Hi. Fairly new to PD -diagnosed in November. Neurologist put me on sinemet 125mg 3 times a day. My question for those also on this dosage is when do you take them. I take the first dose when i get up (usually around 6) and have then been taken the 2nd and 3rd roughly 71/2 hours apart -i.e 1 and 8.30 - i do find find however that i could do with the second dose by about 12 - would i be better taking them about 1/2hour before meals? It leaves a big gap between tea time and the morning -but do i need the meds if i’m asleep? Any insights on this please.
Rough rule of thumb is half-an-hour before eating [i.e. empty stomach] or 1 to 1 1/2 hours after eating. Taking Sinemet with High-protein meals should be avoided if possible as protein inhibits the drugs uptake. There is a controlled release version of Sinemet if you feel you need a " top up " during the night. Consult your doctor or Parkinson’s nurse who can best advise you about a dosage regime but to a certain extent you have to experiment a bit yourself to get the best results.
PS many advise taking tablets with plenty water to aid absorption
Hello Shir, my husband was on this dosage of Sinemet when first diagnosed 7 years ago. He used to take them at 7am, 12 noon and 5pm. That gives 5 hours between. I think 7 1/2 hours between is too large a gap but obviously if that is what you were told by PD consultant then it must be ok. He never took the controlled release Sinemet until early last year. Unfortunately it didn’t suit him at all so it was stopped. These days he takes 25/250 Sinemet four times a day at 7am, 11am, 3pm and 7pm. So that’s four hourly, but obviously his symptoms have become more difficult to control hence the increase in his meds. He tries to take them a good half hour before eating but as with all things, in reality this doesn’t always happen when out and about. But we do try and do this when we’re at home. Then at bedtime he takes Melatonin to aid sleep. As you’ll no doubt find out, the meds will begin to wear off quicker as PD advances, but to reassure you, he was fine for a few years on the dosage you’re on now. Hope it continues thus for you. Jean
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HI and welcome to our friendly forum @Shir, It’s nice to hear that you’ve jumped right in and already have some answers to your questions about Sinemet. As others have pointed out, it’s best to talk to your doctor or Parkinson’s nurse about changes to your medication. It can sometimes take a while to adjust to something new and they can suggest what you could do to make the best of your medication and dosage. Your pharmacist can sometimes be a big help here too.
I’m looking forward to seeing more of you on the forum in the future. If you have any concerns, don’t forget our Helpline, which is on 0808 800 0303.
Best wishes,
Janice
Forum Moderation Team
Thank you Jean - I paid for a private neurologist appointment as the NHS referral time was so long - he simply said take 3 times a day - with no suggestion for timing.
Thank you. Haven’t seen my GP since diagnosis and don’t have a Parkinson nurse - so will experiment to find the best timings.
I was diagnosed some 2.5 years ago and was put on Sinemet 125 three times a day. I do not recall any special instructions about mealtimes but was told to space the doses 8 - 8 - 8 hours apart. This suited me as 7:00 was getting up, 11pm was going to bed and I set an alarm on my phone for 3pm to keep everything in sync.
Since then, I was transferred to a different consultant and he decided to increase my dose by 50%, i.e. 187.5mg. This worked fine, but later on it was decided that I felt more “drained” in the evening and there might be some benefit in doing 7am, 2pm and 9pm, i.e. 7 hours apart but a longer gap at night. On the whole I have found this beneficial as I have a bit more energy last thing at night for cleaning my teeth and getting undressed (buttons!)
The main problem I have found is that in the evenings, I might be out or doing something and simply forget to take it at 9, but at least I will take it as soon as possible, between 10 and 11.
Please don’t take my comments to change your regime without advice from your consultant.
I was put on 1 x levadopa 3 x a day and when I was first prescribed them in hospital they were given to me at 8am, 5pm and 930pm.
When I got out of hospital and started seeing the Movement Disorders Clinic they suggested 730am, 1230pm & 5pm or similar because they said you need them in your waking hours not while you’re asleep.
So this is what I do. They’ve also recently prescribed an extra levadopa tablet to take on an as needed basis. I’m in Canada by the way but Parkinson’s is the same wherever you are!
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Please seek your local Parkinson nurse (hopefully your GP can guide you). Our Parkinson Nurse is fab and adjusted the timings of Sinemet. She also found that it was contra-indicating with high blood pressure medication which was causing fainting. Sinemet causes the blood pressure to drop.
I’m surprised you paid for the private neurologist and they’ve left you unsupported on the treatment part.
Your experience sounds like mine. I was given 12.5/50 and told to take it 3 times a day and that was it. My parkinsons nurse later suggested 7.30, 12 and 5.30 which means that the sinemet lasts from 7.30 till about 10.30 or 11 pm, when i go to bed and go to sleep, when I don’t need sinemet. HTH
Neil
Hi shir, hope your timings have been sorted. It’s quite concerning that a doctor is prescribing time critical medication to a newly diagnosed patient without discussing or considering at what time they would be best taken! Too many people are diagnosed and not given information about PD, as I was 13 years ago, nothings changed. Thank God we have Parkison’s UK to fill in the large gaps!
If you get the opportunity Shir, it may be worth seeing a movement disorder specialist and a referral to a Parkinsons nurse.
Forest
UPDATE:
thank you for the replies -really helped. I have changed my timings to 6 hours during the day and doing a lot better. My worry was not having the meds at night time - but now realise I don’t need them then.
Will be booking a 6 month follow up appointment with the neurologist soon (we agreed I would see if my initial NHS referral came through i would use that - it not (and it hasn’t) i would go back to see him - will have a better idea of the questions i want to ask now, and will ask for Parkinson nurse referral)
Great help knowing this forum is here.
Hi, Shir. I was diagnosed in March 2022, and my neurologist prescribed Sinemet 25/100 three time a day, without specifying timings. My Autistic brain thought that I should take the tablets evenly spread throughout the day, every eight hours (7am, 3pm, 11pm), similar to antibiotics. At my first check-up in October the neurologist said I didn’t need to take the tablets every eight hours. I looked slightly undertreated and could try and taking my doses more frequently during the day, I was also given discretion to take an additional fourth dose (a half or a whole tablet) if I wished. I had my first meeting with my Parkinson’s Nurse in January 2023 and she said that I didn’t need the medication whilst sleeping. She recommended taking a tablet at 8am, 1pm and 6pm, with the optional fourth dose if I felt I needed it later in the evening. This has helped me tremendously, and I feel more confident when driving my car and riding my bicycle. HTH Neil
I’ve had parkinsons 15yrs and 5yrs dx 8yrs dbs .I’ve always been told there is a 4hr window half an before and half an hour before wearing off.So take 8pm/12,pm/4pm/8pm/10.30pm controlled release at first then as time went bye my on time got worse so introduced Entacapone to make on time last longer. So tablets half ,1/2 to switch on ,So take 8am on time 8.30am wearing off starts 11.30am .So take 12pm to over lap off time so you hopefully have steady on times. And bedtime have slow realize controlled tablet so your able to move around in bed and not so much on time that you can’t sleep .
The time of taking medications usually depends on the doc’s prescription. I took pills in the morning and evening
Hi, it’s been the same with my dad (diagnosed april this year). 3 times a day it says on the sinemet box. Nothing about timings. The carer comes at 7am and 8pm, so i thought 7am, 1pm and 7pm to take them. Thing is, he takes so many other tablets, especially in the mornings that i think it may not be such a good idea. For instance, they’ve got him taking iron, thyroid, blood thinners and other things i don’t know what for all in the morning. About 13 seperate tabs in total, all in one dose in the morning! I’ve asked for a meds review, as i know certain tabs inhibit others working.
No one told us about timings, which i only found out after Dr Google searches!