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MComes RPH

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Everything posted by MComes RPH

  1. sleep aid with primidone

    Chuck, I'm glad for the extra information, sometimes Desyrel can have that effect on people. I think it is a good idea to start the Benadryl and give it about a week to see if it works. If not, you can increase the dose to 2 tablets (total of 50mg) at bedtime. I hope this helps and please keep me posted.
  2. sleep aid with primidone

    Kay, Essential tremors usually happen all the time, but are most noticeable when the hands are in motion. Resting tremors are exactly that, a tremor that occurs when the hand is at rest, but when in motion the tremor is barely visible. I hope this helps and please keep me posted.

    klmdoc, As I look at your regime, I would change one thing. I see that you take Sinemet and Requip at the same time at 8:00am, 2:00pm, and 8:00pm. Sinemet should be taken on an empty stomach, so taking it with Requip could affect the absorption on the Sinemet. Some doctor's do recommend taking them at the same time, but I usually see that when the Sinemet is taken 1 hour prior to Requip the off times seem to be lessened. I would keep the Sinmet at 8:00am, 2:00pm, and 8:00pm. I would then change the Requip to an hour later, which would be 9:00am, 3:00pm, and 9:00pm. As far as the Tranxene is concerned, I would probably keep with my original advice. With newer meds available, with less side effects, and longer lasting. I would suggest changing or adding, at least at bedtime, to one of the medications I had suggested in the last post. I hope this helps and please keep me posted.
  4. on off medication dosage

    Til, I have noticed some gaps in the Madopar which may be affecting the on/off periods. I also see some dosing of Madopar, which should be taken on an empty stomach, with other medications. With the great number of medications and times, i know it may be hard to avoid, but I tried to adjust. I will show you the new dosing chart after I explain why I made changes. I first noticed that the all of the meds, except Ambien, are taken at 6:00am. Taking both Madopar's together may not be giving the coverage that might be needed. Also, since Madopar should be taken on an empty stomach, which I know can be difficult, I have moved the morning doses of Requip and Azilect to different times in the morning. I believe this move will also help with a longer coverage range. The last item I noticed is that Madopar 50/12.5 (which I will just call Madopar 50) last dose is given at 19:30 and the last dose of Madopar 100/12.5 (which I will just refer to as Madopar 100) is given at 22:00. This is a 2.5 hour difference, whereas the dosing during the day is only a 1.5 hour difference. I noticed that there is a 6 hour difference between Madopar 100 from 6:00 to 12:00 and a 10 hour difference between the 12:00 and 22:00. I have also assessed this difference of this and of the Madopar 50. I have also adjusted the Requip to alternate with the Madopar to alternate with the Madopar, since Madopar should be taken on an empty stomach. I do know that everyone is different and that their medication dosing may also be different. I have tried to adjust the regime to maximize the on periods and minimize the off periods from a medical perspective. Here is the new dosing schedule I have come up with: Madopar 100: 6:00, 14:00, and 22:00 Madopar 50: 7:00, 8:30, 10:00, 11:30, 13:00, 14:30, 16:00, 17:30, 19:00, and 21:00 Requip: 6:30, 8:00, 9:30, 11:00, 12:30, 15:30, 17:00, and 18:30 Azilect: 6:30 Ambien: 23:00 When there needs to be a medication adjustment, it should only be done for one medication at a time, unless one of the medications is only being taken once a day and the shange is less than 6 hours. Since the changes in times are very small, you could make the change in that medication without tapering it. This is the order in which I would change them and for how long before changing the next medication. 1) Change the Madopar 100 times first. It can be started immediately. 2) The second and third medications to change should be the Requip and Azilect These should be started 1 week after changing the Madopar 100. 3) The last medication to change should be Madopar 50. This should be started 1 week after the Requip and Azilect change. 4) The Ambien should remain the same. I hope this helps and please keep me posted
  5. sleep aid with primidone

    Chuck, Great question. Since PD has official diagnosis and, in some people, can mimic Parkinson's. There are a couple of ways to differentiate between Essential Tremors ans Parkinson's Disease: (1) Parkinson's is usually unilateral (effects one side. Example: one arm, one hand, etc...) (2) Essential Tremors is usually bilateral (effects both sides. Example: both arms, both hands, etc...) 3) Parkinson's will respond to Sinemet 4) Essential Tremors will not respond to Sinemet 5) Parkinson's is not affected by drinking alcohol (6) Essential Tremors will usually decrease with alcohol consumption So, there are some differences between the two. One of the major ways that I have seen doctors determine if it is Essential Tremors or PD (if the symptoms are very, very similar) is to give the patient Sinemet for a 1 week period of time. It is usually increased slowly over that period of time, but PD patients will usually feel relief after the first dose of Sinemet whereas people with Essential Tremors will continue to tremor. Like I said, that is usually the first option if the doctor has a positive idea from some simple physical tests. People with Essential Tremors will have no relief when given Sinemet. It seems to be that your doctor is kind of going through the back door to diagnosis Essential or is fairly positive that the diagnosis will be Essential Tremors which will, over a period of time, show a positive outcome with using primarily Primidone. A second way to differentiate between the the two, which is also more fun, is to consume alcohol. If the tremors lessen or go away, the diagnosis is probably Essential Tremors. If the tremors stay the same while consuming alcohol, the diagnosis will probably be Essential Tremors. Using Sinemet is probably the best way to differentiate Parkinson's from Essential Tremors. If tremors decrease while taking Sinemet, you probably (to a great extent) have Parkinson's Disease. If no relief of symptoms or tremors, there is a very good chance the diagnosis will will be Essential Tremors. I just wanted to give you some background on an easier way to differentiate between the two. If you try Primidone and it does not work, instead of believing it is Parkinson's Disease, it could just be that you may require a higher dose of Primidone to lessen the symptoms the symptoms. Whereas, if the patient is given Sinemet and the symptoms decrease or stop, the Doctor would then conclude you have PD and should be given Sinemet. Now back to your question of which sleeping medications has an interaction with primidone: 1), Rozerem: No interaction with Primidone. The way this works is by increasing Melatonin in your body, and breaking down to Melatonin in your body. Personally, I have seen very little success with this medication. 2) Benadryl: It has no interaction with Primidone and, at one point a long time ago, was used to treat Parkinson's. People who are sensitive to medications, this would be a good choice. 3) Ambien: It does have a interaction with Primidone. Primidone can decreasethe concentration of Ambien in the liver which means a regular dose of, let's say 10mg, only about half of that dose will be available for the body fro use. I DO NOT recommend using this. 4) ***BONUS ANSWER*** My choice for a sleeping medication would be Desyrel. It is an antidepressant, which I do not see it used for that much any more. Most of the time the doctor will write for this as a sleep aid. It has very few side effects and is compatible with Primidone. I hope this helps and please keep me posted.
  6. sinemet and benzo drugs schedule

    klmdoc, I forgot to mention in the previous post I made that there is Drug Interaction between Tranxene and Sinemet. If they are taken too close to each other, the Tranxene can decrease the effects of Sinemet. There are two different ways to avoid this interaction: (1) Avoid the is to take the Sinemet at least one hour PRIOR to taking the Tranxene. This way the Sinemet will be absorbed before the Tranxene is taken (2) The second possibility to avoid this interaction is to take Sinemet two hours after Tranxene. This will allow for the Tranxene to be absorbed and metabolized before the Sinemet is even taken. I have found that the first option, taking the Sinemet one hour prior to the Tranxene, appears to work best. This is because the Sinemet can start working to diminish the tremors and other PD issues, which can be a precursor to anxiety. Once again, I hope this helps and please keep me posted.
  7. sinemet and benzo drugs schedule

    klmdoc, Sleep is so important for Parkinson Patients because it is the only time during the day that our muscles use the least amount Dopamine. Because of this, Dopamine that we do produce is stored up and used as soon as we awake in the morning. The same situation also applies to naps. I encourage Parkinson patients to listen to their body. If you feel tired, lay down. Even when we just sit or lay down, our bodies can still store up our body can still produce. If I remember correctly, you were to take the Tranxene 3 times a day. If that is correct, I would start my doses later in the day. Most medications that are prescribed 3 times a day are usually given at 9:00am, 3:00pm, and 9:00pm. In your case I believe if you adjust the timing of the Tranxene it may help at bedtime. I usually call this the "Wind Down Time.) I would start by taking the Tranxene at 12:00pm (noon), 5:00pm, and 10:00pm. I would try this for a week and see how things go. If you keep a journal of when you take and how you feel in betwee doses, this may help you figure out a dose that may work better. If that does not seem to work, then I may suggest you take them at 1:00pm, 5:00pm, and 9:00pm for 1 week.to try a different medication. Again, see how that works. If you appear to be getting more sleep you know you are on the right track. If that regime does not seem to work, You could then try 2:00pm, 6:oopm, and 10:00pm for 1 week. Again, see how that works. Lastly, if you do not see ANY imporvement at all, I would have you try to take it at 3:00pm, 6:00pm, and 9:00pm. This would be last adjustment I would recommend for this medication. If this still does not show ANY improvement, I would probably ask your doctor for a change in medication. When Tranxene is prescribed to take it 3 times a day, it is probably being used for anxiety and sleep. If that is the case, there are newer medications with less side effects that can be used. A few examples of antidepressants that are used for anxiety AND sleep are Lexapro, Zoloft, Celexa, Paxil, and Prozac. All of these medications come in a variety of strengths so you can start off at a low dose which can be increased over time. A second option could be to use one of the antidepressants above during the day and take Benadryl at night. Benadryl is mainly used for allergies and allergic reactions, it is also the number one sleep aid used in hospitals because it causes drowsiness. With this in mind, you could use one of the above antidepressants above and take Benadryl Another option that may work is to use one of the antidepressants above during the day and take a medication like Desyrel at bedtime. Desyrel is also an antidepressant, but does have a more sedating factor than the above antidepressants.. This medication also comes in a variety of strengths so you can "start low and go slow." Desyrel can also be used at low doses during the day along with a higher dose at bedtime The last option that you can discuss with your doctor is to use a medication ( Ex. Xanax or Ativan) specifically used for anxiety during the day and a sleep medication (ex. Ambien or Restoril) at night. This combination is mainly used in desperate situation. Here are a few non-medicine things you can also use to get a better sleep. A study that was performed at the University of Chicago and posted in Men's Journal says that a routine is just as important as sleep itself. Here are the 10 best rituals for better sleep: 1) Dim the lights 2) Turn down the thermostat 3) Stay clear of the bedroom unless it is for sleep 4) Power down electronic devices, such as cell phones, computers, and tablets.your sleep area 5) Keep out of the kitchen. Finish dinner no later than 3 hours before bed 6) De-clutter your sleep space, Tidy up and make sure you make the bed every morning 7) Do not drink alcohol within 3 hours of bedtime. Once it is metabolized, it will cause you to possibly wake up and/or toss and turn all night 8 ) Save stressful things for the morning. Also, if you write them down before bedtime, this will keep your mind from constantly thinking about it 9) Face your alarm clock to the wall and/or turn your cell phone face down 10) Ban pets from the bedroom. This will probably be the hardest thing for you and the animal may have to adjust to. I hope this helps and please keep me posted.
  8. Sleep trouble

    Pdpatient, The first thing I see when I looked at your medication regime is that you take Acetaminophen and Sinemet at the same time at 2:30am. Acetaminophen is metabolized in the liver, as is the Sinemet. When they are taken together, the Acetaminophen uses all the liver enzymes to break it down and the Sinemet has to wait until the Acetaminophen is completely metabolized before the Sinemet can be metabolized. This interaction may delay the breakdown of Sinemet by at least an hour, if not more. To eliminate this there are two possible choices: 1) Take the Sinemet 30 to 60 minutes BEFORE taking the Acetaminophen. 2) Take the Sinemet 2 hours AFTER taking the Acetaminophen. I usually recommend the first option because that way you know the Sinemet will be metabolized and start working before you take the Acetaminophen. With the way you are taking the Sinemet and Acetaminophen at the same time now, the Sinemet is probably not beginning to work until several hours later. One of the side effects of Sinemet is sudden sleep or drowsiness. The effects can last a long while. I would try this for about a week to see if this changes the drowsiness or fatigue factor. The other option you may want to discuss with your Dr. would be to take a medication that is a stimulant. Since Sinemet and Parkinson's Disease can both cause tiredness, drowsiness, and fatigue, many Dr.'s will try one of these at a low dose. These products would be Nuvigil, Provigal, Ritalin, and Adderall. Some of these do come in an extended Release formula, that might be another option for you. I hope this helps and please keep me posted.
  9. on off medication dosage

    Til, Could you please give me the specific times you take the Modopar 50mg? Also, is the Modopar 100mg a sustained released (Extended Release) or an immediate release tablet. I would like this information so I may better give you a medication regime to help limit your "off" periods. Thank You

    Klmdoc, I am having trouble deciphering the medication schedule you posted. Here is the part I am having trouble with: 800am, 200 pm, 800pm = 1 mg requip + two 25/100 sinemet 11am + 200 pm = 2 sinemet (1) Are you taking 1 Requip and 2 Sinemet at 8:00am, 2:00pm, and 8:00pm (2) Are you then adding 2 Sinemet at 11:00am & 2:00pm. I want to make sure I understand this so I can give you the best advice to help you with your situation. If I read the schedule as it has been written, it appears you are then taking a total of 4 Sinemet at 2:00pm. So I can better understand your medication schedule, could you please write it in this form: Medication. Strength. Number of tablets Time (Example schedule below) Synthroid 0.5 mg 1 tablet at 7am Requip 1mg 1 tablet at 8am, 2pm, 8pm Sinemet 25/100 2 tablets at 8am, 11am, 4 tablets at 2pm, and 2 tablets at 8pm When should I take my 1 tablet of Tranxene 3.75mg? This way I know exactly how many tablets of each medication you are taking at what time. Sorry for the inconvenience, but I just want to make sure how many tablets you are taking at what time do I can give you the most accurate times to take your Tranxene. Thank you and I will get back to you after you send me the updated medication schedule.
  11. Nick, What I sometimes see is a Dr. will use Sinemet for about a week to reassure the diagnosis of Parkinson's. If the tremors go away, then the diagnosis of Parkinson's is correct. After that, in patient's who are under 60 years old, I usually see an agonist used. When that no longer seems to be effective, then a change to Sinemet may me in order. Keep in mind that along with the agonist the Dr. may add on other meds, if needed, for dystonia or gait (walking/movement) issues. I rarely see Sinemet used before another medication unless there is some other extenuating circumstance. I hope this helps and please keep me posted.
  12. GeorgeNW, I'm glad I could help. If you need anything else, please feel free to contact me.
  13. valeria

    Noah, Thank you my friend. It is my pleasure.
  14. Namenda

    Michelle, You are more than welcome. Anytime.
  15. valeria

    Noah, I get ya. Sometimes you can find a Parkinson's Sleep clinic, but they are few and far between. I think as long as you stay at or below 56 drops a day you should be good. Like I said, increase by 5 drops for one week, so 33 drops a day for one week, and see how it goes and let me know. Also, your not being a pain. It is a true honor to be able to help you and everyone here. It's not too often you get a pharmacist who has Parkinson's. I'm glad I can help. I hope this helps and please keep me posted.
  16. valeria

    I would say go no higher that 56 drops, which is 2,000mg. It is way down lower the amount (20,000mg) that can cause severe problems. But like I said, only increase in increments of 5 drops per night for a week at a time. Then you can get an idea of the effect. The other idea I had, if you haven't tried it yet, is a sleep clinic. They have done wonders for some people I know. I hope this helps and please keep me posted.
  17. valeria

    Noah, I just had a "pop-up" that said you had a reply to one of my answers, but when i clicked on it nothing was there. Please resubmit id this is the case,
  18. FDA Approves Osmolex ER

    Otolorin, I am completely on board with that, but making a drug for anything is a difficult task. We have just seen that Pfizer, the company that's main focus was on Parkinson and Alzheimer's medication, said that they are no longer going to be researching medication for those issues anymore. There are very few, if any, new medications that are unique to themselves. Most of them are just newer versions of older medication. I do think there should be more work on finding the cause. When you find the cause, you find the cure. I had an article done on me about 12 years ago and I just found it the other day. In that article I said the same exact thing. I also said that I believed Stem Cells would be our best option to help those with Parkinson. I guess time will tell. I hope this helps and please keep me posted.
  19. FDA Approves Osmolex ER

    FDA Approves Osmolex ER (amantadine) for the treatment of Parkinson’s Disease and Drug-Induced Extrapyramidal Reactions BRIDGEWATER, N.J., Feb. 19, 2018 (GLOBE NEWSWIRE) -- Osmotica Pharmaceutical US LLC (“Osmotica” or the “Company”), a privately-held specialty pharmaceutical company developing novel central nervous system (CNS) treatments utilizing its proprietary osmotic drug delivery platform, announced today that the U.S. Food and Drug Administration (FDA) has approved Osmolex ER, an amantadine extended release tablet, for the treatment of Parkinson's disease and for the treatment of drug-induced extrapyramidal reactions in adult patients. Extrapyramidal symptoms are known side effects of many common medications.“ The FDA’s approval of Osmolex ER provides a new treatment option for those patients suffering from Parkinson’s disease and adults who have extrapyramidal reactions, or movement disorders, that are caused by certain medicines. We are eager to make Osmolex ER available to physicians and patients in the U.S.,” stated Brian Markison, Chief Executive Officer of Osmotica. “We are currently finalizing our plans to commercialize the product and ensure patients and providers have access as soon as possible. We believe that the approved indications and compelling value proposition will be important factors in physician adoption and marketing of Osmolex ER,” added Markison. Osmolex ER tablets, a proprietary drug formulation containing a combination of immediate release and extended release amantadine utilizing Osmotica’s patented Osmodex® technology, represents a new once-a-day approach to the treatment of Parkinson’s disease and drug-induced involuntary movements in adults. The Osmolex ER tablet is taken once-daily in the morning, releasing amantadine throughout the day. Physicians have three dosage options with 129 mg, 193 mg and 258 mg tablets, with a maximum daily dose of 322 mg, providing them with dosing flexibility for each patient. Osmolex ER is protected by three formulation patents with protection extending through March 2030, with additional patent applications pending. About Osmolex ER Osmolex ER tablets, a proprietary drug formulation containing a combination of immediate release and extended release amantadine utilizing Osmotica’s patented Osmodex® technology, represents a new once-a-day approach to the treatment of Parkinson’s and drug-induced extrapyramidal reactions in adults. The Osmolex ER tablet is taken once-daily in the morning, releasing amantadine throughout the day. Tablet strength options include 129 mg, 193 mg, and 258 mg with a maximum daily dose of 322 mg. Indications Osmolex ER is indicated for the treatment of Parkinson's disease and for the treatment of drug-induced extrapyramidal reactions in adult patients. Important Safety Information INDICATIONS AND USAGE Osmolex ER is indicated for the treatment of Parkinson's disease and for the treatment of drug induced extrapyramidal reactions in adult patients. CONTRAINDICATIONS Osmolex ER (amantadine) extended-release tablets, is contraindicated in patients with creatinine clearance below 15 mL/min/1.73 m2. WARNINGS AND PRECAUTIONS Falling Asleep During Activities of Daily Living and Somnolence: Patients treated with amantadine have reported falling asleep while engaged in activities of daily living, including the operation of motor vehicles, which sometimes has resulted in accidents. Patients may not perceive warning signs, such as excessive drowsiness, or they may report feeling alert immediately prior to the event. If a patient develops daytime sleepiness or episodes of falling asleep during activities that require full attention (e.g., driving a motor vehicle, conversations, eating), Osmolex ER should ordinarily be discontinued. If a decision is made to continue Osmolex ER, advise patients not to drive and to avoid other potentially dangerous activities that might result in harm if they become somnolent. Suicidality and Depression: Suicide, suicide attempts, and suicidal ideation have been reported in patients with and without prior history of psychiatric illness while treated with amantadine. Monitor patients for depression, including suicidal ideation or behavior. Prescribers should consider whether the benefits outweigh the risks of treatment with Osmolex ER in patients with a history of suicidality or depression. Hallucinations/Psychotic Behavior: Patients with a major psychotic disorder should ordinarily not be treated with Osmolex ER because of the risk of exacerbating psychosis. Monitor patients for hallucinations throughout treatment but especially after initiation and after the dose of Osmolex ER is increased or decreased. Dizziness and Orthostatic Hypotension:Patients should be monitored for these adverse reactions, especially after starting Osmolex ER or increasing the dose. Withdrawal-Emergent Hyperpyrexia and Confusion: Abrupt discontinuation of Osmolex ER may cause an increase in the symptoms of Parkinson’s disease or cause delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression, or slurred speech. It is recommended to avoid sudden discontinuation of Osmolex ER. Impulse Control/Compulsive Behaviors:Patients can experience intense urges to gamble, increased sexual urges, intense urges to spend money, binge eating, and/or other intense urges, and the inability to control these urges while taking one or more of the medications that increase central dopaminergic tone, including Osmolex ER. It is important for prescribers to specifically ask patients or their caregivers about the development of new or increased urges while being treated with Osmolex ER. Consider dose reduction or stopping the medication if a patient develops such urges while taking Osmolex ER. ADVERSEREACTIONS The most common adverse reactions reported in ≥5% of patients at the recommended dosage of immediate-release amantadine were nausea, dizziness/lightheadedness, and insomnia. DRUG INTERACTIONS Other Anticholinergic Drugs: The dose of anticholinergic drugs or of Osmolex ER should be reduced if atropine-like effects appear when these drugs are used concurrently. Drugs Affecting Urinary pH: The pH of the urine has been reported to influence the excretion rate of amantadine. Alterations of urine pH towards the alkaline condition may lead to an accumulation of the drug with a possible increase in adverse reactions. Monitor for efficacy or adverse reactions under conditions that alter the urine pH to more acidic or alkaline, respectively. Live Attenuated Influenza Vaccines:Amantadine may interfere with the efficacy of live attenuated influenza vaccines. Therefore, live vaccines are not recommended during treatment with Osmolex ER. Inactivated influenza vaccines may be used, as appropriate. Alcohol: Concomitant use with alcohol is not recommended, as it may increase the potential for central nervous system effects such as somnolence, dizziness, confusion, lightheadedness, and orthostatic hypotension. About Osmotica Pharmaceutical Osmotica Pharmaceutical US LLC is a privately-held fully-integrated specialty pharmaceutical company utilizing its proprietary osmotic technology platform, Osmodex®, to develop high-quality branded and generic pharmaceutical products. The Osmotica portfolio includes multiple products currently on the market, and a pipeline of therapeutic drug candidates in various stages of development, addressing central nervous system and neurological movement disorders. Osmotica has a track record of developing products with successful commercialization strategies around the world and through its U.S. affiliates Vertical Pharmaceuticals, LLC and Trigen Laboratories, LLC. Osmotica Pharmaceutical has principal operations located in the United States, Argentina, and Hungary. For more information, please visit the Company’s website at www.osmotica.com. Source: Osmotica Pharmaceutical Posted: February 2018 Related Articles: Osmotica Announces OS-320 (Osmolex ER), Has Been Awarded Orphan Drug Status by the FDA - July 22, 2015 Osmolex ER (amantadine hydrochloride) FDA Approval History
  20. Namenda

    Michellee, That medication is not available in the US yet, but I will keep an eye out for it and let you know.
  21. Carbidopa exceeds daily maximum

    Sharon, What I may recommend is leaving the Stalevo at the times you presently give him. About an hour after you give him the Stalevo, I would give him the Sinemet CR. I think by giving them together you are getting a plateau effect. This is basically where two medications that are similar are given at the same time so the basically pile on each other and peak at around the same time. This can then cause a severe drop off of the medications at around the same time, causing off periods. What I am thinking is that is we separate the by just an hour for about a week, then we can see how is off period is. if it is better, but still not graet, you can maybe move the sinemet to right between doses of Stalevo. This is what you can run by the Dr. to see if he finds it reasonable. I hope this helps and please keep me posted.
  22. Carbidopa exceeds daily maximum

    Noah, You may get a better result if you take them about an hour apart. The Sinemet must be taken for best absorption on an empty stomach, which is 1 hour prior to a meal or about 3 hours after a meal. If you were to take the Azilect then wait an hour and take Sinemet, you should be ok. I hope this helps and please keep me posted.
  23. Namenda

    Michelle, The reason why most Parkinson patients do well in the morning is because when we sleep or are at rest, we don't move much. Since Dopamine is the main chemical that helps us with muscle control, we store up dopamine at sleep or rest. The meds used for dementia can really do some odd things, that is why I say to "start low and go slow" when starting a new medication. Also, Many of these meds may take up to a month before seeing improvement, but in your case I believe you did the right thing. If he is having issues with Sinemet not working, it may be the case that it be starting to wear off. The longer someone is on it the more likelihood they have later of increased doses not working. I is very reasonable to add Azilect of to a Sinemet regime even if the Dr. decides to decrease the Sinemet. What I usually see is that Azilect 0.5mg is added on the current regime os Sinemet dosing. The dose of Azilect can be increased to 1.0 mg is needed. I will usually give a medication at least one month (usually 3 months) to see how it is working. Of course if there are horrible side effects, call the Dr. and they will let you know how to decrease it accordingly. I hope this helps and please keep me posted.
  24. Namenda

    Thanks for the info Miracle.
  25. Sinemet absorption with applesauce

    Noah, Thanks for the input. The liquid Sinemet can help throughout the day can really increase the quality of life for someone who is having serious off periods. It's basically like having a constant flow of Sinemet in your system. I hope this helps and please keep me posted.