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criesser

failed dose

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What causes failed dose of sinemet? My husband has had two of these episodes in the last 10 days. It is like his sinemet does not even work at all.

 

He takes 2 sinemet ER at bedtime (9:30- 10pm)

2 1/2 sinemet, 1 comtan at 6am

2 1/2 sinemet, 1 comtan at 10:30am

2 sinemet, 1 comtan at 2:30pm

2 sinemet, 1 comtan at 6:30 pm

 

The sinemet is 25/100

 

Thanks for your help.

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There are a few things that could cause sinemet not to be effective:

1- sinemet must be taken 1 hour before or 2 hours after eating.

2- if any protein is eaten, he may have to take it 1 1/2 before or 2 1/2 hours eating protein.

3- any medication taken an hour before or an hour after taking the sinemet that can slow the absorption. Medication like antacids, prilosec, tums, anti-diarrhea meds, etc

4- if sinemet is taken with whole milk that can sometimes slow the process.

5- external factors: stress, anxiety, fatigue, using his muscles more than usual, insufficient sleep

 

These are the main factors as to why the sinemet might not work.

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In some patients the exact opposite occurred. The comtan increased the INR levels of the warfarin. So, I would have to say no, it would not have any effect on "missed dose."

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Have you ever heard of lemonade blocking absorption?  In the last week I have had 3 instances of "failed" doses.  In each case, I swallowed the pill with lemonade.  

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In all the literature I have looked over, no where does it state that lemonade or lemon water will interact with coumadin. The only thing I could think of is that maybe the lemonade made the stomach more acidic causing the coumadin to be broken down quicker. Now this is just a shot in the dark, so if I were you, I would stay away from taken it with lemonade just to be on the safe side.

Keep me posted.

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