Hi- I am a cc physician who was diagnosed 6 years ago at age 41--I have not had tremor or dyskinesia but certainly have significant off time-progressive over the years. I had relied predominantly on Stalevo---before i switched this weekend to Rytary I was taking C/L- 150 am -200 comtan and then C/L 100 with 100 Comptan at intervals--total 5 doses/day-not satisfied! My early experience with Rytary has been positive--despite switching "on a dime" and having a pretty bad viral infection- I am significantly better. I started 23.75/95 (4 capsules) TID--but noted that I was a bit "hyper" with this dose and my sleep was not as good. I changed to Rytary 23.75/95 x 4 iat 6-7 am--x3 approx. 11 am--x3 approx 2-3 pm and x2 6-7 pm---so I am taking the same toal dose but have been less wired in the early afternoon and have slept better----tel me what you think?---I obviously don't want to increase my risk of dyskinesias--experience is obviously limited but i would think that the lower exposure during the nightime might actually be better--any thoughts????

hard to comment, seems good you can eliminate the COMTAN? does your neuro consider you a "guinea pig"? wonder if patients will experiment adding regular C/L in 50mg increments since easy to split and cheap vs. adding a rytary cap?

from my readings and from better relief from continuous delivery dudopa pump, less drug isn't the goal but keeping l-dopa brain levels constant. especially concerning dyskinesias.

I just started Rytary 195 strength. Trying to cut down on number of pills/expense. Does anyone know for sure if 1 of the 195 strength is basically equal to taking 2 of the 95 strength in all ways (minus the 5mg difference)?

I've been on taking Rytary for 1 month. I take 3 capsules of 47.85/195 MGs 4 times/day ( take @ 0600, 1000, 1400 & 1800). It is working very well. I have almost no wearing-off like I did with regular C/L but seems very sensitive to protein. If I eat a high protein meal within less than 1 hr from taking the capsules, I suffer wearing-off much more than when I wait 1 hr after eating. Otherwise I'm very happy with Rytary!
Slumpy217

Slumpy,
Trying to compare things, wondering what strength of regular C/L you were taking before? Glad things are working nicely for you...

eds195

I was taking 18 (eighteen) of the regular 25/100 C/L per day including waking up at 1-2AM to take a couple.
Slumpy217

I just got back from my appointment with my Neurologist. I have been on 3 caps of 48.75MG-195MG 3 times a day. My doctor was interested in my feed back because I was his 1st patient taking it. You can see my other posts to get a profile on me I won't repeat what was previously Posted.
I took the aforementioned dosage at 8AM-4PM-12PM ie. 8 hr intervals. The medication was effective for 5 1/2hrs so I would supplement it with 1 carb-lev 25-100 at the end of the 5 1/2 hr duration which got me thru to the next Rytary capsules. I only supplemented the 8AM Rytary and he 12PM Rytary. This worked reasonably well. After a month I found the Rytary caps had no affect on me while I was sleeping. I would get up several times during the nite to go to the bathroom and I had trouble making it to the bathroom. It was if I had no drug in me at all. So on my own I changed my intake for the next 15 days until I saw my Neuro again to 6AM 11:30AM and 5PM 5 1/2 hour intervals and I did not take anything else during the nite because it had no affect. I still had the problem of almost falling down each nite while traveling to the bathroom.
I visited my Neuro today and he had no problem with my switching the intervals to 5 1/2 hrs but he was worried that i could fall down in the nite. He said you could take the Rytary 4 times a day at 5 1/2 intervals but that will no help your nite time problem that the Rytary does not work while you sleeping so he put me on a delayed carb/lev 50-200MG at bedtime to see if that would get me thru the nite.
Oberservations and other side effects:

I had more nausea especially at first while on Rytary. This has diminished but I still have some.
Ryatary is affected by the food you eat more than Car/Lev. Meat drastically impacts Rytary's effectiveness.
Other foods have some impact I won't specify because it is probably an individual thing.
You should try to separate the pills and the food you eat by 1 hour.

Overall I am pleased with the Ryatary it is a big improvement over taking Car/Lev every 2 hours.

I hope there was some benefit to you from my observations this is a nasty disease and I wish the best for you.

Getting the right dosage is important for all drugs. However, my experience so far is that for Rytary it is crucial. It also is very tricky to achieve. I wondered why Impax came out with so many variations of Rytary. Now I understand.

I started out taking 3 caps of 48.75MG-195MG 3 times a day (at 6am-12pm-6pm). This led to daytime dyskinesia, wearing-off and sleepless nights. After trying additional modifications, I'm currently taking 2 caps of 48.75-195MG combined with one cap of 36.25-145MG at 6am and 10:30am followed by one cap of 48.75MG-195MG combined with two caps of 36.25-145MG at 5pm and bedtime.

I'm also taking 100mg of Amantadine twice a day.

This combination seems to be working, but I'm guessing that it will be a continuing process to get the dosage right as symptoms change.

Rytary is a great drug, although getting my insurance company to agree to pay for it with a reasonable co-pay is a battle.

One of the rytary "rules" my MDS gave me when he provided me the rytary was "Take Rytary one hour prior to meals." My MDS was involved in the clinical trials and helped Impax and FDA come up with the recommended dosage. Another rule, "it will take 2-3 weeks to establish a stable clinical state of clinical picture after the switch to rytary."

I am also very happy with rytary. The first dosage schedule my MDS was 3 capsules of 195 MG ever 4 hrs at 6AM. 10, 2 and 6PM. But after about 3 weeks I had some minor wearing off in the late afternoon about 4-5PM so I switched to the alternate schedule my MDS provided which was 3 capsules ever 3 hrs at 6AM, 9, Noon and 3 PM then 1 capsule at 6PM which is 1 more capsule then the 1st schedule (13 capsules/day vice 12) and very slightly exceeds the FDA max dosage/day of 2450MG. This alternate schedule seems to be working better with no wearing off. I have not had any problems at night with 12 hrs from my last dose at 6PM to my first dose the next morning at 6AM.

Slumpy

boy, that sure seems odd it doesn't work during the night. have you contacted IMPAX labs about that?