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Gene

Going back to Mirapex from Neupro

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My neurologist switched me from Mirapex 3mg daily to the Neupro patch 4mg about a month ago. I was miserable so he up it to 6mg and then to 8mg. I'm still not doing very well. If I were to go back to Mirapex, what would the best way to go. Just start Mirapex 1n mg 3 times a day or titrate it again. Or should I suggest to the neurologist, to try requip. It seemed when I went to Neupro, my sinement was wearing off in 2 to 3 hrs rather tahn the usual 4 hrs

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If you were having issues with Mirapex and then with neupro, I would have him switch you to requip. That is if side effects or effectiveness were an issue.

Even though they are all in the same class, it seems people have less side effects with requip.

Of course you will have to titration up, but if those were the issues I would try the requip.

Keep me posted.

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The Neupro seemed to make the Sinemet not last as long. Before the Neupro, I was taking Sinemet 25/100 3 times a day and seemed to be doing pretty good., Now, I'm only getting 2 to 3 hrs before it wares off. Going off Neupro to Requip, will this help the Sinemet, wearing off effect?

Thanks

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I thought you were asking about changing back to Mirapex. Sorry I misunderstood. If you are asking what you should try, Mirapex or require, I would try the requip. Even though Mirapex and requip are in the same class of medication, requip seems to have less side effects.

Now, if you need something to help the sinemet last longer, you could add comtan along with the sinemet. It is specifically made to help the sinemet last longer and help with off periods.

I hope this helps.

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I thought you were asking about changing back to Mirapex. Sorry I misunderstood. If you are asking what you should try, Mirapex or require, I would try the requip. Even though Mirapex and requip are in the same class of medication, requip seems to have less side effects.

Now, if you need something to help the sinemet last longer, you could add comtan along with the sinemet. It is specifically made to help the sinemet last longer and help with off periods.

I hope this helps.

They are finally reducing the Neupro Patch. When is your thought on cutting the 4mg patch in two when it comes to reducing to 2mg? The package insert states not to cut them, but the neurologist says it is okay be cause it hasw his patients do it a lot. I was on 8mg, now I've been on the 6mg for 2 weeks and will start the 4mg this week for 2 weeks then will go to the 2mg

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I know the package insert says not to do it, but I am with you're Dr. Go ahead and cut it in half.

It looks like the titration off looks good also. Stepping down at that place is the way to go.

Keep me posted.

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Mark, sorry to chime in...

 

I would like to ask you if Neupro patches should be stored in the refrigerator, especially in the summer. Also, if exposure to relatively higher temperatures than those indicated in the package (25-35 degrees of C) for  a period of  several weeks may reduce their efficacy. 

 

Thank you

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Neupro should be stored at room temperature. Extreme temperatures can affect the efficacy and also the adhesive of the patch. The rule of thumb that I use, if is in the car, and you pick it up, and it is hot, that's too hot. If it is for less t than 24 hours, the patches should be fine. Any longer than that and they are probably stuck to the dashboard.

So, I f you need to leave them in a car or extremely hot place, the best thing to do is take a thermos out of you're cupboard, take the patches out of the box, and put them in there. No need to put anything else in it. They sho u l d remain at the temperature at which you put them in.

Hope that helps.

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Back to cutting the Neupro in half. After cutting the patch in half, do you use the other half the next day or do you dispose it? If you use the second half how do you keep it fresh with out losing any medication?

Thank you

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Neupro , if cut in half, you should try to place it back in the original package bit came in. Then for extra security so that none of the medicine leaks out, you should place the original place the original package in a seal tight sandwich bag. That way you have the original package to stop any leaking, then your sandwich bag as a safeguard , two ply to make sure there is NO LEAK what so ever.

Better to be safe than sorry. At this point you should store it along with all the other patches.

Great question and if you have any more, please feel free to ask

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I've now been off the Neuro patch for a week. The neurologist wanted to see how the Sinemet 25/100 worked by itself. (Take it @ 8am, 11am 2pm, 5pm and 8pm, sometimes in the middle of the night. Since that time with just sinemet I've had terrible restless legs with jerks during the night. Maybe getting 2-3 hrs of sleep a day (mostly short naps during the day). I have very short "on" time. Isn't sinemet also used for restless legs besides PD? What can I do? The md give a prescription for Requip long acting 2mg and titrate up weekly.. To start when I think I need it. Should I start that?

Thanks

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Sinemet can be used for restless leg, but rarely. It is mostly requip and mirapex. I would start it and titration up as prescribed. That should help also with the PD symptoms also. As with any med change or new med, it is always best to start low and go slow. It may take a bit of time, but it will be worth it.

Keep me posted.

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