Rytary question
 

Neuro has offered Rytary to us and we are wondering....how is this different from other CR sinemet combos?

Having to take almost twice as much levodopa is also worrisome....why? Doesn't that just put a lot of drug floating around in the body not being used by the brain (not good)?

I have read mixed reports from patients who have tried it, who here is taking it and for how long, is it better than regular C/L or CR C/L? Thanks!

My Pharmacist told me that Rytary was no better than the ER (extended release) levodopa which gives me 5 to 6 hours of relief so I just use the ER. The cost was the same as the regular Levodopa (with insurance my co-pay cost is $15/mo).

how did rytary come up, did your neuro suggest it or did you ask about it? i haven't talked to my neuro about it but did attend a pd event where a respected MDS mentioned it was available.

the worst that would happen if you tried it would be it didn't work well and you just switched back to the C/L you were taking. the best would be less off times with less dyskinesias? are you being asked to be a guinea pig or does your neuro have patients that are doing better on it?

when you think about it, you really need just a tiny amount of dopamine in your brain and you want to keep it constant, how much extra l-dopa you have to take to get that little bit into your brain and what the consequences of taking that amount is a good question. do you have more of a homocysteine problem so would you be better adding a mao-b inhibitor or comtan or an agonist and reducing l-dopa, assuming you can tolerate these. opening a can of worms here.

not to digress, but there are 2 rescue products in development, inhaled l-dopa and a sublingual apomorphine strip, they both get directly into the blood so no digestive tract interference. that might allow one to reduce their C/L because the consequences of going "off" will be less.

i'm amazed how many insco's pay for rytary and how low the copay is. this stuff isn't cheap, wonder how long that will last?