Same morning issue
 

Any help would be greatly appreciated-- I already take stalevo every 2.5 hours- from 630 a to 6:30 p--it seems like I have no dopamine in the am--and need to leave for work by no later than 7 am. When I wake up-I feel sore and stiff and relatively quickly my feet and toes curl making it impossible to walk--short of taking my Stalevo at 6 am and waiting 30 minutes before I get out of bed--does anyone have any suggestions- orthodox or unorthodox to get started quicker-

My only caveat is that the answers are either "neutral" or positive--thanks

1. take 1 to 1.5 50/200cr tablets before bed is all i can think of. you might have a little l-dopa coming from those pills when you wake up. supposedly taking with fat - maybe a piece of avocado? - slows down stomach emptying and extends the drug delivery time of CR? I haven't really tested that statement which i think is on the package insert, at least about taking with food.
2. can't think of anyway to speed up stalevo dissolving and getting into your small intestine and the methods to speed up plain C/L might reduce the time to 20min sometimes.
i haven't read back thru your old posts but i assume azilect or an agonist are not options?

"--does anyone have any suggestions- orthodox or unorthodox to get started quicker-" ?

Agonists and rasagiline have a longer pharmacodynamic half-life than levodopa based drugs. So, a controlled release agonist taken on going to bed, e.g. Requip XL, may last overnight.

If you want to stick to levodopa based drugs, an IR pill will give the fastest response (look up the pharmacokinetic properties Cmax and Tmax). You want to reduce the time to gastric emptying. Taking the pill with fizzy water is recommended by my Parkinson's nurse, others have recommended eating dry biscuits, but eating too much will slow digestion. I've tried dissolving (or perhaps dispersing) Stalevo in orange juice and also in Vitamin C.

Exercise seems to help me absorb my drugs better.

My experience is that results are variable and benefits are low. So, to judge success you need many trials and a good measurement system.

You may also notice that constipation appears to slow the absorption of your medications. So, easier said than done, doing something about that, may help.

John

If you are like most of us and do not sleep straight through the night, have a c/l cr tablet ready to go for a 3-5 AM wake-up....if you do make it through the night, that is a big positive even though it doesn't solve your issue..

Eric

My neuro told me that taking sinemet with some lemon juice in the water would speed up the absorption. I find that it does but you have to be careful to rinse your teeth after to avoid tooth enamel damage. It also seems to help absorption if I've had too much protein too close to my next dose. I put maybe a tablespoon in a glass of water.o