I avoided making any posting regarding a radical medicine changeover until we were sure there were little or no major side effects....
My wife 56/15 was taking 12 x 10/100 diluted in one litre of OJ daily with a measured dosage each hour. This was doing a very very good job of leveling the on-offs. This has been her normal routine for the past four years.
In addition to a few CR50/200 (generic) and an assortment of vitamins and minerals, her other main med has been PERMAX.25MG and she was up to 19 EACH DAY.
As her symptoms began to increase over the past six months (stiffness and lots of difficultly when she begins to walk) Since she is almost always ON, I was concerned that these deteriorations were leading us to consider DBS (Deep Brain Stimulation of the Subthalamic Nucleus) surgery sooner rather than later.
However, a combination of side effects.....discolouration of her ankles and lower calf and an increase in water retention, increase in dystonia and her inability to take more 10/100 without throwing her over the edge into dyskenesias led me to speak with her neuro (at a recent semi-annual) exam to consider a new medicine course.
Upon seeing her we reviewed her recent decline and the noted side effects and he agreed/suggested a coordinated gruaduated combination of 10/100 INCREASE and a REDUCTION of the PERMAX to a ZERO LEVEL over a 3-4 week period.
Down side:
Next week we will be close to completing the changeover and it then we will begin the process of tweeking the dosage which might include adding back one or two Permax during the weakest part of the day.
I post this to the rest of the CG/CP list almost as a reminder that our PWP can be flexible in the medicine routine. Everyone is different and unless there is a specific medical reason to the contrary, the meds available to us and the schedules are purely subjective and can be adjusted with the consent of the neuro.
good luck to us all....