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Dear doctor..I would like to know the way Syndopa CR

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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5737 Questions

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Posted on Wed, 26 Dec 2018 in Brain and Spine
Question: Dear doctor..I would like to know the way Syndopa CR 125 works??wt does this CR mean?? How long it works in the body?? What is the difference between taking syndopa plus and Syndopa CR 125??? What shd be the ideal time gap to be given to the patient with mild senile parki sons??
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Follow up: Dr. Sudhir Kumar 0 minute later
Dear doctor..I would like to know the way Syndopa CR 125 works??wt does this CR mean?? How long it works in the body?? What is the difference between taking syndopa plus and Syndopa CR 125??? What shd be the ideal time gap to be given to the patient with mild senile parki sons??
doctor
Answered by Dr. Sudhir Kumar 8 hours later
Brief Answer:
Syndopa CR is longer acting as compared to syndopa plus.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted the details provided by you. Based on this, I understand that the patient has been diagnosed to have Parkinson's disease (PD).

Syndopa plus and syndopa CR both contain levodopa and carbidopa. CR means controlled release and the medicine is slowly released. Therefore, the duration of action of syndopa CR is longer as compared to syndopa plus or syndopa. Syndopa plus action lasts for 2-6 hours depending on the stage of PD. Syndopa CR works longer, usually 6-24 hours depending on the stage of PD.

The gap between two doses can be 4-6 hours, however, final dosing interval depends on the patient's symptoms and side effects.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Sudhir Kumar 0 minute later
Brief Answer:
Syndopa CR is longer acting as compared to syndopa plus.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted the details provided by you. Based on this, I understand that the patient has been diagnosed to have Parkinson's disease (PD).

Syndopa plus and syndopa CR both contain levodopa and carbidopa. CR means controlled release and the medicine is slowly released. Therefore, the duration of action of syndopa CR is longer as compared to syndopa plus or syndopa. Syndopa plus action lasts for 2-6 hours depending on the stage of PD. Syndopa CR works longer, usually 6-24 hours depending on the stage of PD.

The gap between two doses can be 4-6 hours, however, final dosing interval depends on the patient's symptoms and side effects.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sudhir Kumar 15 hours later
Dear Dr.Thanks for reply.The above query pertains to my mom aged 86.she has been taking Syndopa for the last 4 years.Initially started with syndopa plain and then changed to plus...Intial dosage was 1 per day ..Even present dose is 1 per day of syndopa plus. DIAGNOSIS is Senile parkinsons by our local physician.Infact 2 years back the dosage was increased to 3 per day which ended up with severe hallucinations..waking up at night etc etc.So Now last 2 years dosage is stabilised at 1 syndopa plus at 4.30 PM.Reason for this time is she used to get sort of mild tremors on her legs ar this time.So the timing has been shifted to 4.30 PM from earlier 11.30 AM after lunch.Now why we are asking about CR dosage is as below.1)after taking syndopa plus at 4.30 PM ..she gets sound sleep for an hour or so and gets very fresh say by 6.30..and able to have full energy ...walk well(of course with walker only within home)..have dinner in the dinner table sitting well..All these she is able to do only after this dosage.while she gets up in tge morning all energy is lost...she behaves as if she has no interest..etc.The most important feature in the morning session is She is not able to speak properly..not able to swallow properly...we have to mash the food and help her in eating rather feeding her with a spoon.She is not able to walk also in the morning and after noon session till such time the syndopa goes in...all the symptoms reverses once the drug works till 10.30PM..we give her restyl .5 mg at around 10.30 to make her sleep.EVen at this time we cld see the drugs effect tapering off..Another important clinical symptoms apart from swallowing pblm...unable to walk..thickening of Tongue is very high fear...she does not allow to be left alone in the room even for 10 mts. So it looks clear to us that she needs this syndopa drug through out the day...But we are scared that once ...it was 2 years back...when dosage was 3 times a day...including one at bed...the sude effects were terrible...Severe hallucinations...Getting up at night ..inspite of sleeping pill . etc... we have never tried CR formulation...so we would like to know whether we can go for that...If so what is the ideal time to ve given since she takes syndopa plus at 4.30PM since last 2 years......................... I would also like to add here that bases on local physicians view of trying 1/2 of syndopa plus at 11.30 AM after lunnch...it did work only for 2 hours and by 2.30 PM suddenly she became restless...and started getting tremors ...unable to speak...lower jaw muscle movement was awkward...etc etc and beleive me doctor BP shot up and this we had to administer BP lowering drug as well as syndopa plus as per adv of doctor.Question here is how the half tablet while experimented in the morning after lunch..could give such a drastic clinical alarming symptom...exactly after 2.5 hours of administering the dosage??? Unable to understand this as the same drug given on full dose at 4.30 PM...works..... . INFACT doctor...this experiment of trying in 1/2 tablet after break fast also met with same consequences only..This is the reason we dont want to try any divided dosage...in the bfast or after lunch timings..I hope I have given the clear back ground picture of the clinical picture of my mother..KINDLY GO THRO PATIENTLY AND ADVISE US SIR as to how to space the dosage..what formulations whether normal type or CR type..We started syndopa almost 4 years back on the symptom of shaking of left arm..especially on the fingers..at rest and also lower jaw involuntary movement at rest...As per Neuro this is Senile parkinson.It s a clinical manifestation which we are daily seeing after that dosage at 4.30 PM....she gets very fresh..walks...talks..swallows on her own ..sitting on the dining table..mixing the food on her own..she says at this time...tongue is normal ...So the above is the picture Doctor.Kindly guide us . THANKS & BEST REGARDS XXXXXXX
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Follow up: Dr. Sudhir Kumar 0 minute later
Dear Dr.Thanks for reply.The above query pertains to my mom aged 86.she has been taking Syndopa for the last 4 years.Initially started with syndopa plain and then changed to plus...Intial dosage was 1 per day ..Even present dose is 1 per day of syndopa plus. DIAGNOSIS is Senile parkinsons by our local physician.Infact 2 years back the dosage was increased to 3 per day which ended up with severe hallucinations..waking up at night etc etc.So Now last 2 years dosage is stabilised at 1 syndopa plus at 4.30 PM.Reason for this time is she used to get sort of mild tremors on her legs ar this time.So the timing has been shifted to 4.30 PM from earlier 11.30 AM after lunch.Now why we are asking about CR dosage is as below.1)after taking syndopa plus at 4.30 PM ..she gets sound sleep for an hour or so and gets very fresh say by 6.30..and able to have full energy ...walk well(of course with walker only within home)..have dinner in the dinner table sitting well..All these she is able to do only after this dosage.while she gets up in tge morning all energy is lost...she behaves as if she has no interest..etc.The most important feature in the morning session is She is not able to speak properly..not able to swallow properly...we have to mash the food and help her in eating rather feeding her with a spoon.She is not able to walk also in the morning and after noon session till such time the syndopa goes in...all the symptoms reverses once the drug works till 10.30PM..we give her restyl .5 mg at around 10.30 to make her sleep.EVen at this time we cld see the drugs effect tapering off..Another important clinical symptoms apart from swallowing pblm...unable to walk..thickening of Tongue is very high fear...she does not allow to be left alone in the room even for 10 mts. So it looks clear to us that she needs this syndopa drug through out the day...But we are scared that once ...it was 2 years back...when dosage was 3 times a day...including one at bed...the sude effects were terrible...Severe hallucinations...Getting up at night ..inspite of sleeping pill . etc... we have never tried CR formulation...so we would like to know whether we can go for that...If so what is the ideal time to ve given since she takes syndopa plus at 4.30PM since last 2 years......................... I would also like to add here that bases on local physicians view of trying 1/2 of syndopa plus at 11.30 AM after lunnch...it did work only for 2 hours and by 2.30 PM suddenly she became restless...and started getting tremors ...unable to speak...lower jaw muscle movement was awkward...etc etc and beleive me doctor BP shot up and this we had to administer BP lowering drug as well as syndopa plus as per adv of doctor.Question here is how the half tablet while experimented in the morning after lunch..could give such a drastic clinical alarming symptom...exactly after 2.5 hours of administering the dosage??? Unable to understand this as the same drug given on full dose at 4.30 PM...works..... . INFACT doctor...this experiment of trying in 1/2 tablet after break fast also met with same consequences only..This is the reason we dont want to try any divided dosage...in the bfast or after lunch timings..I hope I have given the clear back ground picture of the clinical picture of my mother..KINDLY GO THRO PATIENTLY AND ADVISE US SIR as to how to space the dosage..what formulations whether normal type or CR type..We started syndopa almost 4 years back on the symptom of shaking of left arm..especially on the fingers..at rest and also lower jaw involuntary movement at rest...As per Neuro this is Senile parkinson.It s a clinical manifestation which we are daily seeing after that dosage at 4.30 PM....she gets very fresh..walks...talks..swallows on her own ..sitting on the dining table..mixing the food on her own..she says at this time...tongue is normal ...So the above is the picture Doctor.Kindly guide us . THANKS & BEST REGARDS XXXXXXX
doctor
Answered by Dr. Sudhir Kumar 15 minutes later
Brief Answer:
I would suggest any dosage adjustment under close supervision.

Detailed Answer:
Thank you for getting back.

I have gone through the additional details provided.

Unfortunately, there is no easy way to find the correct form of syndopa and the dosage. The problem are two: 1. As the disease duration increases, the effect of syndopa decreases, which means patients require more number of tablets to get the same benefit. 2. The side effects are more. In the initial years after diagnosis, patients tolerate the syndopa well, however, as the number of years increase with this disease side effects such as hallucinations, sleep disorder, vomiting, abnormal movements (dyskinesia) and freezing (where patient is unable to walk) increase.

Older age people have more problems with medications.

Therefore, I would suggest any dose adjustment under the close supervision of a neurologist. I admit my patients for 3-4 days for this purpose.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sudhir Kumar 0 minute later
Brief Answer:
I would suggest any dosage adjustment under close supervision.

Detailed Answer:
Thank you for getting back.

I have gone through the additional details provided.

Unfortunately, there is no easy way to find the correct form of syndopa and the dosage. The problem are two: 1. As the disease duration increases, the effect of syndopa decreases, which means patients require more number of tablets to get the same benefit. 2. The side effects are more. In the initial years after diagnosis, patients tolerate the syndopa well, however, as the number of years increase with this disease side effects such as hallucinations, sleep disorder, vomiting, abnormal movements (dyskinesia) and freezing (where patient is unable to walk) increase.

Older age people have more problems with medications.

Therefore, I would suggest any dose adjustment under the close supervision of a neurologist. I admit my patients for 3-4 days for this purpose.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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