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Cramping of muscles around the abdomen and Sinemet
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NCTERP posted:
My 85 yr old Mom diagnosed about 4 or 5 yrs ago finally started treatment 2 yrs ago. Took Senemet without problems for a year, then about a year ago doc increased her Sinemet dosage to 1.5 tablet 3 times/day and she began having severe abdominal cramping episodes--not interal cramps but more (she says) like someone is pressing down on her abdomen very hard with great pressure. Puts her in misery. Switched to Requip XL (long transition) which seemed to resolve the cramping but her gait deteriorated seriously and she began to experience drooling even with the addition of 1/2 Sinemet 3X day. Back to Sinemet at previous levels--cramping returned--now trying 1/2 Sinemet up to 6 time/day to see if that works. Also taking as of recently, Carbidopa/levodopa CR at bed. She is a 90-pound woman and al of these medication changes are very hard on her (and me). Has anyone else had this experience with Sinemet?
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DUKE MEDICINE
Mark A Stacy, MD responded:
Dear NCTERP
As you know this is fairly complicated... Given her abdominal cramping is quite uncomfortable, I would agree with the change to Requip XL. This switch is often difficult because the drugs are not equivalent in potency. I use a conversion of 3-4 mg Requip XL to 100 mg of levodopa; in this case it would have been 16-18 mg per day.

If that dosage was not reached, it may be that she could get to 18 mg/d Requp XL and 1/2 tab sinemet 3-4 times a day.

Another trick for this dyskinesia is to try amantadine 100 mg daily (but this can sometimes effect memory), so be careful.


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