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Topic Should Sinemet ER be cut in half? One doc says yes, other doc says no. Help! :-( Go to previous topic Go to next topic Go to higher level

By FightingPDinNYC On 2015.09.27 19:02
Our neurologist told us the the new Sinemet Extended Release my mom's trying can be cut in half.

But there is no divider line on the pill like the normal Sinemet immediate release tablets.

I've heard conflicting opinions, saying you should NOT cut the pill in half, because of the "time release" and the way the pill is made.

Anyone know what the truth is?

By Sheridan On 2015.09.27 21:35
Did you get an info insert with the RX? If you don't have that you could try google.

By sosad25 On 2015.09.28 14:31
I have always been told that time release pills cannot be cut in half and if there is no dividing line on any pill that it should not be cut in half.

By VioletV On 2015.09.28 17:14
From J. Erik Ahlskog, The Parkinson's Disease Treatment Book: Partnering with your Doctor to get the Most Out of Your Medications (2005 edition).

"Breaking the tablet in half slightly reduces the sustained-release property, but this is probably not significant. However it should not be chewed or crushed since this will abolish the sustained-release effect." (p. 163)

This is such a very helpful book, especially the new one (second edition 2015). I think every person with PD would benefit from having a copy. the first edition is now pretty inexpensive used on Amazon since there is a new edition.

By LOHENGR1N On 2015.09.28 17:59
Fighting, check with his pharmacy. The pharmacist can advise you as to splitting or not some can be some cannot depending their strength. Always consult medical doctors and pharmacists with questions concerning drugs and dosing. We are not doctors and cannot give absolute medical advice in regards to this.

By VioletV On 2015.09.28 18:22
Al, of course, you are right. The pharmacist is the final arbiter of this kind of thing.

VV

By brainstorm On 2015.09.28 22:16
While Sinemet CR is NOT meant to be cut in half, it can be if the patient's needs are for medication that is a bit less than a Regular sinemet. For example 1/2 regular sinemet 25/100 has 50mg dopamine that is released immediately, where as 1/2 of sinemet cr 25/100 also has 50 mg but even though it is cut, it will still release at a somewhat delayed rate than 1/2 of a regular sinemet, so the side effects of dyskinesia, low blood pressure do not have a sudden surge. This is more important for elderly or more advanced patients.

My elderly mother's neurologist had prescribed her 1/2 of the sinemet cr when she was in her advanced stages, and it did help control her dyskinesia and daytime sleepiness a lot better. When she would take 1/2 regular sinemet she used to fall asleep at the breakfast table, once we changed to the sinemet cr, she remained awake. So it helped her quite well. My mother passed away 2 yeas ago at age 91.

Medication management for this insidious disease it not cut and dry unfortunately. It is a matter of trial and error and finding what works best for controlling a patient's symptoms.

My mother's neurologist was a world renowned movement disorder specialist for PD, and the best advice he gave us as far as medication management went was "Keep it simple, and Less is more" where PD is concerned. With this protocol my mother beat this disease for over 20 years and had no dementia and very mild hallucinations at the end. Hope this helps.


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