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MComes RPH

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About MComes RPH

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  1. In that case the Trazadone will more than likely replace the Nortryptaline, but that is a decision your physician will have to decide. The maximum dosage used for sleep is 50mg to 75mg at bedtime. It should be started at 25mg for a period of 5-7 days and then increased by 25mg. It is not recommended that this only be taken for a maximum of 14 days unless authorized by your physician. You should also contact your physician to let them know that you are taking this so they are aware and can place it in your chart notes. If taken along with Nortryptaline, it may cause some extra drowsiness (which is an additive effect. Ie. 1+1=3) and possible next day "fogginess." You may also experience dry eyes, dry mouth, and dry skin. I hope this helps and please keep me posted.
  2. Noah, I was unaware that you were taking Nortryptaline at bedtime. If you were taking that for sleep, then the Trazadone would replace that. They are in different medication categories so, depending on how long you were on Nortryptaline, you may have to taper off of it before trying the Trazadone. This will be a decision your physician will have to make. As always, I hope this helps and please keep me updated.
  3. I came across two articles while reading my Flipboard news. After reading the articles I thought I would pass them along to you. One talkes about 54 Supplements that may increase Dopamine and the other speaks of 11 foods that are considered "Dopamine Filled." I am posting these as and information only piece. I do not recommend eliminating medication and only use these foods and supplements to maintain your symptoms. The other issue is we do not even know if any of these will cross the Blood Brain Barrier, which must happen in order for a chemical to work. Once again these are just for casual and leisure reading . Please keep that in mind when reading them. Thank you. 54 Natural Supplements, Agonists and Drugs to Increase Dopamine (and 12 things to Avoid). Http://flip.it/yHpr-D 11 Dopamine-Filled Foods. Http;//flip.it/H2LOAU
  4. Cape, Lightheadedness and dizziness are very common side effects of Sinemet. As to why it did not happen straight out of the gate I am not sure. One thing to make sure of is that when he rises from a laying, sitting, or kneeling position that he does it slowly. The same should also be used if he arises from a position of being bent over. Since Sinemet can cause some dizziness and lightheadedness, it must also be pointed out that Parkinson's itself can cause Orthostatic Hypotention. This phenomenon happend when someone tries to get up to quickly and the blood pressure does not correct itself quickly causing the person to feel lightheaded and dizzy. So it could have beed a combination of the two that could be contributing to this issue. I also noticed that you gave him some grapefruit. Grapefruit is actually contraindicated when taking Sinemet because it can cause spike pr decreases in the amount of Sinemet into the system. It may also cause a blockage of Sinemet being absorbed in the stomach and intestines. If he were to take the grapefruit (even grapefruit juice) one hour prior to taking Sinemet or take the grapefruit 2 hours after taking Sinemet he should be in the clear. I hope this helps and please keep me posted.
  5. The side effect of nausea usually goes away in time, by about the first month or so. It usually decreases the longer you are on the medication. I usually recommend the 'start low and go slow" method of dosing when it comes to PD medications. This means that you start at a low dose and take the dose increases slowly as to avoid side effects. Since it does come in several strengths it is very easy to increase the dose with ease if need to control symptoms. I also recommend trying a medication for a period of at least 3 months, unless you have a reaction to the medication. This three months is a good trial period to find out if the medication is going to be effective and also allow for at least one dosage increase, if not two, over that three month period of time. I hope this helps and please keep me posted.
  6. If you are considering taking it in tablet form, I would recommend the Azilect due to less side effects and greater efficacy. I hope this helps and please keep me posted.
  7. Noah, You do not have to wait any length of time in order to take the Benadryl. Also, Trazadone is not like Clonazepam. Clonazepam (Klonipin), Alprazolam (Xanax), and Lorazepam (Ativan) are all medications used for anxiety and do have an addictive potential for addiction. Trazadone is classified as an antidepressant, but is mainly used as a sleep aid. I hope this helpa and keep me posted.
  8. Yes, 2 capsules would equal 240mg. I hope this helps and please keep me posted.
  9. No problem. Any time. Please keep me posted.
  10. Selegiline: Selective Monoamine Oxidase B (MAO-B) Inhibitor- Monoamine Oxidase Metabolizes Dopamine Also has some affinity for MAO-A Usually used in combination with levodopa Has a food restriction interaction with foods containing Tyramine (wine, aged cheese, cured meats) and can cause a severe spike in blood pressure Is available in tablet and patch form One of it's metabolites is a derivative of Amphetamine so it should not be used too close to bedtime has also been used for depression Azilect: Newer than selegiline Selective MOA-B Inhibitor with no apparent affinity for MAO-A Used as Monotherapy solely for Parkinson's Disease There has not been a reported case of any food interaction's as there are with Selegiline Appears to be Neuroprotective where as Selegiline does not Does not have an Amphetamine derivative as a metabolite so there is no restriction on time of day dosing More potent than Selegiline (lesser dose controls symptoms to a greater extent than Selegiline) Only used for Parkinson's Disease Less side effects than Selegiline I hope this helps and please keep me posted
  11. Noah, The sleep issue your are battling is very common with PD patients. I have read many studies about Vitamins and herbs to help aid with sleep and the jury is still out as to their effectiveness. As far as the 2 you are currently taking, melatonin and valerian, The main issue has been if these products even cross the Blood Brain Barrier in order to work. The molecules seem to be too big to pass through this, which means that they have very little efficacy if any at all. The product Nocturest (as per their website) is a combination of passion flower, melatonin, valerian, lemon balm, hops, chamomile, theanine, and magnesium. On e again the issue is the same. Are these able to cross the Blood Brain Barrier and, if so, will that concentration be enough to work. Most of the studies say, "No." I understand your reluctancy to take hypnotics (ie, Ambien, Lunesta, etc...) due to the side effects of theses medications. Have you tried Benadryl (Diphenydramine)? This product is primarily used for allergies, but the side effect of drowsiness makes it effective for sleep also. It has also been used, way back in the day, to treat PD symptoms. Maybe a 25mg tablet to start may help. It is effective in some people and does not usually cause the "drug hangover" feeling the next day. I would also recommend that you do not take this in combination with any other natural products. If this does not seem to work you may want to speak to your Dr. about possibly trying a prescription medication called Desyrel (Trazadone). It is indicated for treatment of depression, but as with many of these medications it is the side effect of drowsiness that can be effective. I know several people who have had great success with it to help with sleep. It comes in strengths of 50mg, 100mg, and 150mg. I have seen starting doses at 1/2 of a 50mg tablet (25mg) at bedtime for sleep. It can be titrated up to a dose that may work for you. I have also seen that it does not seem to cause the "foggy" feeling the next day. There are a few opinions and options for you. Please keep me posted and remember with any of these medications it is best to "start low and go slow" with the dosage of any of these medications. I hope this helps.
  12. Noah, I would first make sure that the Sinemet is taken 1 hour prior to a meal or 2 hours after a meal. The second idea I have is to try and take the Sinemet earlier in the evening than 8:00pm. I have also had this trouble, on and off- no pun intended) throughout the years. There is no ryme nor reason as to why it happens and I cannot figure it out. I was talking to a therapist friend of mine who made a great point. He stated that me just worrying about the medication working on time may delay the symptom relief. It may appear and look as if I am "off" but it may really be an anxious reaction to me thinking, "Is it going to work?" Of course my first question was, "So, how do I go about not thing if my medication i going to work?" He replied with a grin and we discussed it at length. Some of the suggestions were to get involved in a project that may start about 7:00pm and take me through about 9:00pm. I have many hobbies, such as stained glass working, glass etching, painting, and memory games just to name a few. So I have tried those and it seems to work sometimes. When I brought this up to my Neurologist, he suggested a low dose Anxiolytic (ie. Xanax, Ativan, etc...). I was not a big believer that I need one beacuse I am one of the most laid back people you would probably ever encounter. We agreed to a dose of Xanax 0.25mg to be used once daily IF NEEDED at about 8:00pm. Well I know that the side effect is drowsiness, which is one thing I was trying to avoid. So what I did was take my Sinemet between 7:00pm and 7:30pm, try to engross myself in one of my projects, and if after about 30 to 45 minutes I did not feel like I was getting symptom control I would take the Xanax and continue my project. This worked wonderful. Most days I do not need to take the Xanax because I am so focused on my project. What I need to do was find a hobby or project that takes up a large quantity of time. I have found that putting together a puzzle, doing a HUGE word search, BIG cross word puzzles, or any other project that takes longer than 2 hours to complete is the best, If you choose to do many little or small projects your mind has a tendency to refocus on your medication issue between these small projects. I hope this helps and please keep me posted on your progress.
  13. Gardener, You will probably not have any symptoms unless your magnesium a seriously elevated. Those symptoms may be confusion, decreased reflex time and muscle weakness. In your case, you probably will not experience any of these. In your case it could be the daily dose of MOM that could be contributing to the slightly elevated magnesium levels. Some of the main things that could help decrease the magnesium levels are to keep hydrated (it is recommended to try and take in approximately 1 to 2 liters a day), keep moving (usually walking every day is a good way to get the exercise needed and is low impact), and to avoid caffeine or alcohol. As far as a laxative is concerned, it sounds like you have tried the correct avenue with prunes etc.. May I suggest an over-the-counter product called Miralax, or the house brand which is the same but usually less expensive It is something you can use daily and is very predictable in it's outcome. It has no flavor, so you can just mix it with water or fruit juice. Just make sure that you separate it from your other medications by at least 2 hours. Any medication that can either slow down or speed up the digestive system has the potential to interfere with the absorption of other medications. I hope this helps and please keep me posted.
  14. Twitchy, The efficacy of one Generic to another is very patient specific, I have heard that the Mylan does work very well. I would suggest that you ask the pharmacy to special order the Activis generic Brand for you. Many of the pharmacies have a primary wholesaler who will automaticall switch to the generic brand that is either at a cheaper cost or one that they have received a great deal on. They also have a secondary wholesaler where they can order specific generic medication and apply a "no substitution" to the product. This means you will get the exact Generic brand you would like. If they are unwilling to do that, may I suggest that you have your Doctor write on the prescription "Actavis Generic Only." I do know that the Actavis Generic is still being produced. It is a light blue oval/oblong tablet with the numbers 659 imprinted on them. You can also let the pharmacy know that the NDC (the National Drug Code which is specific for each medication begins with 00228-3659-XX. The 00228 is the manufacturer of the medication (in this case it is for Actavis products). The second set of numbers, 3659, refers to the medication and strength (in this case it represents Ropinirole 4mg ER). The last two digits, which I have made an "XX" are two numbers that coincide with the package size that the medication comes from (usually 02 is the package size of 100 tablets). This number may differ from manufacturer to manufacturer, but 02 seems to be the most used for a bottle size of 100. Inyour case, you may want to ask the pharmacist is they can order NDC number 00228-3659-02. This should allow them to order Actavis Generic Ropinirole 4mg ER tablets in a 100 count bottle. Usually if you just say that you would like the Actavis Generic because it gives you better control of your symptoms and give them the 00228-3659 part of the NDC, they should be able to look it up and order it for you. I hope this helps and please keep me posted.
  15. Otolorin, There is not an amount of protein that requires Sinemet to work, rather it is the avoidance of protein for Sinemet to be effective. The interaction that happens when protein is taken too close Sinmet happens in the liver. The protein has a greater affinity for the liver enzymes so the protein will be metabolized first and then the Sinemet. This can delay the onset of action, depending on the amount of proyein you take, anywhere from 30 minutes to upto 2 hours. The best rule of thumb to follow is this: take Sinemet at leaset 1 hour prior to ingesting protein or 2 hours after ingesting protein. these time frames will first: allow the Sinemet to be absorbed and metabolized before the protein is ingested, and secondly: it will take approximately 1 and 1/2 hours to 2 hours for the protein to be absorbed and metabolized by the liver before the Sinemet is taken. This will then allow the Sinemet to have a clear path to be metabolized by the liver with no interaction of protein. I hope this helps and please keep me posted.