Sinamet - timing

The reason I am asking is that I am timed to have my last sinamet at 8pm but usually I forget (!) and end up taking it at bedtime 10.30pm.
Could this be part of my sleep problem - does sinamet stimulate ! I know It makes me feel better during the daytime but could it be affecting me at by taking it so late?
I have been diagnosed for only 3 years and still learning. I find sinamet helps me cope (4 x 25/100 per day)backed up by 1 x 1mg tab Azilect per day.

HI, If your sleep problem is you wake up shaking, I had the same problem and was told to miss the last dose of sinimet and take a sinimet CR (SLOW RELEASE) at 10pm and now I have a better nights sleep.
Hope this helps.

Hi John,

I take half Sinemet Cr (controlled release) 45 mins before I go to bed. At first it did make me feel more alert and I was staying up until the early hours of the morning but now I've got used to it. I used to take normal Sinemet last thing at night but that didn't seem to keep me awake. When you forget your 8pm dose of Sinemet, are you not finding your pd symptoms are returning? If you find you are managing and sleeping OK then perhaps this works better for you. My neuro advised me to slightly tweak the timings if I find i'm not responding well and to keep a record of how I'm responding. It's trial and error.


Hi Mossy,

I started half Sinemet cr a few months ago, because I was waking up in the night with 'off dystonia', sweating a shakes. I was having to take an extra Sinemet about 4am to take me through to the morning. Since starting the controlled release I find I'm sleeping through most nights although when I first introduced it, I did find it made me feel more alert although my body was tired.


The effects of ordinary sinemet last about 2 hours, whereas the CR version lasts about 4 hours.

However CR isn't absorbed so well; as a result it's only about 70% as effective for the same no. of mg's.

I take my last normal sinemet at 8:30pm, and then a CR at around 11:30pm just before I (try to) settle down. I take another CR at 4am, and then back to normal sinemet at 8am.

When I say "normal" sinemet I'm actually talking stalevo, which is levodopa + entacapone + carbidopa.

My sleep is always broken though: I never sleep right through, and NEVER more that 3 or 4 hours in one go. I don't let myself worry about this though, or the stress would make it worse. I just accept it as the way life is nowadays.

Forgotten to take tablets? I use a simple reminder. It is a pocket size box with a bleeper which can be set at any interval. I simply prepare a days supply and it reminds me to take the tablet

The box is fairly cheap and can be obtained from RNB supplies tel, 0207435 2417

I was diagnosed about 12 months ago and my main symptom is a shaky right hand. I`ve been taking Sinimet plus for quite a while and it has worked reasonably well. However, I now seem to be shaking about 2 hours or so after I`ve taken a tablet. I take 3 tablets a day at 5am 11.30 and 4.30. This is to fall in line with taking them half an hour before a meal.
Does this rule of taking half an hour before a meal fly out of the window for those of you who take more than 3 a day?
I am a rather nervous person by nature....Could it be nerves that are making me shake more or do you think the sinimet is not as affective?
I see my neurologist in 3 weeks but welcome any comments.



Do you take entacapone with your sinemet plus? This helps its absorption. Some people take stalevo, which is simply a pill combining the two.

My understanding is that a dose of sinemet plus takes about half an hour to kick in, and lasts for about 2 hours. This would fit in with your timings, i.e. you start to get the shakes as it is wearing off.

Not sure about the half-hour rule, but sinemet plus should not be taken at the same time as food, whereas it doesn't matter with sinemet CR.

The CR is controlled-release; it takes about an hour to kick in, but lasts for four hours or more. Many people are therefore prescribed CR at night time. It doesn't get absorbed as well as sinemet plus though, it's only 70% as effective, so 100mg of CR would equate to 70mg of Plus. Many consider CR gives you a smoother overall "ride".

Any kind of stress is bad for PD, and is likely to exacerbate the symptoms. So if meeting strangers (for example) was something which particularly stressed YOU out, the shakes would inevitably increase, probably both in intensity and frequency.


Thanks for the feedback Merve.
No I don`t take anything else and yes I do shake when meeting people (which doesn`t help as I`m a rep).
Only last weekend my hand was all still and calm until my mate asked me how I was and instantly the shakes started again which is strange cos I felt calm as I was half way down my 4th pint of Stella. STARTED SHAKING AGAIN NOW JUST BY TYPING THIS.
Anyway, Well done to you. I don`t contribute a lot on here but I do read it a lot and I know you help and advise a lot of people. Thanks again . You`re one of many kind people on here.
Cheers mate.


Thanks Brian, appreciated.

I'm like you when it comes to typing on here. Depending on where I am on my drug cycle, my fingers might be whizzing round the keyboard, or hovering above it, motionless apart from an uncontrollable judder. So a message like this could take anything from 2 minutes to an hour or more!

One thing I do is type all of my postings of more than around a dozen words into a Word document first, then cut & paste it into the forum when it's finished. This means I can refer back to the forum window whenever I want, whilst working on the document in the Word window.

It also means I automatically get to keep a copy, which could be useful in the event of a network problem, or if the moderator were to subsequently delete it for some reason.

Take care.


Thanks to all of you for the replies. I suppose it makes sense that when I take a sinamet it keeeps me going for 4 hours, so if I take one at bedtime it must boost my system just at the wrong time.
I'm going to try my last one a couple of hours before bedtime and see what happnes.
Incidentally, mine are not Sinamet CR - must ask about that next time I see consultant.
Good luck everybody - I suppose the thing to do is not let it get you down Easier said than done !!

I always tell myself there are plenty of worse conditions one could be stricken with. Not to mention natural disasters, just watch the news!

Most of the time I find that comparing my lot with someone, who is clearly worse off, does not give me much comfort as there are so many more, who (as far as I know/see) seem to be blessed with better fortune. For a long time I was extremely jealous of anyone , who could walk 'normal', especially if they were older than me.

Hi Kate.

I tend to consider my lot in life on a global basis, rather than by comparing myself with those immediately around me.

There are 6 billion people on the planet, of which 2 billion are in China and 1 billion are in India. Many millions of the rest live in poverty and in disaster areas. Millions more have to kowtow to evil dictators.

Despite PD I still have 4 limbs, 2 eyes, 2 ears and one or two teeth. Also a wonderful wife. I have a guaranteed (albeit paltry) income, and an NHS I'm still proud of. And I live in the country with the best football in the world.

I just MUST be amongst the luckiest people in the world, despite my PD!


Since I posted the question about having sinamet just at bedtime I have made sure that take it 2 hours before bed. Believe it or not it worked. Maybe mind over matter but the last two nights I went to bed at 11pm came downstairs for an hour at about 2pm and then slept the rest of the night until 9am yes 9am !!! Can't believe it 9 hours sleep for two nights - I feel great.
It's amazing what a difference it makes , my shakes are hardly noticable and I am not walking around in a daze and falling asleep every time I sit down.
Just hope I can keep it up.