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#1 MJHILLY

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Posted 09 November 2011 - 08:57 PM

I have horrible reactions to food effecting my parkinsons meds. I have to take small amounts of stalevo more frequently, for example one half of a stalevo 100 every hour and a half to stay on top of my symptoms.If I have any kind of food it slows my absorption and heaven forbid if I eat a so called normal meal it could take me 3 hours to come "on" My question is how much is too much. I have episodes of being practically paralyzed and shortness of breath and feeling oh so heavy.Is this the meds not working or a side effect, I also take Requip XL 20mgs a day and Azilect.

#2 MComes RPH

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Posted 17 November 2011 - 10:30 AM

Great question. The first issue I hear that could be a problem is that you said you take 1/2 stalevo tablet. Stalevo is designed to be a long acting tablet so, by splitting it, it changes from a long acting to a short acting tablet. By splitting the tablet, the medicine that should be released over time is now being released immediately in your system. You get immediate, short acting results, but you also get immediate side effects. This results in the medication being released at different rates which will result in non-predictable on-off times. Also, when a long acting medication is split, one of the main side effects is stomach issues. The tablet coating helps protect the stomach and control the release of the medication. Right now, by splitting the tablet, you would get the same result by take 1/2 tablet of sinemet 25/100 because the extra ingredient, Entacapone, is not intact to help the sinemet work longer. That is why you are getting such a short coverage span.
So, how do we fix this. I have a few ideas:
1- I usually do recommend that PD patients eat several small meals than 3 big meals most of the time. It seems to help cut down on interactions and help keep energy levels higher throughout the day. Just make sure that you DO NOT eat protein at least 2 hours before or after the stalevo. The protein will bind up the enzymes in the that break down the stalevo, making ot non-effective.
2- were you prescribed to take 1/2 tablet of stalevo 100? If so, this could be most of the problem, as I stated above. If you were told to take 1/2 tablet of stalevo, contact the Dr and have them write a prescription for stalevo-50. This will give you the longer acting affect you are looking for because the ingredient that helps the carbidopa/levodopa work longer will be intact the whole time allowing it to work.
3- if it is by choice that you split themdue to cost, or what ever, then you may talk to your dr about changing to sinemet CR. this is q long acting sinemet which will also give you better coverage.
**I would also recommend downloading the "medication schedule" at the top of this forum. I made this to help people in your situation. You must have Microsoft excel. It can be downloaded and saved on your computer. You can the type in the date, medication, strength, and how many tablets you take at a specific time of the day. There is also a space at the bottom for notes where you can type what you ate, what side effects you had, any converns you may have, etc... You can do this daily as you add a new medication or try to figure out a dosing schedule. The best part is, and this is what I do, that you can then fax or email these sheets to your Dr 2 or 3 days before your appointment. This way, your Dr can go over this material before your appt. As we all know, half of our appt is used discussing what has happened since the last appt. My method van save time and, from what I have been told by many Dr's including my own, this is incredibly helpful to them. Information is priceless to them.
Keep me updated.



I have horrible reactions to food effecting my parkinsons meds. I have to take small amounts of stalevo more frequently, for example one half of a stalevo 100 every hour and a half to stay on top of my symptoms.If I have any kind of food it slows my absorption and heaven forbid if I eat a so called normal meal it could take me 3 hours to come "on" My question is how much is too much. I have episodes of being practically paralyzed and shortness of breath and feeling oh so heavy.Is this the meds not working or a side effect, I also take Requip XL 20mgs a day and Azilect.


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#3 Woody

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Posted 20 March 2012 - 12:42 AM

Hi Dr McCombes
Are you able to advise where I can download the Medication Excel Schedule. It may help us document things as well.
Cheers
Woody

#4 MComes RPH

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Posted 15 April 2012 - 12:07 PM

Woody,
Sorry for the delay, the page switched and I missed your question, I am very sorry.
Here is how you download the medication schedule.
When you are on the forums page, you click on "Ask the Pharmacist." Under "topics" near the top of the first page is a topic entitled "Medication Schedule." You click on that topic to get into that section.
Once in, you will see the instructions on how to download it. After the instructions, you will see the "Medication Schedule" download. Just tap that, then answer "download."
It will then be a Microsoft excel document where you can input the date, medication, the strength, number of tablets you take at a specific time, and a section for notes at the bottom.
You can do this as often or as little as you want, just remember, if you are doing it several days, make sure you give it a new title (I usually use med41411) for the date of 4/14/2011.. If you do not do this, it will re-wriye over the original.
Then, a few days before your appt, you can email, or fax, to your Dr. That way you can save time during the appt because the first 20 minutes is usually, "So, what has changed since you were last here?" He already has the info.
Once again, sorry for the delay, and a "Double Cheers" back to you mate.


Hi Dr McCombes
Are you able to advise where I can download the Medication Excel Schedule. It may help us document things as well.
Cheers
Woody


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




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