How Long Does Sinemet Take To Show Effect?

Posted on Tue, 27 Oct 2015

Question: Been on sinamet 4 days take only at bed time help the stiffness when I wake at night Dose is 25-10 o mg tab myla I alsa take. Stalevo 5xdaily 150 tab XXXXXXX seem to be better at night but during the day my head is bobbing up and down a lot more Before only sometimes How long for sine met to work fully? Is my head bobbing a reaction maybe from sinamet?

Answered by Dr. Rahul Tawde (8 hours later)

Brief Answer:
Sinemet- 7 days. Maybe Sinemet induced dyskinesia

Detailed Answer:
Hi,
Thanks for posting the concern. From the question posted above, I could understand that you are on levodopa/ carbidopa 25/100 combination and levodopa / carbidopa /entecapone combination alongwith some antacid preparation. You have asked about head bobbing in the question. You are a 64 yr old lady and I can understand your distress for sudden change of symptoms.
The first thing I would like to say is that the stiffness symptoms you had at night was due to some type of side effect usually seen with levodopa / carbidopa combination. However, your head bobbing is a different type of symptom. The former was due extrapyramidal adverse effect and the latter due to dyskinesia.
Now, the answer of your first question is Sinemet starts acting after one dose, full action can be obtained after 7 day use. For a regular user, time to peak action is about 2 hours and it works for about 4 hours if taken as per doctor's advice.
Your head bobbing reaction may be due to side effect of levodopa. Two of your medications except Myla, contains the drug. And they are really the mainstay of treatment of the diaease fron which you have been suffering.
You should consult your treating doctor or neurologist at the earliest regarding the management. Some medicines are there that may help. alongwith this, please take your medicines at fixed time each day, and avoid a high animal protein containing diet and report to doctor for any sleep deprivation.
Hope, you have got the answer of your two questions.
For any other information, please write back to me directly. If you are satisfied with the answer, please close the thread and rate my answer.
Regards,
Dr Kaushik Sarkar

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rahul Tawde (47 hours later)

Going on day4 no sinamet today head movements were less still very unsteady and I am using a cane to balance mouth is a little dry and very little appetite the sine met is extended release taken at bedtime I also take temazapam for sleep and also donepezil at bedtime during the day I feel hyper can't sit still

Answered by Dr. Rahul Tawde (5 days later)

Brief Answer:
Please continue the medication till other advice by neurologist

Detailed Answer:
Hi, Sorry for being late. I think you have been rightly given Donepezil and Temazepam. There is evidence that the former may improve cognition in PD induced dementia or memory or cognitive problem. The latter is used for improvement of sleep. Although both the uses are off label, studies have been going on and many of them suggest betterment with the use of the two. However, alteration in the Ach level in brain due to the drug may pose some problems, even can aggravate PD or motor symptoms. As you have taken the right decision to consult your neurologist, I would suggest you to continue your PD medications and Temazepam Sos for sleep problems. For any other information, please write back. Regards,
Dr Kaushik Sarkar

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj