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Brand Sinemet vs. generic levadopa/carbidopa
When my Dr. first prescribed the generic form of Sinemet, I has a lot of nausea issues. When he switched me to brand name, I did not seem to have the same nausea issues. Although, maybe once or twice a week, I get so dizzy to the point of almost blacking out, I need to get horizontal. After laying down for about 5 or 10 minutes, I am fine. I take Sinemet 25/100 2 tabs 3x/day. Does anyone else have a problem like this on Sinemet or the generic? My neuro said to space out the time between the 2 tabs; eg; take 1 tab at breakfast, then the other tab 10-15 minutes later after I take food.
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20 Replies
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My medication for/against PD started with one tablet of Sinemet 25/100, 3 times a day at 4 hr intervals, from 8 a.m. After a few months it was increased to 4 times a day. I’ve been on that since. No other changes.
Blackouts – had one lasting half a second or so. That had me on my back on a nice grassy bank. Nowhere near pill time but I had been putting some moderate effort into walking.(I do around 40 mins a day – the limit I can do) On a couple of other occasions I’ve had to sit & rest for a few minutes before carrying on walking.
Cycling is easier – but that’s not quite the effort required for walking. Bit of catch-22 🙂-
William, it most certainly is a catch-22; trying to find the right balance of exercise (duration and intensity). I too cycle at about half the pace/cadence I used to and I am so wiped out after 30 minutes. Gone are the days of 30 mile rides… 🙁
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I am newly diagnosed and my neurologist prescribed levodopa/carbidopa 25/100 three times a day. Last Tuesday, I started with one pill a day and am to increase to twice a day after a week and then three times a day the third week. I am experiencing nausea even though I am taking the pill on a full stomach. The nausea lasts for hours. It is hard to imagine taking an additional pill starting tomorrow. Does anyone know if the nausea gets better in time? Do you think I should go ahead and let my doctor know about this side effect and ask if I should try the brand Sinemet?
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hi cathy. sinemet is no longer available (In NY anyway). I got nauseous on genric, so my dr. put me on brand which was a little better. now brand is no longer available. i have gotten used to generic and no longer get nauseous. some things that have helped me:
1. drink LOTS of water with your dosage.
2. smelling essential peppermint oil has helped nausea
3. I take a dose at 6am with lots of water, then eat bfast one hour later. have also heard it is best to take either one hour before or one hour after a meal.
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Hi Cathy,
If you’re newly diagnosed, you might ask your neurologist about switching from levodopa to either an agonist (p.e., Mirapexin) or Mao-B inhibitor (p.e., Azilect).
Parkinson’s affects everbody differently (“When you’ve seen one case of Parkinson’s, you’ve seen one case of Parkinson’s”) and though it is a shame that your stomach and Sinemet have issues, there are other options.
If you do continue with Sinemet and manage to build up a tolerance to it, please let us know, because this might be helpful for others
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Thank you, Jean. This is most helpful. I haven’t been drinking very much water when I take the pill so I will do that. Do you recall how long it took for you to get used to it and not get nauseous?
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That is good to hear, Lou, that there may be other options. I will keep the Forum posted.
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Cathy, i think for me it was more a case of getting the timing of taking the meds right vs. getting used to them.
pd affects us all differently as do the meds we take. i would say maybe a couple of months? occasionally, once in a blue moon, i do get the nausea back where i feel if i dont lay down asap, i will pass out. that could be meds, PD, or just a bad PD day. what is important though is drinking lots of water . if you feel the need to eat something with your dose, maybe some bland crackers or rice cakes (no protein)
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<div dir=”auto”>Jean,</div>
<div dir=”auto”>I still ate breakfast about an hour prior to taking my pill. This time I drank about 16 oz. or more of water. It definitely helped! Thank you for the tip.</div>
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<div dir=”auto”>I saw that Oatmeal has about 5 grams of protein. Is that too much protein?What do you eat for breakfast? I’ll try it on an empty stomach tomorrow since I know drinking a lot of water helps.</div>
<div dir=”auto”>Cathy</div> -
Sorry for the extra symbols in my post. I forgot and replied to the email I received. So I copied and pasted my response to the post. The symbols didn’t show up until I submitted it.
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cathy, no worries on the symbols… i do eat gluten free toast with avocados and hardboiled eggs and pumpkin and sunflower seeds most mornings, so it is high protein. thats when i started taking meds at 5-530am, go back to sleep for an hour or so, then make my bfast. everyone is different. unfortunately what works for some does not work for others. it is all trial and error. i have started tracking med times in a journal, notate when i eat and what my symptoms are in addition to what exercise i did.
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Jean, that is great to know that you can eat protein a couple of hours after you take your meds. How long after breakfast do you take your next dose? I can see that it is all trial and error. That is a great idea to keep a journal while trying to figure it all out.
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i have beenon carbdopa/levodopa for almost 2 years and i am still experimenting. since sinemet is off the market, i have been having a terrible time trying to take my meds so they are effective. right now i am (1) 25/100 at 6am, 10am, 2pm,6pm. seeing neuro next week and this may change.
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What a bummer that you are having such a tough time getting your meds regulated so they are effective! What a shame that Sinemet is no longer being produced. I can already see in just one short week that it is a challenge. Yesterday, I had a good day with the meds with very little nausea in the morning and again, very little nausea after I took the second pill for the first time. I eat crystallized ginger and get relief fairly quickly. But I still had the tremors in my right hand even though my handwriting improved for a short time. So I figured I’d get better results with taking the med on an empty stomach like you do. OMG! I took it on an empty stomach this morning and drank a lot of water as you suggested but the nausea was very intense for about 90 minutes. I keep hoping it will improve in time but I may contact my neurologist as Lou suggested regarding trying another med. I know Levadopa/Carbidopa is the Cadillac of these meds so I keep giving it another try.
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Hi Cathy:
I believe I’ve read that the carbidopa was added to the levodopa in Sinemet precisely to help prevent nausea. Ask your neurologist about this, but instead of 25/100 carbidopa/levodopoa, take an additional carbidopa suplement so it will be, in effect, 50/100 carbidopa/levodopoa. Remember, I’m no neurologist and there might be very good reasons for *not* doing this, but it seems like a logical thing to try.
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hang in there Cathy. it is a daunting journey we are on trying to find the right ‘cocktail’ of meds, timing and dosages. a description of how you feel, when you take the meds should be helpful for your dr. in trying to find the right med for you. good luck.
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I appreciate your input and suggestions so much, Jean and Lou!
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you are most welcome! thanks to you, lou and william for participating in the conversation
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Hi Jean, Lou, William and all participants interested in this topic.
Here is an update on my experience with Carbidopa/Levadopa. After a couple of weeks on the med and still experiencing nausea, I contacted my neurologist and he told me to take only 1/2 pill at a time. Then after two weeks, try the whole pill again. I asked him about taking an additional Carbidopa supplement. He said that was a possibility but it was a very expensive med so he leaves that for a last resort. Taking a half pill worked like a charm. After two weeks, I could tolerate a whole pill without nausea. I always drank at least 12-16 oz. of water with each pill as Jean suggests.
My situation as of late is that one pill, especially after my first dose in the morning, does not relieve my tremors. I find slight improvement after the second and third dose. My neurologist wants to increase my dose to two pills three times a day but said he wants me to have more time with one pill at a time for my body to get used to it.
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hi cathy
thank you for sharing you experience with C/L. for over a year I have been trying to find the right dose/timing of my C/L. It truly is an individual journey
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