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How do you decide between the different oral longer acting levodopa medications?

E.g., Rytary, Crexont, Stalevo, Sinemet CR
2 Answers
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Mednet MemberInvited Expert
Neurology · UC San Diego
Answered on

The question would be, why are you changing, and what are you changing from? (i.e., are one of these your initial agent, a change due to Sinemet side effects, or a change because of motor fluctuations?) The current theory on dopamine replacement is "smoother is better," so the longer (and lower) you...

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Mednet Member
Mednet MemberInvited Expert
Neurology · University of Miami Miller School of Medicine
Answered on

In general, I reserve Sinemet CR for bedtime dosing or for patients with tolerance issues with Sinemet IR. Otherwise, it is an inconsistent pill with a slow onset.

Stalevo, Rytary, and Crexont play similar roles in reducing off-time for patients on IR formulations. Availability/insurance coverage ma...

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