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Gene

Rytary conversion

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I realize you have  covered this before and are not a fan of it. But I would like your opinion on this conversion> I was on sinemet 25/100 every 3hrs for 5 doses, but because of dyskinesia, Neuro wanted to try Rytary.  Stop  sinemet one day, start Rytary  36,25/ 145 and 48.75/195  one of each at the same time, at 8am 1pm, 6pm and 11pm the next day. Is'nt that quite a jump of levo in one day. I was on the couch most of the day.

Thank you

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Gene,

That is a large dosage change for the Levodopa. There is a conversion chart when switching from Sinemet to Rytary, which will tell you how much Rytary to take depending on how much Sinemet you were taking. You can find the chart if you Google "Rytary dosing schedule." I will break it down for you.

The only figure the chart takes into account for is how much Levodopa per day you are taking. So, a Sinemet  25/100, it has 25mg of Carbidopa and 100mg of Levodopa.  All we will work with is the 100mg.

You were taking 5 Sinemet 25/100 per day, which equals 500mg of Levodopa per day (100mg Levodopa X 5 tablets per day = 500mg).

To convert it to Rytary dosing, the chart has 3 parts to it:

(A) Total daily Levodopa taking now

(B) Total daily Levodopa dose of Rytary you should change to

(C) Dosing schedule of Rytary

This is where you should be:

(A) You are taking 500mg of Levodopa daily in the Sinemet. On the chart you are in the category of taking between 400mg to 549mg of Levodopa per day. 

(B) The chart then states how much Levodopa in Rytary you change to. Yours should be 855mg.

(C) The Rytary dose should then be: Take 3 capsules of Rytary 23.75/95 Three times per day.

From the information you gave me about the Rutary dosage the Dr. gave you, I worked backwards from that. 

The dosage of Rytary per day is equal to 1,460mg of Levodopa per day, which would mean that you took between 750mg to 949mg Levodopa per day in Sinemet. 

The dosage seems high to me and I would look up the chart and speak with your Dr. about it. The dosage she gave you is almost double of the recommended dose. There may be a reason that I don't know about, but I would definitely discuss this with your doctor. 

I hope this helps and please keep me posted 

 

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The same thing happened to me (almost).  I was started at three "195" capsules TID (at  8/1/6).  I truly felt as if my head were coming off, and I haven't been able to sleep much at all ever since.  (Could these be related events, Dr?).  After taking the first dose,  I was giddy and "high"  for a couple hours then crashed into a Zombie-like state for the next 12 hours.  OFF TIMES  were far more intense than normal.  Wouldn't be surprised if 5-10 years from now, we start seeing some ugly long-term side effects.  It may be C-L based,,  but I thing RYTARY is dangerous.

Edited by klmdoc

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I have seen some people work well on Rytary while others work well with Sinemet and Sinemet CR.

It seems like the exact conversion is a little too much of a dose and comes with the side effects. Some of the doctor's I have talked to are doing the conversion and then lowering the dose a bit.

I hope this helps and please keep me posted. 

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I am sorry Mark, I missed stated my dose, I left off the half tablet. The correct dosage of my Sinemet is One and a half tablets of Sinemet 25/100mg at 8-11-2-5-8. Which I believe is750mg of levo. So the switch according to Rytary that was originally ordered was not completely out of the ballpark just a the high side , but after talking with her. We are now trying 2 of the 36.35/145mg 8-1-6-8. This is only the start of the 2nd day, but so far things are going better, esp. less dyskinesia. Thank you for helping me out.

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Gene,

I am so glad I could help.

I hope this helps and please keep me posted. 

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