Hello everyone. Has anyone here ever received what they believed to be a "bad" bottle of sinemet from their pharmacy/supplier? I get my sinemet from the VA pharmacy, and until recently I always got the carbidopa 25mg/levodopa 100mg made by Mylan Pharmaceuticals Inc. Not too long ago I got a bottle of 360 tabs, and I swear they're "no good". I say this because they wear off hard and fast right at about 2 hours, and I mean it is "ugly". I've been having the worst dyskinesia that I've ever experienced. At first, I thought the pills were old/out-dated, because the color wasn't quite right. They're "yellow", but it's a slightly darker shade. They're "texture" isn't "correct" either--they seem "harder" than usual. Then I noticed they're larger. So, I took a look at the imprint (m/721), and sure enough they sent me a bottle of 360 tabs made by Mayne Pharma US. For some reason, my brain dose not like this med. So, before I actually figured out I simply had a different manufacturer, I called my VA neurologist and told her I had a "bad" bottle. Her remedy was to write me a prescription to be filled at a regular pharmacy. Well, "News Flash"--I can't really afford another prescription at SAMs Club or anywhere else. Oh well, I'm screwed AGAIN. This is madness. I take 3 tabs, four times daily. When this bottle runs out, whose to say the next prescription won't be from Mayne Pharma US again. I guess it's time to write my senator again, although he's already working on something else for me right now.
Question: My symptoms began around June 1996, so I'm 23 yrs into this. Could this length of time make me more sensitive to whatever subtle difference(s) there may be between makers of sinemet? I mean, I always thought "regular" sinemet was "regular sinemet."

toyl,

I'm sorry to hear of your problems.

The fact that you are having the "worst dyskinesia" suggests that the new pills are stronger (a higher CMAX than usual). And, the fact that you have shorter "on"/"off" transitions suggests that THALF is less.

The regulatory system demands bioequivalence, but this is interpreted rather loosely. Very roughly speaking this allows about a 5% difference.

See the thread:
Sun Pharmaceuticals new supplier

Last year I measured the weight of my pills (Stalevo in my case) and found inter-batch differences and intra-batch differences of 4%. Note that's the total weight of the pill, not the weight of the active ingredients.

Weighing tablets

After what dose are you having dyskinesia? You may find benefit spreading out your doses. Similarly, with the strong transition, perhaps eating a little fat with the dose may extend the half-life.

John

Won't the VA let you trade in this questionable batch & try a new batch?
Or give you a few days worth from another batch to test them?

I'm sure is possible for batches to have slightly different mix , but not recall worthy..
Just like food or anything.. if you get something that seems off ask about a return or exchange...

Thanks, johnt, for your reply. Don't know what CMAX is, and don't know what THALF is. I did have a look at the "Sun Pharmaceuticals" link, and was surprised to see so many different makers.
For about 4 years now, I've been taking 3 tabs, four times daily of the carbidopa 25mg/levodopa 100mg formulae. Except for a few years beginning around the year 2000, I have always taken the Mylan carbidopa 25mg/levodopa 100mg (Imprint Code: M;CL2).
Your idea of "weighing" individual tabs and then trying to objectively decide if the heavier tabs worked "better" or caused worse "off" crashes or whatever, if that's where you were headed, sounds interesting. Of course, you realize that drug makers, as well as 8th grade chemistry and home-economics students, are quite adept at ensuring that each individual pill (or cupcake) in the batch contains the correct dose of ingredients. It's really quite simple, save some catastrophic mechanical failure in the "process". It's achieved by "extensive" mixing of ingredients. This is why I don't understand how a Mayne Pharma carbi/levodopa can have such a profoundly different affect than the Mylan made pill of the same ingredients.
Yes, "spreading out" my doses is always critical. After all, sinemet is essentially "poison".

Thanks for your reply, Jo*mar. Well, everything you've just said is exactly what I was thinking. I think if my VA neurologist had received maybe 5 or 6 complaints similar to my own, she would have actually done something to look into it. Maybe she would have asked the maker and or distributor for documents that would certify the date of manufacture (to verify the "use by" date).

Our regular pharmacies here, we got all the paperwork about the med and the labels had the maker and some code number or identification..
Yours didn't have that info with it?

My dad got the generic C/L often the shape & color changed between 2 or 3 makers. But we didn't notice any issues..

There were posts many years ago about generics having more filler or lesser active percentages.. I think by soccerteses?? I probably misspelled the username..but it is close to that.. you can search for those posts with a name or keyword..

Oh taking any other meds?
After some years we had to drop the add on meds due to the accumulated side effects.. plus they weren't doing any positives by then.
Mirapex (pramipexole) was one those dropped

I think as we age we lose nutrient absorption. ..
That is written about on many website for ageing & nutrition.....
So I assume medication absorption changes too for better or worse..

When pot became legal in Oregon, we asked dad if he wanted to try it or CBD oil
, we had asked his neuro too but she claimed no knowledge on it and PD, so my parents did not want to give it a try.. Anxiety and hallucinations/delusions were a main symptoms by then.. and fatigue..