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MComes RPH

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MComes RPH last won the day on November 19 2018

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About MComes RPH

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    Board Certified Pharmacist, Medical Board Member, & Consult
  • Birthday 05/24/1968

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  1. Oh goodness, so sorry. My intent remains the same. CONGRATULATIONS!!!
  2. Noah, First, let me congratulate you on being a Grandfather. Secondly, if you haven't heard there is a new inhaler used for Parkinson's called Inbriji. It is a Levodopa inhaler that is used to help recover from"off" periods and I think it would be great for you. When a patient starts to experience an "off" period they just use this inhaler and it starts working in 15-20 minutes. I worked with the Doctor who did the trials and the results were amazing. It is supposed to be available at the March to April time frame. I hope this helps and please keep me posted.
  3. Jsalts, Thank you for sharing your story. That it what this form is all about. It is not just about me giving advice, but also about sharing stories that may help other people. I truly appreciate your input. I hope this helps and please keep me posted.
  4. Noah, First, let me congratulate you on being a Grandfather. Secondly, if you haven't heard there is a new inhaler used for Parkinson's called Inbriji. It is a Levodopa inhaler that is used to help recover from"off" periods and I think it would be great for you. When a patient starts to experience an "off" period they just use this inhaler and it starts working in 15-20 minutes. I worked with the Doctor who did the trials and the results were amazing. It is supposed to be available at the March to April time frame. I hope this helps and please keep me posted.
  5. Esther, This makes more sense. It seems that the issue may be the Doctor. Even is they do switch you to Rytary, it has the same ingredients as Sinemet (Carbidopa/Levodopa). In some patients hanging from Sinemet to Rytary has helped, and vice versa. Since the Doctor is not willing to try the Sinemet CR, there are only a few changes I could recommend that may help. One would be to change to the long acting amantadine, Gocovri. This may help give you a more constant level of Amantadine over a longer period of time. The second may be to add Azilect. Azilect is used along with Sinemet to give greater relief is Parkinson symptoms. I hope this helps and please keep me posted.
  6. Camt, Thanks for the information, it is very helpful. My best recommendation, since you are at a low dose, would be to take the Ropinirole about 40-45 minutes after taking your Carbidopa/Levodopa. This way you can see is the "on" times are extended. You may not see much of a change at the lower dose of Ropinirole, but as the dosage is increased you may have a better result. The Ropinirole is a medication that can be increased every 5-7 days, so you may want to discuss this with your Doctor if you have done so already. I hope this helps and please keep me posted.
  7. Otolorin, Well, as you know, there is much, much, more involved at the Federal level. I hope this helps and please keep me posted.
  8. Mip, Thanks for sharing your story, it is greatly appreciated. The timing of most medications is a rule more than a suggestion. With medications for Parkinson's Disease this can be different. A regular schedule of one, two, or three times daily is usually the initial dosage schedule for most PD medications. As you know, each patient is different and the progression in each patient is also unique. There does come a point in the progression that the medication will have to be taken according to when symptoms arise rather than a timed schedule. Once again, thank you. I hope this helps and please keep me posted.
  9. Jsalts, Thanks for the information. The addition of Amantadine could have helped with the change in the "off" period. It could also be a change in "off" times as the disease progresses. Many times the "on" and "off" times will change ass the disease progresses which can result in "on" times being shorter. In some cases changing the medication schedule can hep with this. By just taking the medication earlier than usual may help. I hope this helps and please keep me posted.
  10. Esther, I do see how it may be difficult to find time to space out food and medication. If I may ask, how long did you try the Sinemet CR? Also, did you try the combination of the CR and Regular Release? As far as the Amantadine is concerned, how long have you been taking it? I also see that you are taking it once daily and just so you know it can be taken twice daily. There is an Extended Release version of Amantadine called Gocovri which may be more beneficial in your case. If you could just clarify those those questions so I may help you more I would appreciate it. I hope this helps and please keep me posted.
  11. Noah, Always good to hear from you and thanks for the information. I guess is you were female this would be a good thing. I'm just kidding. I hope you are doing well and, as always, i appreciate your input.
  12. Rick, Sinemet CR and Sinemet ER are actually one in the same. Many physicians still write for Sinemet ER which does not exist. The CR, or Controlled Release, is the only long release Sinemet available. Many times patients are prescribed Sinemet CR as a long release form, and a regular release Sinemet, just called Sinemet, which is used to control "off" periods or as a rescue type product. The usual dose of the Sinemet CR is three times a day, but I have seen it used more times a day to relieve symptoms in patients with advanced cases of Parkinson's Disease. I hope this helps and please keep me posted.
  13. Otolorin, Unfortunately there is not enough information or studies for me to make a conclusion on the effects of Marijuana or CBD oil and PD. I am all for trying new methods to help with the symptoms of PD, but I believe more studies need to be performed. So my belief is that I believe we need more aggressive and controlled studies to determine it's safety. This may be a little more difficult because even though recreational use in some states is legal and medical marijuana is also available for patients with PD in many states, it is still illegal on the Federal level. The best method to see if it works for you would be to have your Doctor sign for you to get a medical marijuana card and then be monitored by that Doctor. I hope this helps and please keep me posted.
  14. Camt, You said that your Doctor wants you to take them at the same time, are you doing that and what was the outcome? My recommendation to start is to try and take the Ropinirole about half way between your doses of Carbidopa/Levodopa. This will give you a good starting point. You can try this for about a week then you can judge if you need to move it closer to the Carbidopa/Levodopa to get better results. The duration of action, as you know, can vary from person to person. With knowing this, the onset of action is usually around 30 minutes or less. Ropinirole reaches it's peak in about 2 hours and the effects can last up to 6 hours. Once you establish the time frame then I think we can fine tune to try and limit the Carbidopa/Levodopa. I hope you understand. I hope this helps and please keep me posted.
  15. Esther, Let me first ask if you are taking it on an empty stomach? This is very important to the absorption of the medication. An empty stomach is considered to take the medication 60 minutes prior to a meal or 90-120 minutes after a meal. Also, other medication taken with this medication can effect how fast it is broken down in the liver. If possible try and take this medication by itself. Lastly, it does take between 30 and 60 minutes to to start working. This could be the simplest answer. In order to avoid this you may want to take the Carbidopa/Levodopa about 30 minutes prior to when you are currently taking it. This way you should avoid the off periods you are experiencing. I hope this helps and please keep me posted.
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