Could anyone explain the difference in 10/100, 25/100, 25/200 sinemet? My husband has only ever been on 25/100. Was once on slow release 25/100 and I believe that was the start of the willy waws with him so not anxious to go that route again.
I checked with the pharmacist about liquid sinemet and he said there isn't any so guess those of you going that route are melting it in liquid. How much and what kind of liquid. I tried a generic in water this morning and think most of it ended up stuck to the glass.
Our neuro doesn't like the generic sinemet but pharmacy was out of the real stuff before we went away so that's what we got. Not sure if I can tell much difference. Have a feeling that several companies make generics so the quality may vary quite a bit.
Carbidopa ...blocks the enzyme which would convert the levodopa to dopamine OUTSIDE the brain, so that more of it can reach the brain. It thus dramatically decreases such side effects as nausea, vomiting, loss of appetite, lowered blood pressure when rising, rapid heart rate. With sinemet, the first number is carbidopa, the second is levodopa. Most persons require 75-150mg carbidopa to prevent levodopa from being metabolized before reaching the brain.
I would also note that there was past discussion of the concern that it was possible to get too much carbidopa, and to avoid that one can take the 10/100 rather than 25/100, getting less carbidopa with same amount of levodopa. You will find discussion in the PIEN list archives, of course, including recipe for making liquid Sinemet. It is not available commercially, but lots of PWPs use it, by crushing the regular Sinemet tablets and adding to liquid, often orange juice.
As for generics, here's what Dr. Romero wrote to PIEN:
"The problem is not that generics or brand name are superior. The problem is that they are not exactly equivalent to each other and some people who switch may find that they need to be "re-titrated" if you have already been stabilized on brand name. Just let your neurologist know and he may have some suggestions for readjustment.
"It is unfair that they force people to switch if they are stable on one medication, but that's the law - written by people who are not medical and don't understand the concepts of bio-equivalence well.
"In any event, generic levodopa works well if you stick to it. It will work as well as the brand name, and will be less expensive. However, switching back and forth will create problems, or even switching between two different generics, if in the future someone else comes out with a third generic alternative. Make sure you insist that your pharmacy dispense THE SAME generic each time.----Jorge Romero,MD"
May I suggest that you and others call NPF asking for the medication booklet and others in their set of excellent publications? They even send multiple copies free for our local support group!
