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Suggest Dosage Adjustments Of Syndopa Plus, Pramipex And Amantadine

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Posted on Tue, 21 Jul 2015
Question: I am suffering from Parkinson disease since 2008.I was on syndopaplus from 2010.Because of drug complications I undergone bilateral STNDBS two years ago. My right cerebral lead was removed due to infection after few months. Left lead is fine controlling my right half of body. now I am on syndopaplus one tab five times a day(6am ,8.45am, 11.45 am ,3pm and 6pm).I also take syndopaCR half at night.
I am also take Pramipex ER1.5mg once a day. Because of on and off and dyskinesia I started on Amantadine 100mg once a day now increased to twice a day.
I am still having off periods from 11.30am to12.30pm and in evenings3.00pm to 5.00pm and doses lost for less than two hours. can you suggest any dose adjustments
















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Answered by Dr. Neeraj Kumar (46 minutes later)
Brief Answer:
Adjust meal, Drug timing, or use liquid levodopa

Detailed Answer:
Hello XXXXXXX XXXXXXX
I have gone through your question and understand your concerns.
It's strange that you are having off period between 11:30 am to 12:30 pm when you are taking dose at 11 :45 am and similarly off during 3-5 pm with drug been taken at 3 pm.
Are you taking drugs empty stomach without any meal preceding or succeeding at least one hour.
One possibility may be delayed on either due to meals being taken simultaneously or poor gastric absorption from stomach.
If possible you can prolong the timing between initial morning doses to suit your schedule.
Another option is liquid levodopa.
You can make it in home by crushing all tablet of a day into 1 litre water and add some lemon juice. Then you can divide it into 5 equal doses to be taken according to your schedule.
Consult a neurologist for any problems.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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Suggest Dosage Adjustments Of Syndopa Plus, Pramipex And Amantadine

Brief Answer: Adjust meal, Drug timing, or use liquid levodopa Detailed Answer: Hello XXXXXXX XXXXXXX I have gone through your question and understand your concerns. It's strange that you are having off period between 11:30 am to 12:30 pm when you are taking dose at 11 :45 am and similarly off during 3-5 pm with drug been taken at 3 pm. Are you taking drugs empty stomach without any meal preceding or succeeding at least one hour. One possibility may be delayed on either due to meals being taken simultaneously or poor gastric absorption from stomach. If possible you can prolong the timing between initial morning doses to suit your schedule. Another option is liquid levodopa. You can make it in home by crushing all tablet of a day into 1 litre water and add some lemon juice. Then you can divide it into 5 equal doses to be taken according to your schedule. Consult a neurologist for any problems. Hope you found the answer helpful. Regards Dr Neeraj Kumar Neurologist