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gruland6007

Allergic reactions to yellow dyes in Sinemet

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When I first was prescribed Sinemet for my Parkinson disease I had to, on my own, find a medication that did not have yellow synthetic dyes. This is due to the fact that I am very allergic to them. The staff at my neurologsts said the pharmisist would be able to find one. They did not. By researching the FDA.org web site I found one, Senemet CR 25/100 Brand Name. This was the only place I found that actually listed inactive ingrediences. The pharisutical companies would not give out info on inactive ingredients either. It was the only med I was able to find at that time that didn't have yellow dyes. It was made by Merc originally and distributed by Bristol-Myers Squibb. Finally my meds had been working right and for the first time in many years I felt normal again. BUT THEN just this week when I went to renew my prescription, it was not available. The group manufacturing that Brand Name Sinemet CR 25/100 has stopped production for good. I now NEED a generic or brand name sinemet medication that does not contain yellow 5, 6, 8 ,10 etc. . Does any one have knowledge of a med on the market that is available with out these dyes? // Are their other forum members that are facing this same problem? // Your timely response to this request would be greatly appreciated.

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This allergy is more common than you think. I will let you know the brand name sinemet is NOT be discontinued. It is being re-formulated and should be out sometime in may. I have attached the original press release from the company itself concerning this issue. There are 3 strengths that are still being reformulated: 25/250, CR 25/100, and CR 25/250. FYI, I believe the genric CR 50/200 is yellow dye free. I can check on this on Monday and post it for you.

 

ARTICLE:

Merck has sent a letter to the Parkinson's community to inform us that the FDA has approved their new supplier of Sinemet and Sinemet CR.  Merck believes that this should mark the end of the Sinemet shortage.  As a result of this change, the pills you receive from the pharmacy will likely be changing in shape, color, and marking.  The tablets will no longer be scored for splitting.  NPF will post images of the new pills to our website as soon as they become available.

 

Though we think the shortage is coming to an end, NPF has received calls in the past 24 hours from people who were unable to fill a prescription for Sinemet.  We have information that there may be trouble filling prescriptions for Sinemet immediate release 25/250 and Sinemet CR in the 25/100 and 50/200 formulations.  NPF has been collecting reports from people unable to fill a prescription for branded Sinemet as well as from people who have experienced negative effects from being switched to a generic version of their medication.  We hope to prepare a letter to Merck and the FDA detailing the current situation and its impact on patients.

 

If you have been affected by the Sinemet shortage either because you have been unable to fill your Sinemet prescription or if you have experienced challenges after switching to a generic alternative, NPF would like to know.  Please call us at 1-800-4PD-INFO (1-800-473-4636) and tell us about it.

 

 

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When I first was prescribed Sinemet for my Parkinson disease I had to, on my own, find a medication that did not have yellow synthetic dyes. This is due to the fact that I am very allergic to them. The staff at my neurologsts said the pharmisist would be able to find one. They did not. By researching the FDA.org web site I found one, Senemet CR 25/100 Brand Name. This was the only place I found that actually listed inactive ingrediences. The pharisutical companies would not give out info on inactive ingredients either. It was the only med I was able to find at that time that didn't have yellow dyes. It was made by Merc originally and distributed by Bristol-Myers Squibb. Finally my meds had been working right and for the first time in many years I felt normal again. BUT THEN just this week when I went to renew my prescription, it was not available. The group manufacturing that Brand Name Sinemet CR 25/100 has stopped production for good. I now NEED a generic or brand name sinemet medication that does not contain yellow 5, 6, 8 ,10 etc. . Does any one have knowledge of a med on the market that is available with out these dyes? // Are their other forum members that are facing this same problem? // Your timely response to this request would be greatly appreciated.

 

 

What type of a reaction do you experience when you take a yellow Sinemet? How do you know it's the yellow dye that's causing the reaction and not something else such as the starch that binds the pill together?

 

Regards,

Richard

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>>This allergy is more common than you think

 

How common is it?

 

Tks,

Richard

 

This allergy is more common than you think. I will let you know the brand name sinemet is NOT be discontinued. It is being re-formulated and should be out sometime in may. I have attached the original press release from the company itself concerning this issue. There are 3 strengths that are still being reformulated: 25/250, CR 25/100, and CR 25/250. FYI, I believe the genric CR 50/200 is yellow dye free. I can check on this on Monday and post it for you.

 

ARTICLE:

Merck has sent a letter to the Parkinson's community to inform us that the FDA has approved their new supplier of Sinemet and Sinemet CR.  Merck believes that this should mark the end of the Sinemet shortage.  As a result of this change, the pills you receive from the pharmacy will likely be changing in shape, color, and marking.  The tablets will no longer be scored for splitting.  NPF will post images of the new pills to our website as soon as they become available.

 

Though we think the shortage is coming to an end, NPF has received calls in the past 24 hours from people who were unable to fill a prescription for Sinemet.  We have information that there may be trouble filling prescriptions for Sinemet immediate release 25/250 and Sinemet CR in the 25/100 and 50/200 formulations.  NPF has been collecting reports from people unable to fill a prescription for branded Sinemet as well as from people who have experienced negative effects from being switched to a generic version of their medication.  We hope to prepare a letter to Merck and the FDA detailing the current situation and its impact on patients.

 

If you have been affected by the Sinemet shortage either because you have been unable to fill your Sinemet prescription or if you have experienced challenges after switching to a generic alternative, NPF would like to know.  Please call us at 1-800-4PD-INFO (1-800-473-4636) and tell us about it.

 

 

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The estimate is about 5% of the population has an allergic reaction to dyes. This percentage could be higher due to the fact that many times a "food" allergy is classified as an allergic reaction to the food when it could really be an allergic reaction to a food color additive in the food itself.

The dye allergy could be topical or oral, meaning that a reaction occurs on the skin as in the case of hair dye or a reaction to ingested dye as in the case of a medication or food coloring.

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Mark,

Sorry to dig up and old post.  Picked up a new scrip from the pharmacy yesterday, and my Mylan (which previously been ok) is giving me an allergy type reaction.  Could it be that I started lunesta a week ago, and theyre fighting or the yellow?

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More than likely it is not the combination of the two. Some people do not have an allergic reaction to something the first time they use it or let day have an allergy to something. It can happen the second time around.

If you have been on the Lunesta for a week you can probably count that out. It may be the sinemet dye.

Try this. Take a Claitin (or generic) tablet in the morning. It is a non drowsy antihistamine that may reduce or eliminate the reaction from occurring. It may take a couple of days to find out, but it may be worth a shot.

The other option iso benadryl (or its generic) for this. Thee main issue with this medication is that it can cause drowsiness. So it it not a good choice for daytime use or in combination with Lunesta. Those two together can be bad combination. If you would like to replace a benadryl at night for a Lunesta, if the reaction persists, that is another viable option.

I hope this helps.

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Well, we 86'd the lunesta. Starting on Remeron.

 

My working theory is that the natural rise of catecholamines in the morning is hitting along with the 9am dose (my second of the day), is dumping massive amounts of adrenaline into my system. Or, that its a low grade allergy, which is dumping adrenaline into my system.

 

I've now had three incidents at mid to late morning. Something isnt right. Either reason more accurately explains the reactions and the 20 pound weight loss which I cant outeat at even 2100+ calories a day,

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Well, don't count out the wildly sensitive (in a bad way) or lightly allergic just yet- I'm always the outlier, "that patient".  My system is effective, stupidly sensitive, and metabolizes things like a champ.  I maintained 140 to 146 lbs on a 5' 9" frame for 20 years with just my eating.   I'm now eating 2100+ simply to maintain the 126 I've fallen too. Anything less and it drops off.  It's not just the fat that's gone- it's now eating up muscle.  (And I'm not anxiety ridden or clinically depressed.  Mild adjustment disorder which doesn't require a med, only if I want one.)

 

I don't have any food allergies that are known. Only drug reactions. I can take the old formulations of just about everything, but not the new one.    Ambien lasts two hours, and I don't even get the pleasure of sleep eating. No hallucinations either. The regular dose of vicodin is more like advil- doesn't do much, it's pretty boring. Nyquil doesn't make me sleep- I sit in stage 1 with wakeful dreaming all night. I can even manipulate the dreams, which is occasionally amusing.  Dramamine I can take all day with no adverse effect.  Zofran makes me dizzy in 2 minutes and I want to barf.  Morphine and demerol sure!  Fentanyl- beyong sick, vertigo, vomit, you name it.  Can't take hormonal birth control of any sort (3 to 5 days I will puff up 3 dress and cup sizes.  My OB still owes me the quarter we bet on it.) Even my IUD with the hormones was noticeably different in my system. The cortisone shot in my hip a month ago gave me reactions like I'd been taking pills for two weeks. 

 

Can only have a propofol push for general, but am really hard to get to under and pop back of out that in record speed. I've heard "she's awake!?!" before I've left the OR every I've had general.  Found out I was generically susceptible to malignant hyperthermia- which would explain why I was sicker than a dog for 4 months after the only time I've had a such/gas/propofol for surgery.  (Am now considered a class 2, likely 3 for general. Yeah, they hate me.)

 

Rytary sent me to the ER on dose # 7.  My pre-syncope at Mayo and this latest reaction were all in mid to late morning, as was the Rytary.  The latest reaction was a fuzzy throat I couldn't clear, throat muscles doing a slow spasm to bring my chin to my chest, clenching jaw, agitation.

 

My working theory is this.  Either my stupid metabolism is just sent into hyper drive by the excess adrenaline created by my sizeable c/l dosing (1400mg a day- genetics indicate I need more PD meds than normal) regardless of wether or not it's required to control the tremor or not, it's just more than my system can handle.  Or, I'm lightly allergic to something in it, so it's dumping too much adrenaline into my system.  Either way, the second dose of the day is at 9am,  and the natural rise of my cathecholamines of the dose are going to town together.

 

My question is this- does the agonist class of c/l mimics also metabolize into adrenaline?

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Wayward,

I see lots going on. Your answer is no, it does not metabolize into adrenaline. I have a question for you. Throughout all of this have you ever had an EKG done?

The reason I ask is because I have researching prolonged QT period in PD . It may be more common than we think. Most people with PD pass away due to a fall. What causes the fall, everyone figures walking instability. A prolonged QT eroded in the heart can cause a black out situation where you just passed out. It happens when the heart beats to push the blood to the body, a signal is sent to the brain to pump again, but the electric charge (for lack of a better term) does not make it back to the heart on time. This causes someone to pass out and possibly be out for a few minutes to several minutes.

Like I said this is a hypothesis, I am trying to figure out how to proceed.

You may want to get and EKG done to see.

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I saw an integrative medicine doctor yesterday with a sleuthing reputation yesterday to help get a grip on some of this- first the weight loss and if themeds are causing allergy type issues. That makes more sense than anything else.

 

I'm normally a low HR and BP person- my HR is still 75-100 for hours and hours a day starting . Very unusual, and it's put me up into a fat burning zone that's now eating muscle.

 

The ER ECG on 7-5 during the Rytary episode said "sinus bradycardia".  The ER ECG on 8-5 at Mayo pre-syncope said "normal sinus rhythm, low anterior forces".  At the 10-20 meds reaction they didn't do one.  BP wasn't high enough.

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Very interesting. You may be the anomaly amongst us. I am at a loss. Please do make. Please do make sure to get the EKG. This may still play a role in this.

Thanks for the information and if I come across something about your situation, I will let you know.

You have a very interesting case.

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I have an appointment to see a cardiologist at the Penny George Institute in Mpls. It should be interesting to hear what she's got to say about my HR as an integrative medicine cardiologist. Normally that's on oxymoron!

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When you see the cardiologist ask about testing the QT wave. It is something I just ran across in the literature that can affect PWP. It can cause lethargy, tiredness, lightheadedness, and even passing out. Just to be safe, ask about it. They may say no, but it is worth a shot.

As far as not starting the Remeron, I think that is a smart move. Any time you go in for testes it is best to have just your basic meds you take and try not to add any extra in that could possibly throw off the tests. Make sure you double check with the cardiologist about the Remeron also. A second opinion never hurts.

Also, if you have a diary of all that is going on with your meds, how you feel, off periods, etc...that would help a great deal. Any and all information you can give them above and beyond what they already have is gold to the Dr.

Hope this helps. Keep me posted.

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teva makes a 25/250 blue pill, scored and easy to split even into quarters. you'll be getting less carbidopa but it may not matter.  it works fine for me, i started using it when i had to pay for my own meds and it"s not much more expensive than teva 25/100

mylan's 50/200CR is blue

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Thanks Soccertese for the info. Besides the Teva brand of the 25/250, I have also come across a few other manufactures that make a blue 25/250 tablet. those companies are Actavis, Apotex, Sun, and Mylan. as to whether those are still available I am not sure. This list came from Drugs.com and is up to date.

I hope this helps.

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Mark-

News from the Cardiology front.  No QT that was ever mentioned on any of my reports.  Holter monitor showed bradycardia and tachycardia.  Echo showed an enlarged right ventricle, but the cardiac MRI ruled that out but revealed an enlarged right atrium.  This is new since last August, of unknown origin but most likely hypertension induced.  Autonomic testing at Mayo showed completely normal autonomic function.

 All known genetic causes of PD were ruled out.  Going to do the pharmacogenetic testing for all known drugs (so many of them are used in PD I figured why not.) Amino acid testing showed that my weight issue might actually be a urea cycle disorder involving the dopamine cycle as well as how I use meds in my liver and kidneys.  It probably would have never come out if I hadn't been YOPD.  Still investigating that angle and will let you know.

Justine

 

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Please do keep me posted. The QT wave issue was one issue I brought up because when it happened to me I decided to look up any and all correlations between prolonged QT wave and PD. The search revealed very little information, but enough that I felt it need to be mentioned.

The urea cycle has 5 parts and is very difficult to understand let alone explain. The urea cycle mediates the removal of ammonia as urea through the urine. A diagnosis of of defective urea cycle is usually made by a blood test called an aminogram where it has been found that glutamine and alanine levels are high. When there is decreased activity glutamine synthesis a result can be to excessive amounts of glutimate. We do know that glutimate plays an important role in Parkinson's Disease.

I hope this helps and please keep me posted.

 

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All of the 50/200's were moved to purple and the 10/100 class has all been moved to blue.  "Reduce confusion" about which one you were taking.

Unfortunately, the 10/100 isn't getting enough levodopa through, I'm down to a 2.5 duration for a 2 pill dose so that's 6 doses a day, plus a CR at bedtime.  This level of med isn't sustainable- I'm years from diagnosis as Young Onset.   I'm going to custom compounding of meds to get it completely dye free.  About 75 cents a capsule.

 

Mark- The custom med is loose in a capsule, versus a pill. How much faster will the absorption be as a powder versus the pill?  The docs suspect that part of my epic Rytary failure was that the capsule dissolved to quickly, dumping all of it into my system at once.  I'd prefer not to repeat that experience....

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The breakdown and absorption of oral forms of medication is normally this:

Tablet- slowest (Break down complete range 30-45 minutes, full absorption range 45-60 minutes) 

Gel Tablet

Gel Capsule

Capsule- (Break down complete  range 15-30 minutes/ full absorption range 30-45 minutes)

Liquid- Fastest (No break down and ready for immediate absorption

One thing to keep in mind that the above scenario is on a perfectly healthy body with no Stomach, GI, Liver, Bladder, or Kidney issues. Basically a perfect atmosphere. Once again this is a range and will be different for every individual.

I hope this helps.

 

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