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DESPERATE FOR SCHEDULING HELP

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Man, would that be the miracle of all miracles!!  I sure hope you're right!   

One clarification, please  :  I assume it's safe to simply add in the 4TH dose without titration (right?) --  so when would be the best time to add it into this schedule  One R + 2 Sinemet @ 8, 2pm, 8pm ; plus two Sinemet @ 11am and 5 pm.

  • Should I simply add 1 mg it to the 5 pm dose?
  • Or add  .50 mg  to the 11am and 5pm doses such that every dose would contain some Requip? 
  • OR should I take it  alone around midnight or thereabouts when I always wake up to turn over?  

Please advise!  I can't wait to check this out, but I want to do it right.  
You're a national treasure!  Thank you so much for your help!
Linda

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Linda,

I would go for the midnight time frame. I would give 0.5mg at midnight for 2 nights, then increase it to 1 mg there after.

Normally I would like to see it more evenly spaced (ie. 9am, 1pm, 6pm, 11pm) during waking hours, but if we can get it to work this way, the coverage may get through the night. 

I hope this helps and please keep me posted 

 

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Thanks so much for the speedy response!!  Here's what worked LAST night

800          last "regular" day's dose (went to sleep immediately)

1000        (awakened by caregiver to take 3.75 mg tranxene/back to sleep immediately

1230        (awakened by stiff/tingling legs;  took flexeril 5mg which calmed legs and allowed return to sleep in recliner)

200           took 1/2 sinemet and returned to bed -- slept immediately and until 5:30 am

Although fragmented, that's the most sleep I've had in DAYS.  If this gives you any more insight into where to put the Requip, or anything else, I'd love to know.
Take care!

Linda

     

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Linda,

I think around midnight would be best. Like I said, try 0.5mg at that time for 2 nights and see how it goes. You can then increase to 1mg after that.

We may find that the 0.5mg may work well, but only you can tell.

I hope this helps and please keep me posted 

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Hello, quick question about scheduling. I am a caregiver and responsible for meds. We have currently added on Amantadine 100mg twice daily to clients schedule. 

 

Levothyroxine 75mcg 1tb on awakening

Sinemet 1/2tb x 5daily starting 7 am 3hours apart

The Sinemet does come close to meal times, may not entirely be on an empty stomach.Doc says it inevitable, not to worry too much.any thoughts? 

What is the best time for the Amantadine, so as to deal with dyskinesia. 

Thanks

 

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Linmuia,

The Levothyroxine should be taken first thing in the morning on an empty stomach. It can be taken with some food about 30 minutes after taking it, but these food should be avoided because they can decrease the absorption of T4 (Levothyroxine). Those foods are calcium in all forms ( vitamins, calcium added to juices, etc...), walnuts, soybean flour, cotton seed meal, and dietary fiber (powder, tablets, or waffers).

As far as when to take the Sinemet, it is important to take without food. The best absorption is when the Sinemet is taken 1 hour prior to a meal or two hours a meal. Most people have the best success with taking it one hour prior to meals because it is easier than waiting two hours to eat. If someone needs a small snack within the time constraints of one our before or two hours after a meal, that is fine. The main product to completely stay away from is protein. When protein is taken taken too close to Sinemet, the protein will almost always be metabolized before the Sinemet in the liver due to the greater affinity the liver enzymes have for the protein.

As far as to when to take the amantadine, it will all depend on when the dyskensia usually happens throughout the day. The best way to figure this out is to make a journal that will look somewhat like this:

Medication           Strength     Time Given     Symptom time start/stop

Levothyroxine        75mcg       7:00am             none

Sinemet                  ? (1/2)          8:00am           none

Sinemet                  ? (1/2)          11:00am          Dyskensia at 12:00 Noon

Amantadine           100mg          12 Noon         Dyskensia stop at 12:45pm

once you have this information for the first day, you will then be able to adjust for the next day. The first day may be the toughest because you will have to wait until the dyskensia starts and the give the Amantadine. So, in the example above the Dyskensia started at Noon. Which means to avoid it the next day, you should probably try to give it around 11:30am. When yo keep this type of journal it will be easier to manage when to give the medications. As time goes on you should a very precise medication regime. There will be days that may go again st the normal, but that will happen and you will just have to adjust to it on those days.

The last point I can give you is that you may feel that have to adjust more than one medication at a time. The main thing to do is to get the timing of the Sinemet timing correct, or as close to correct as possible. From there, you will see what time the dyskensia occurs, Just an FYI, Dyskensia will usually occur when the Sinemet levels are even just a little too high. So, you may see it happening after possibly the second and fourth doses of the day. They may also occur at different times because no two patients are the same. This is why you use the journal to have a specific medication regime for that patient.

I hope this helps and please keep me posted.

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