Sinemet - change of formulation


#1
I started on Sinemet 5 years ago and for the last 4 years, have been stable on Sinemet 10/100. About 4 weeks ago, I picked up my repeat prescription and noticed that the small mid-blue elliptical shapes with the depression in the centre had morphed into round pale blue pills. Within days, my hard-won equilibrium had disappeared. Instead of 4 'good' hours out of 5, I was down to 2.5 - 3 after which the familiar signs of wearing off set in. I was fortunate enough to know someone who pointed me in the direction of this link: http://www.medicines.org.uk/guides). I contacted the manufacturer, spoke to someone in the relevant department and a couple of hours later, I was told what I already knew: that the formulation had indeed changed. Noone warned me, least of all my local chemist (whom I have now, for different reasons - given the order of the boot). Yes the active ingredient is the same but the so-called inert 'bulk' - in other words the carrier - has changed and possibly with that change the absorption qualities of the med. The moral of the story: never take a med for granted just because it hasn't changed its name!

I'd be interested to know if anyone has had a similar experience to mine

#2
Marlinak07
The "change" happened around Nov last year also with 25/250 and Plus 25/100. We are told that there is no change in effect although the colour,shelf life,shape and design have all changed. My Parkinson's Nurse says she has had reports of change in effect. I also have a friend that says effect had changed for him.

I take the plus 25/100 and as this no longer works effective for me I now insist that pharmacy supply me with 25/100 co-careldopa. Problem for me solved. Perhaps you could ask for the 10/100 co-careldopa. The pharmacy will tell you that this is the same as your present new tablets and so will supply this other alternative brand if asked. Try your luck. After all, Parkinson's drugs all seem to be a matter of pot luck anyway.

Actionman

#3
Hello, Just wanted to ask as I am new to the world of PD, and the medications. It seems that you know a lot about the meds. My OH has only been on sinemet the lowest strength for 2 weeks @ 3 a day, then he seen a Neuro who dx that he had PD and doubled the dose (sinemet plus) 3 a day which he has only been on 10 days, I know it very early days but his tremor is much worse since doubling the dose. In your experience with Sinemet would you say that this is to be expected? The other thing that seems to make it worse is the cold, so maybe its just a combination of things, just that he keeps saying to me I thought this shaking was supposed to get better with the meds? any advice would be greatly appreciated, love hols x

#4
Hollytree29. I have had PD for 3.5 years. The tremors for me can be none and through the scale up to severe. There does not appear any logic. I believe the drugs never totally get rid of the tremors but are also used to act against or slow down other problems from developing. Mind you levodopa(contained in Sinemet) over time, can lead to dyskinesias and other problems according to the medics. So best keep dosage as low as possible.

In your case you appear to have taken first Sinemet 12.5/50 (oval tablet) and now have moved on to Sinemet Plus 25/100 (round tablet). Well the plus 25/100 had a change in production late last year with amongst other changes the tablet moved from oval to round. We are assured quality would not be affected but including myself found a number of people for which the new version of the tablet did not work so well as the older version.

If I have got your tablets right, I would suggest that you change your tablets to either 6 a day sinemet 12.5/50 or 3 per day 25/100 Co-Careldopa which is the same as sinemet plus but for me works better. The pharmacy will issue co-careldopa if you wish even if your prescription shows sinemet plus.

These are my personal views and tips and I am not qualified in medical matters.
Actionman

#5
Hollytree29. I have had PD for 3.5 years. The tremors for me can be none and through the scale up to severe. There does not appear any logic. I believe the drugs never totally get rid of the tremors but are also used to act against or slow down other problems from developing. Mind you levodopa(contained in Sinemet) over time, can lead to dyskinesias and other problems according to the medics. So best keep dosage as low as possible.

In your case you appear to have taken first Sinemet 12.5/50 (oval tablet) and now have moved on to Sinemet Plus 25/100 (round tablet). Well the plus 25/100 had a change in production late last year with amongst other changes the tablet moved from oval to round. We are assured quality would not be affected but including myself found a number of people for which the new version of the tablet did not work so well as the older version.

If I have got your tablets right, I would suggest that you change your tablets to either 6 a day sinemet 12.5/50 or 3 per day 25/100 Co-Careldopa which is the same as sinemet plus but for me works better. The pharmacy will issue co-careldopa if you wish even if your prescription shows sinemet plus.

These are my personal views and tips and I am not qualified in medical matters.
Actionman

#6
Hollytree29. I have had PD for 3.5 years. The tremors for me can be none and through the scale up to severe. There does not appear any logic. I believe the drugs never totally get rid of the tremors but are also used to act against or slow down other problems from developing. Mind you levodopa(contained in Sinemet) over time, can lead to dyskinesias and other problems according to the medics. So best keep dosage as low as possible.

In your case you appear to have taken first Sinemet 12.5/50 (oval tablet) and now have moved on to Sinemet Plus 25/100 (round tablet). Well the plus 25/100 had a change in production late last year with amongst other changes the tablet moved from oval to round. We are assured quality would not be affected but including myself found a number of people for which the new version of the tablet did not work so well as the older version.

If I have got your tablets right, I would suggest that you change your tablets to either 6 a day sinemet 12.5/50 or 3 per day 25/100 Co-Careldopa which is the same as sinemet plus but for me works better. The pharmacy will issue co-careldopa if you wish even if your prescription shows sinemet plus.

These are my personal views and tips and I am not qualified in medical matters.
Actionman

#7
One of the lessons I've drawn from the whole episode is to check every med carefully and not just leave it to the pharmacist. As far as I'm concerned the pharmacist who dispensed the first "new" formulation should have warned me - he didn't. I've changed pharmacists. The current one uses "own brand" boxes to put the branded meds in. Result: I'm checking every individual blister pack to make sure a generic or other brand hasn't crept in. Noone told me I'd have to be my own pharmacist as well! This can't be an accepted practice surely?

#8
Thanks all, I see where you are coming from. My OH would not know any difference as he has not taken them for long, but I will bring this up at the next appointment and see what is said, will let you know, cheers and thanks again, love hols x

#9
Requip/ropinrole??????????

The same?? No way.

My OH was precscribed Requip for years and then one presciption, some years ago,it was Ropinirole. A few weeks later and symptoms were not being controlled. Asked our GP to go back to Requip and the problem was resolved. Generic medication is not always as effective.

The big companies spend zillions of £'s developing the medication and then, when the licence is up after some years, other drug companies can also manufacture the medication but it may not be exactly the same constituents. Why then do GP's prescribe the generic medication??? ££££££££££'s.

#10
Benji
Perhaps this is why I went 5 months on ropinirole without any benefit. It seems that what you say I should have had reguip. Wow, I just took off the sticky label on my old ropinirole container and underneath it says requip.

But it is not always generic at fault, see some of the above.

#11
Benji
Re above I am now getting worried about the whole drugs thing. Looking back through the forum there are plenty of worried people having all sorts of problems with drugs and "changes".

Also non supply of drugs up to 6 months at a time. Both sinemet and co-careldopa had delievery problems last year. Why?

It is becoming clear that each of us should become mini experts in drugs for our own safty as the medics do not seem to know what is going on.
Actionman

#12
Generics have the same active ingedients as the original drug but not necessarily the same carrier ingredients. Some people are very sensitive to any change in their medication while others are not. It seems more of a problem if you have been on meds a while. Some people find generics suit them better.
I havent had problems so far thankgoodness as every script i get dispensed for Ropinerole (requip) comes from a different manufacturer.

#13
Hikol - you're very fortunate. I seem to be hypersensitive to the least little change. I certainly couldn't tolerate what you seem to be able to. After five good years with sinemet (Until MSD decided to change the formulation) I've decided it's no longer for me.

#14
I know i am lucky, so far Marlinak.. Im actually on Madopar which hasnt changed but Ropinerole is always different each script.

Maybe I'm still in the 'honeymoon' phase. You have decided sinimet is no longer for you so what are you going to do?

#15
The problem with Ropinirole, a generic of the original Requip, was that every time it was prescribed,the manufacturer was different.Requip was OK, inasmuch as it was the original product and not a generic one but it was not as effective for my OH.

I have the same problem with my thyroid medication which is always now generic,but never was at the start some years ago.Hence, many blood tests to see if my levels are OK. I even have to contend with one supplier for my 100mg and another supplier for my 50mg.and each month they may be different.

Don't tell me that that is satisfactory.It's not, and I have had to have more blood tests before a soon to be op as my levels were haywire and I blame it on inconsistent components of generic medication which do not have the same constituents as the original, much researched, and trialled product.