Sinemet

[heattg]

Seems I might have read somewhere that Sinemet can cause Diabetes? Has anyone heard/read this?

[mackjergens]

never heard that about Sinemet but you need to research Sinemet for rls, its not a good drug for using every day for rls. It seems to do well for those that do not have to take it daily. You might type in Sinemet and Diabetes into www.google.com and found out something.

info copied/pasted from www.rlshelp.org
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Sinemet (Carbidopa/LevoDopa)
This medication has 2 components; LevoDopa (L-Dopa), the active Parkinson's medication (this is a precursor drug and turns into dopamine in the brain), and Carbidopa, an inhibitor of the enzyme (decarboxylase) which inactivates L-Dopa. The short acting form of this medication comes in 3 strengths: 25-100, 10-100, and 25-250. The first number indicates the amount of Carbidopa and the second number is the amount of L-Dopa in the pill. The Sinemet pill most often used for RLS is the 25-100.

Sinemet can be started at half a pill (25-100) 30-60 minutes before bedtime. It can be increased to about 3 tablets before bedtime, and will last about 3-4 hours. For early morning awakenings, another half to one pill can be added to help finish the night's sleep. Keep the nighttime total dose to a maximum of 3 pills. The medication generally works better for nighttime RLS than on daytime RLS symptoms.

Sinemet also comes in a sustained release long acting formulation called Sinemet CR, in both 25-100 and 50-200 strengths. This slow release tablet comes to peak action in two hours, so it is often combined with a short acting Sinemet to get relief within 30 minutes. Sinemet CR can be used in the morning also (in patients who get daytime benefit from this medication) for sustained daytime relief.

The main side effects of Sinemet include nausea, mental effects (confusion, hallucinations, dizziness), and dyskinesia (abnormal involuntary movements which occur with long term usage). The nausea can be avoided often if the medication is taken with food (this can however delay absorption of the drug). Dyskinesias are the most common serious side effect to occur in Parkinson's disease patients taking this drug, but occurs rarely in RLS patients. Periodic monitoring of CBC, hepatic and renal function is suggested.

Two main problems for patients with RLS using Sinemet are rebound and augmentation. Rebound occurs as the drug's action is wearing off with the symptoms coming back even worse than they were before treatment. Augmentation is an increase in RLS problems in general, not just as the drug's effects are wearing off and is the most common reason for discontinuing Sinemet. With augmentation, the intensity of the RLS symptoms can increase, can onset earlier and even spread to the upper limbs. Raising the dose of Sinemet may temporarily help the augmentation symptoms, but in a short while the increased dose just leads to further augmentation. Keeping the Sinemet 25-100 dose at no more than 2-3 tablets per day reduce the chances of getting augmentation (it is rarely seen with 1-2 tablets). Augmentation occurs more readily when RLS symptoms are present before 6:00 p.m. (off therapy).

Sinemet CR generally prevents the rebound problem but does not avoid augmentation. The augmentation effect of worsening RLS symptoms lasts for several days after discontinuing the medication. Mirapex or Requip (see below) can be used to treat Sinemet augmentation by giving one of the lowest strength tablets at bedtime, then adding another tablet every 2 days to that dose if needed. The Sinemet can be discontinued abruptly (especially at the lower doses), but may cause an increase in RLS symptoms for a few days as noted above. Mirapex or Requip (as above) will prevent some of this, or the Sinemet can be tapered off over several days.

NOTE: Due to the problems of augmentation which may occur in 50-80% of patients, Sinemet is likely better for mild intermittent cases of RLS, in which the dose of medication can be kept low enough or on an intermittent basis to avoid these side effects. Another use might be in cases where the other medications do not last through the night, a dose of Sinemet CR added to the other Parkinson's disease drugs at bedtime (and only at that time) may provide all night relief from RLS. Now that there are other better Parkinson's disease drugs available, Sinemet should not be used for RLS (except by RLS specialists who are very well versed with the problems with this drug).

[heattg]

Thanks. I stopped taking Sinemet, maybe in October. Right about the same time I quit the Neurologist that prescribed it. Neither seemed to be doing me much good. Quite possibly, they both, made a bad situation worse.

I saw the Sinemet-Diabetes link somewhere, on some medicine info data site. Never gave it much thought, untill the results, from my yearly blood test, in February, flagged me for further testing. I've had glucose testing in the past, yet just over the course of one year, I'm now a Diabetic.

Not really lookng to blame any one or any thing, just trying to understand.

[SquirmingSusan]

http://www.parkinsons-information-exchange-network-online.com/parkmail3b/1999d/msg03215.html

The package insert for the regular sinemet, says that possible abnormal lab
results includes elevated blood sugar results.
After 3 years on sinemet, I was diagnosed as diabetic.
Have any of you had a similar experience?
Nancy Spires

You're not the first one to ask this question. Apparently the packaging for Sinemet includes a warning that it can alter blood sugar levels, and to test blood glucose frequently when taking it.

It's a drag to be diagnosed with diabetes. My daughter just was diagnosed, and put on insulin. We think hers is related to having taken high doses of steroids for months at a time, a few years ago. It doesn't really matter, though. It's something she has to live with, and manage, now.

Best wishes with it.

[coaster]

Ugh. Sinemet is nasty stuff. Unfortunately it's still the first drug many physicians prescribe for new RLS diagnosis. I had to try it; I hated it; it didn't help much and had unpleasant side effects.