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Can I take another dose at 5.30 am when I get up

PAST HISTORY : I am Parkinson patient diagnosed 6 years ago.I am on syndopa plus and entacom at 8.30am. 11.30am, 3.30pm&7.30 pm with half tab CR at bed time.I am on this schedule for 3 years.I am on off state at 5.30am to my first dose at 8.30am.

2 Answers

Patient asked followup Question: 12 years ago

I am getting mild dyskinesia symptoms late evening

Dr. Ramesh Madan answered : 12 years ago

Hi,

Most of the patients start experiencing motor fluctuation after 4-5 years of levodopa therapy,the affect of levodopa begins to wear off approximately after 4 hours and you start experiencing the need of next dose.

You did not tell me the dosage of drugs you are taking right now? If you are not taking the(highest prescribed dose dosage),then I would have personally thought to increase the dose of the drug first,and then reduce your gap in night time tablet and the first tablet you take in morning(by taking the night tablet a little late and taking the first dose of morning a little early). That would have been helpful for you.(this should be even done if you are taking the highest prescribed dosage).

Night time dosage can be increased before adding a drug at 5.30 a.m,because we want to add the dosage as late as possible,as the patient will get used to that dosage also after some time.

Now for dyskinesia sypmtoms the cause is mainly entacapone or levodopa in most people and if it is worsening or severe dyskinesia is present then we would like to change the drug.

Patient asked followup Question: 12 years ago

My dosage is. 8.30 am Syndopaplus (25/100) Entacom. ,200mg Pramipex ER. 1.5mg. 11.30am. Syndopa 110 Entacom. 200mg 3.30pm. syndopa 110 Entacom. 200mg 7.30am. Syndopa 110 Entacom 200 mg At bed time. Syndopa CR half tab alprazolam 0.25 Total daily dose. Levodopa 500mg Carbidopa 90mg Entacom. 800mg. How do you want me to increase the dose of the drug

Dr. Ramesh Madan answered : 12 years ago

Hi,

After looking at your dosages,I would just recommend you to have full tablet Syndopa CR in night and that should resolve all your issues.(if cr tablet is broken to pieces as you take half they loose their cr effect which is controlled release effect) which may be the cause for your symptoms.

If this does not help then you,then you may delay your night time dose by around an hour and you can also try taking your first dose around an an hour early. But first you just increase your night dose,and look for effects and if this does not work then try to reschedule your drugs.

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