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When should I take my PD medications?
Mark A Stacy, MD posted:
PD medication regimens may be as varied as the number of people with parkinson's. There are several things that are useful when organizing a medical regimen.

First of all some PD medications last a short time. Levodopa, the active ingredient in Sinemet, lasts in the blood stream (and brain) from 2.5 to 4 hours. The controlled release form (Sinemet CR) may last up to 6 hours, but usually only 5. Levodopa competes with other protein for absorption to the blood stream, and some recommend that it not be taken with meals. I think this is not a major problem, and have my patients usually take the medication at mealtimes, and as the medication effect becomes shorter, may move to four- hour intervals (eg. 7am -11am -3pm, -7pm). Drugs that make levodopa last a bit longer include entacapone and rasagiline. (Carbidopa/levodopa/entacapone tablets are brand named "Stalevo.")

Dopamine agonists, pramipexole (Mirapex) and ropinirole (Requip), usually last 6-12 hours, and both have recently developed once daily preparations. These new agents may be great for people who are having mobility problems in the night. I recc the once daily forms to be taken with the first dose of the day, unless night-time is difficult, and then will dose later. The original formulations are now available in generic, and may be also dosed at mealtimes - and simultaneously with levodopa.
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tony32vu responded:
I have been diagnosed with PD(pSP=progressive supranuclear
palsy)in 2007. Since then, all Meds are ineffective. So, I used to search webs to find whomever with the same symptom like me and what meds they're taking?
Mark A Stacy, MD replied to tony32vu's response:
I am sorry to read that your medications are not effective; most people with PSP notice less response to drugs that PD patients. However, sometimes higher dosages may produce some benefit. I usually will try to simplify a medication regimen to only carbidopa/levodopa (25/100), and try gradually increasing to 2 tablets four times daily.

You may wish to discuss this strategy with your doctor.

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