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Nightmares


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#1 Southern Belle

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Posted 20 February 2012 - 03:51 AM

I've been diagnosed with Parkinson since 2004. My current medications for this are Azilect 0.5 Mg once a day, Carb/Levo tab 25-100 MG 4 times a day and Ropinirole tab 2 MG total of 5 pills taken daily. My question is do any of these cause nightmares? About 2 years ago the doctor took me off of Stalevo because of reports it put a patient at risk for heart attacks and gave me the Carb/Levo instead. The bad dreams began occuring around then as best I can recall. We didn't make any possible connection but recently they are more frequent like 3 times in the past 2 weeks. Am I on the right track or too far off base to suspect the medications are causing the problem? Thank you for your imput. Mgallo

#2 MComes RPH

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Posted 22 February 2012 - 01:21 PM

MGillo,
Welcome to the club of "interactions." this is very commonplave amongst PD meds. If you don't get the meds just right, who know what can happen. You take to little of a dose, you still have symptoms. You take too much, and the symptoms seem to get worse. So, hopefully this will help.
I believe you have a 3 medication additive affect. Each medication in itself can cause nightmares. Usually in this order: Azilect>Requip>Sinemet. This order can change depending on the dose you are taking and age. The older we are, the more likely we are of experiencing this effect. You appear to be having a 1+1+1=5 effect. Here is what I think you should take to the Dr about.
The incidence of nightmares is highest when Azilect is taken with Sinemet. Also, with the amount of times you are taking the requip daily, i am sure this may be adding to the issue.
Before you call yoir Dr, please reply with your medication list. Include the following:
Medication
Strength
How many you take
Time of day you take them
I will take a look at it and maybe if we just alter times a little bit, with yoir Dr's ok, we can possibly avoid changing meds all together.
Thanks, hope to hear from you soon.

I've been diagnosed with Parkinson since 2004. My current medications for this are Azilect 0.5 Mg once a day, Carb/Levo tab 25-100 MG 4 times a day and Ropinirole tab 2 MG total of 5 pills taken daily. My question is do any of these cause nightmares? About 2 years ago the doctor took me off of Stalevo because of reports it put a patient at risk for heart attacks and gave me the Carb/Levo instead. The bad dreams began occuring around then as best I can recall. We didn't make any possible connection but recently they are more frequent like 3 times in the past 2 weeks. Am I on the right track or too far off base to suspect the medications are causing the problem? Thank you for your imput. Mgallo


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

#3 Southern Belle

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Posted 23 February 2012 - 10:04 AM

Here is my medication schedule:
7 AM = 1 Azilect 0.5 MG, 1 Carb/Levo 25-100 MG, 2 Ropinirole HCL 2 MG, 1 Januvia 100 MG, 1 Triamt/HCTZ cap 37.5-25 for a total of 6 pills.

12 PM = 1 Caltrate 600-D, 1 Carb/Levo, 1 Diovan 160 MG, 1 Klor-Con M20 tab 20 MEQ ER, 1 Ropinirole for a total of 5 pills.

5 PM = 1 Caltrate, 1 CArb/Levo, 1 COQ10 100 MG, 1 Klor-Con, 1 Ropinirole for a total of 5 pills.

10 PM = 1 Carb/Levo, 1 Ropinirole, 1 Vytorin tab 10/40 MG for a toal of 3 pills.

My doctor has suggested I could try 5 carb/leco pills through out a day but that makes me too woozy and I won't do that. I want to be alert and mobile. I usually lie down for 1 hr. nap during the afternoon as after lunch I'm quite tired and a nap can give me enough energy to finish out the day. Thanks you for your reply.

#4 Southern Belle

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Posted 29 February 2012 - 01:50 PM

MGillo,
Welcome to the club of "interactions." this is very commonplave amongst PD meds. If you don't get the meds just right, who know what can happen. You take to little of a dose, you still have symptoms. You take too much, and the symptoms seem to get worse. So, hopefully this will help.
I believe you have a 3 medication additive affect. Each medication in itself can cause nightmares. Usually in this order: Azilect>Requip>Sinemet. This order can change depending on the dose you are taking and age. The older we are, the more likely we are of experiencing this effect. You appear to be having a 1+1+1=5 effect. Here is what I think you should take to the Dr about.
The incidence of nightmares is highest when Azilect is taken with Sinemet. Also, with the amount of times you are taking the requip daily, i am sure this may be adding to the issue.
Before you call yoir Dr, please reply with your medication list. Include the following:
Medication
Strength
How many you take
Time of day you take them
I will take a look at it and maybe if we just alter times a little bit, with yoir Dr's ok, we can possibly avoid changing meds all together.
Thanks, hope to hear from you soon.



#5 Southern Belle

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Posted 29 February 2012 - 01:53 PM

MGillo,
Welcome to the club of "interactions." this is very commonplave amongst PD meds. If you don't get the meds just right, who know what can happen. You take to little of a dose, you still have symptoms. You take too much, and the symptoms seem to get worse. So, hopefully this will help.
I believe you have a 3 medication additive affect. Each medication in itself can cause nightmares. Usually in this order: Azilect>Requip>Sinemet. This order can change depending on the dose you are taking and age. The older we are, the more likely we are of experiencing this effect. You appear to be having a 1+1+1=5 effect. Here is what I think you should take to the Dr about.
The incidence of nightmares is highest when Azilect is taken with Sinemet. Also, with the amount of times you are taking the requip daily, i am sure this may be adding to the issue.
Before you call yoir Dr, please reply with your medication list. Include the following:
Medication
Strength
How many you take
Time of day you take them
I will take a look at it and maybe if we just alter times a little bit, with yoir Dr's ok, we can possibly avoid changing meds all together.
Thanks, hope to hear from you soon.



#6 Southern Belle

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Posted 29 February 2012 - 07:33 PM

MGillo,
Welcome to the club of "interactions." this is very commonplave amongst PD meds. If you don't get the meds just right, who know what can happen. You take to little of a dose, you still have symptoms. You take too much, and the symptoms seem to get worse. So, hopefully this will help.
I believe you have a 3 medication additive affect. Each medication in itself can cause nightmares. Usually in this order: Azilect>Requip>Sinemet. This order can change depending on the dose you are taking and age. The older we are, the more likely we are of experiencing this effect. You appear to be having a 1+1+1=5 effect. Here is what I think you should take to the Dr about.
The incidence of nightmares is highest when Azilect is taken with Sinemet. Also, with the amount of times you are taking the requip daily, i am sure this may be adding to the issue.
Before you call yoir Dr, please reply with your medication list. Include the following:
Medication
Strength
How many you take
Time of day you take them
I will take a look at it and maybe if we just alter times a little bit, with yoir Dr's ok, we can possibly avoid changing meds all together.
Thanks, hope to hear from you soon.



#7 Southern Belle

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Posted 29 February 2012 - 07:58 PM

I guess my first reply didn't go through so I'll try again. Here is a list of my medications schedule:

7 AM - 1 Azilect 0.5 MG, 1 Carb/Levo 25-100 MG, 1 Januvia 100 MG, 2 Roponirole HCL 2 MG, 1 Triamt/HCTZ cap 37.5-25

Noon - 1 Caltrate 600-D, 1 Carb/Levo 25-100 MG, 1 Diovan 160 MG, 1 Klor-Con M20 tab 20MEQ ER, 1 Pantoprazole tab 40 MG, 1 Ropinirole HCL 2 MG

5 PM - 1 Caltrate 600-D, 1 Carb/Levo 25-100 MG, 1 COQ10 100 MG, 1 Klor-Con M20 TAB 20MEQ ER, 1 Ropinirole HCL 2 MG

10 PM - 1 Carb/Levo 25-100 MG, 1 Roponirole HCl 2 MG, 1 Vytorin tab 10/40 MG

Also I am 71 and have been taking Parkinson medications since 12/2004. In the beginning I had trouble with upset stomach for quite awhile until we found a combination that was managable. Again I thank you for your time and hope you have some suggestions. MGallo

#8 MComes RPH

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Posted 09 March 2012 - 11:53 AM

Ok, i see some interactions that can cause the tiredness and a few other that may not be allowing all your meds to work to the best of their ability.
FATIGUE:
1- Hydrochlorothiazide and tiamterene (both) with sinemet each can cause low blood pressure (Orthostatic hypotension) also known as OH. when taken together, they can have a 1+1+1=5 affect. Low blood pressure can cause fatigue and light headedness and dizziness when getting up from a seated position. So, get up very slowly when you get out of a chair or out of bed.
2- Triamterene and hydrochlorothizide and Azilect work by a different mechanism, but the result will be the same as above in #1
3- Sinemet and Azilect also work by a different mechanism, but the result will be the same as above. Also, since both increase levodopa (in their own way) the use tigether may cause dyskensia (involintary musclr movements), so be advised it may not be the PD causing this, it may be the combo of these to meds.
4- Sinemet and diovan can also cause OH.
5- diovan and azilect fall in this group also.
My best advise, try to seperate these meds apart from each other by at least 45 minutes to 60 minutes to try to avoid this intetaction.

OTHER ISSUES:
1- try to seperate the Vytorin from your other meds (especially your PD MEDS) by at least 2 hours. Simvastatin, one of the meds in vytorin, can bind up the liver enzymes. When a sinemet or azilect is taken within 2 hours of the vytorin, the Pd meds (and any other meds) must "wait" for the vytorin to completely metabolise before they can be metabolised. While they are waiting, the PD meds are sitting in the intestine and a greater amount of the PD med is being absorbed while waiting. This can cause side effeccts ike dyskensia to start and the a delay in the onset of how quickly your meds will work.
2- lastly, the calcium and sinemet. Calcium can caise the levodopa (an ingredient in sinemet) to absorb faster than it should. This can cause the same side effects as if you took too much sinemet and it will alsothrow off your on and off times.
If you would like help adjusting tour meds to help stay away from these effects, just let me know.
Thanks

I guess my first reply didn't go through so I'll try again. Here is a list of my medications schedule:

7 AM - 1 Azilect 0.5 MG, 1 Carb/Levo 25-100 MG, 1 Januvia 100 MG, 2 Roponirole HCL 2 MG, 1 Triamt/HCTZ cap 37.5-25

Noon - 1 Caltrate 600-D, 1 Carb/Levo 25-100 MG, 1 Diovan 160 MG, 1 Klor-Con M20 tab 20MEQ ER, 1 Pantoprazole tab 40 MG, 1 Ropinirole HCL 2 MG

5 PM - 1 Caltrate 600-D, 1 Carb/Levo 25-100 MG, 1 COQ10 100 MG, 1 Klor-Con M20 TAB 20MEQ ER, 1 Ropinirole HCL 2 MG

10 PM - 1 Carb/Levo 25-100 MG, 1 Roponirole HCl 2 MG, 1 Vytorin tab 10/40 MG

Also I am 71 and have been taking Parkinson medications since 12/2004. In the beginning I had trouble with upset stomach for quite awhile until we found a combination that was managable. Again I thank you for your time and hope you have some suggestions. MGallo


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




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