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Discovery

Sinemet or Prolopa

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Dr Okun

I wrote you months ago asking which of the two, Prolopa or Sinemet is best for early stage.(see below your answer)

I was diagnosed October 2014 and have done extremely well on just Azilect, however I believe it’s time to add one of the above.

Im very healthy, active and still holding still with right side tremor with some rigidity. 

What side affects are you speaking of  in your reply and with my above info do you think starting on 50/12.5 Prolopa is a wise start for me?

Many thanks

Discovery

 

Prolopa and Sinemet are essentially both dopamine and different varieties are available in different countries.  In early PD you can use these alone, or an agonist alone or a combination.  They are both safe with MAO-B drugs like selegiline and rasagiline.  I choose based on a detailed history, exam, and potential side effects.

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Sinemet is a good choice and we watch for nausea and fatigue as the side effects that are most common.

Agonists have been implicated with impulse control disorders, orthostatic hypotension (low blood pressure) and sometimes other issues.

Many people who are worried about side effects start with Sinemet.

Does that help?

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Prolopa is levodopa plus benserazide; Sinemet is levodopa plus carbidopa.  Both are dopamine replacements and not agonists.  generally Sinemet is available in the US and Prolopa in some other countries.

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