FOR those taking CR or RYTARY, always a good idea to try to get your MD to write you a RX for regular C/L with 1 refill to have for just this situation. get it filled ASAP, pay for it privately if you have to, cost to the pharmacy is incredibly cheap for C/L so don't pay over $20, at $15 they are making a good profit
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Carbidopa / Levodopa Prices and Carbidopa / Levodopa Coupons - GoodRx

nothing worse than running out of CR or CL. As good a relationship i have with my independent pharmacy, i supported their computer system for 15 years before retiring, they are super busy and they got side tracked from trying to find MYLAN regular C/L. the generic they could get i didn't like, made me spacey, so I did a quick experiment to see if chewing 1/2 of a CR worked as quickly as a regular C/L and it did kick in almost the same time. whether this would work for days without some unexpected buildup of CR at times i don't know.

Thank you for highlighting the supply problem. I've not heard of any problems in the UK - yet.

One issue with breaking up a levodopa/carbidopa CR pill is that it increases the bioavailability of levodopa by about 30%. Normally, as a CR pill is sitting in the stomach providing no therapeutic benefit for now, it is slowly being disintegrated and the freed levodopa starts being metabolized. It is only when the levodopa gets to the upper intestine that it begins to get absorbed.

So, watch out for things like hypotension and dyskinesia, and be ready at the end of the drug cycle for a faster "off".

John

Then would it follow that chewing the pill also can facilitate a faster "on" cycle? Or is it that simple....on occasion I come across soomething like papaya enzymeor fizzy citamin C or saltine cracker with butter etc etc thatt will facilitate the "on" transition but it tends to last only awhile.

Just came across this from an old post of our dear departed friend and NT forum member Reverett:



1: Rinsho Shinkeigaku. 1994 Mar;34(3):264-6.

[Gastric acid secretion and absorption of levodopa in patients with Parkinson's
disease--the effect of supplement therapy to gastric acid]

[Article in Japanese]

Yazawa I, Terao Y, Sai I, Hashimoto K, Sakuta M.

Department of Neurology, Japanese Red Cross Medical Center.

Since an oral regimen of levodopa has been instituted for treatment of
Parkinson's disease, its absorption and metabolism has been well demonstrated.
However, its chemical characteristics of high solubility in acid solution and low
solubility in water have not been well known. We paid attention to this
characteristic and studied the relationship between its absorption and gastric
acid secretion in 38 patients with Parkinson's disease who became refractory to
therapy of levodopa. We measured the pH and amount of collected fasting gastric
juice. Gastric acid secretion was decreased in 22 patients (58%). In ten of these
22 patients, 30 ml of lemon juice was prescribed in every administration of
levodopa as a supplement to gastric acid for two weeks. Increases of L-dopa
concentration after 60 min. and 180 min. were observed after lemon juice
supplement therapy. Among the Parkinson symptoms, rigidity, akinesia, and small
step gait were improved in every case except one patient who showed decrease of
L-dopa concentration at 180 minutes. However, improvement of tremor was less
remarkable. We consider this supplement therapy to gastric acid is one of the
effective and useful methods in the management of Parkinson's disease.

MD

john, i was testing if 1/2 of a 50/200 chewed up would substitute in a pinch for a 25/100. would it kick in in about the same time, have the same affect? it was close. so i wanted increased bioavailability from chewing it up. it's not going to have more l-dopa becoming available than a 25/100. fwiw, i also chewed some gum after chewing up the CR, it sticks to your teeth