Treatments


#1
can anyone tell me what difference (if any) is there between my usual equip xl and my new ropinerole ralnea xl

#2
Funnily enough I asked the pharmasist about this as I picked up a filled prescription with mixed brands. The pharmasist could see I was wondering about mixing the brands.

She told me that they contain the same drugs but are simply made by different companies - and that mixing them wasn't a problem as they were in effect "as one".



Saddlers

#3
Hi all, I don't want to sound too skeptical, but my GP has tried changing some of my drugs over the years, for financial reasons and prescribed a cheaper brand. When this has happened I have often found that they don't seem to work as well. I guess you 'get what you pay for'.

Hope your work for you
regards
Glenchass

#4
the chemical (ropinirole) is the same, but i doubt the release mechanism is the same unless they paid glaxosmithkline for the patent so it might be released quicker or slower . hard to find out. the company that makes it doesnt say but i can't see gsk letting an exact copy of its best selling pill be made
- is it the same shape and look? it not probably different release method.
but a chemical is a chemical.

i;ve been given a generic version but not slow release, works ok.

#5
All

You've got me wondering now. Given I expect a certain level of stability to be reached it I take my meds every day at the same time etc - am I likely to feel differently if I take a different branded product, albeit supposedly to do the same thing? I've got packets of Requip XL by GSK at 8 mg and then loads of 2 mg Ralnea XL.

Saddlers

#6
dont want to cause any panic, so to make clear what i was saying -

ropinerole the chemical [u]should[/u] be exactly the same

the delayed release system [u]might[/u] be the same

[u]if[/u] the delayed release system is different the timing [u]might[/u] be affected

and you [u]might[/u] notice or you[u] might not[/u]

#7
many thanks for your views i have had problems before with a change of brand

#8
I echo the thanks. Next time I get a prescription I'll ask for all the same stuff.

Saddlers

#9
My O/H was diagnosed in 2009 and had been on Ropinirole, Requip XL since October 2010. In August 2011 the pharmacist changed the manufacturer to Ralnea XL without mentioning anything to him. He was not that concerned and inspite of my worries decided not to query the change and started taking Ralnea. Within days we noticed a change in his overall condition. It took the drug a lot longer to relieve the stiffness in the morning (1 hour as opposed to 20 mins with Requip) then the length of time that the drug lasted seemed to reduce until finally it was only effective for 12 hours. Even when it was meant to be working, it did not totally relieve the stiffness that he suffered.

Initially he felt that dear old Parkie was rearing it's ugly head and getting worse. I was not convinced. Finally after a very distressing incident I decided not to put up with any more protests from him and contacted our Parkinson Nurse for advice. We decided that he should change back to Requip as soon as possible.

When he was finally able to speak to the Doctor (two days for a telephone consultation, one week for an appointment- that is another story) the doctor agreed to specifically prescribe Requip XL. Luckily O/H found a spare, emergency packet of Requip and started taking it the next day.

He improved straight away, stiffness dying out and normal life returned to our household and I even refrained from saying those immortal words - 'I told you so'. He has continued to improve, looking a lot healthier and losing the Parkie stoop.

O/H was on Ralnea for just over a month and clearly it did not work for him. However, within the misery there were some positive things. His ankles and fingers were no longer swollen and he did not have any vivid, violent dreams. The quality of sleep at night improved with him waking up far less ofter. The downside with Requip was the return of swollen ankles and vivid dreams within two days of taking the drug.

Hope that this will be of some help to fellow carers and their sufferers. What this incident has taught me is not to let O/H accept any change to his medication without querying it.

#10
My experience is not about Requip XL, but is still relevant.
A year or so ago I changed from taking a Sinemet CR pill at the end of the day to Caramet CR. The change was forced on me by the unavailability of Sinemet CR.It took me about a month to get stable again after swapping over, probably because although the active ingredient was the same, the pattern of release was different. The Caramet CR appeared to release the medication more slowly, but lasted a shade longer.

#11
When the drugs run out of patent, there will appear several generic ones to replace it. The other drug companies want a slice of the cake too.
As the generic ones are cheaper, you cannot blame the NHS for switching the patient to these and in a lot of cases it doesn't make any difference. However, if you have been stable on the original drug and notice a significant difference on the generic drug, you can (you are within your rights)insist on staying with the more expensive original drug.
Theregulation of these drugs is apparently that generic drugs do not have to be 100% the same, they have to match the patented drug to a certainlevel(I believe it is 80%?), so not feeling as well on the generics is not always just in the patient's mind.

#12
I too had to change my medication when it became impossible to get Sinemet CR, in July 2010. When I had been started on it, in Novemer 2009, my neurologist had added a note that if Sinemet CR was not available owing to supply problems, I was to take Madopar CR. I therefore asked my GP to be put on that, but it did not work nearly as well, I took it for a fortnight and in that time I had several embarrassing episodes of being stranded in the street with my right foot twisted up in a spasm, (dystonia). I do get dystonia occasionally but this was more severe and more persistent than usual. I asked to be changed to Caramet CR, which I knew was the generic equivalent, and this has worked quite well ever since. However, I do also take a Half Sinemet CR each morning, with the first Caramet CR.
The thing that I have noticed is that if I have an unusually busy day, involving moving around more than usual, the dose seems to wear off earlier. I am not sure if levadopa is used up in line with exertion, but that is how it seems to me. I take 62.5 Sinemet (not CR) if this is a problem.

#13
Hi.

I find it normal for levodopa-based drugs to get "used up" more quickly if the brain is calling for more dopamine than usual.

This could be because I'm being more physically active than usual, or stretching my mental efforts by introducing a little stress (e.g. by trying to multi-task, get involved in more than one conversation at once, do puzzles, or play chess).

This applies for my Stalevo and my Sinemet CR, and in the past with Sinemet Plus.

I carry a small supply of Madopar Dispersible 50mg specifically to get me through situations where I get "cut short", or I know I'm about to "enter the fray". One tab lasts about an hour, and is effective within 10 minutes.

RoS
.

#14
Hi Loose Hinge.

I am in early stage of PD but nevertheless had lost a bit of confidence and mentioned as an example I wanted to go on a rambling holiday by myself (with a group) and the neuro suggested that I take an extra sinemet if I felt I needed prior to exercise. I don't need it - or mostly choose not to take extra - for my usual exercise but on the walking fortnight which turned out to be much more strenuous than advertised (not just my impression) I took an extra tablet (to the three I take now plus Azilect) every day spacing the tabs. out through the day and was fine in spite of having the worst cough/breathelessness I have had for years. I was able to go back to the three a day without any problems.