1/2, 1/4, 1/2, 1/4. I take my first dose at 10:00 am, because normally I would wake up around 9:30, but now I get up between 7:30 and 8 to take another medication, and usually go back to bed for a bit. Even when I get up at 7:30, I have no stiffness.... no tightening muscles....and no involuntary movement. I only have tremors in right hand, arm, and leg... usually mild. However, within an hour of taking my first dose of Sinemet, my right thigh begins to tighten up and I can feel it in my right foot as well. As the day goes on muscle stiffness & tightening, and involuntary movement gets worse. I take my 2nd dose at 2, and then at 6pm and 10pm. The doctor said to try adjusting up and down, to see if it is off or on symptoms. I have tried going down and up a half pill of Sinemet 25/100... doesn't seem to make a difference either way. All I do know, is that in the mornings before taking any Sinemet.... the only symptom I have is tremors. I don't know if I am good because it has been 12 hrs since taking Sinemet (thinking that may be the cause, maybe too much), or if the CR releases in a way that causes this affect.

Additional note: I only started this dosage at the end of April. Before that, I was only taking Sinemet 25/100 3xs a day because the doc I was seeing refused to increase, though I was suffering. Literally, I was not living life... I was existing. It was wonderful the first month after the increase, but slowly the involuntary movement started, and now this past month, the tightening muscles. For the past week, when I go to bed, my foot is moving all around, and even some tremors (though different than what I had before the increase) is starting at night.

Any thoughts?

[soccertese]

just to be clear.
you were taking 300mg of 25/100 daily?
then the doctor switched you to four 50/200 CR plus 1.5 tablets of 25/100?

300mg is a very low dose. when were you diagnosed, how old are you and what other drugs are you taking may i ask?

are you seeing a neurologist?

just from my experience with CR, there are i believe 2 generics, i take the one made by MYLAN, i think the other generic was much less effective but i could be wrong. but that might be something you can discuss with your DR., trying another generic or increasing the dose to 1.5 CR'S as a test. normally you start with a regime and modify it as needed.

i'm not a doctor. be careful.

[MorningGlory]

I was taking the Sinemet 25/100 (25mg carbidopa/100mg levodopa) 3 times a day. That doctor was not wanting to increase, unlike the first doc I went to who was slowly increasing me when I started seeing the local doctor. I also forgot to mention, but was not able to add right away because the post had not been approved yet.... that I also take 3 Lodosyn tablets with the first dose (25mg tabs.) But, I was suffering tremendously... so I went back to the doctor I was seeing who isn't local. He then put me on the 50/200 4 times a day, and later added the 25/100 , dosing with 1/2 pill with first dose, 1/4 with second, 1/2 with third, and 1/4 with fourth dose. (so basically 1 and a half pills of 25/100 spread out with the 4 doses)

I am 46 years old. Tremors began at 39, but I did not get PD diagnoses until I was 42.

[soccertese]

OK,
i multiply the CR dose by 60% when calculating total l-dopa so your're taking maybe 500-600mg l-dopa, CR has less bioavailability than the immediate release - less gets into your blood than with IR. so logically would expect greater relief of your symptoms with more l-dopa which isn't happening. may CR which i believe dissolves and forms a gel which moves slower thru your intestine and supposedly lasts longer just doesn't work for you, it can take 2hrs to reach max. blood concentration so maybe you are getting too much l-dopa at times.

again, you need to pester your doctor for advice and i'll repeat my layman's theory that maybe you need to try another generic or even the brand name, not sure if SINEMET is still sold?

good luck.