Paula, Hope that your neuro is a true expert and trust in his medical judgement on how to fine tune your dose and combo of meds works. Give the new cocktail a chance to work out. but keep notes I am sure your control will be better than current mix. What were you on and what has it changed to. Good luck and good health your friend Alex

My neuro always changes one med at a time, that way we know which med was causing or relieving a symptom.

Hi Paula,
I really don't have the apprehension that you have about changing drug combos. My neuro has always been very careful when changing anything with the meds. She always starts out low dose or only one time a day or both. Like when she started me on amantidine, it was one tablet once a day for a week, then two tablets a day for a week and if that solved my problem then leave it there. The two took care of it so that was that. She is just really careful and I trust her judgement, plus she listens to what I have to say about things. I am very lucky to have a doctor like her.
I'm really sorry that you have those feelings of apprehension. You shouldn't have to go through that. you have enough to deal with. Maybe you should tell your neuro how you feel about this issue. If nothing else, it might make you feel better to just get it out there. It's important that the doctors know how we feel about things.
Joanee

Hi, Paula -

Yes, it's sometimes a throw of the dice when meds are changed. I'll second the advice in posts 1 & 2. I usually do best by increasing doses in small increments (Is there a 3 mg patch?). Bari

Oops - I meant to say Posts 1-3.

Hi Paula----that does seem a big jump with the patch med. It is good to make your feelings known to your dr --- maybe just come out and tell him you would rather go slower. I did look up that Rotigotine Patch and it does come in 3 mg. Maybe he would go with the 3 mg.

I was once told to always remember that it is my body and if I don't feel comfortable increasing meds then the dr needs to abide by that. (I have mentioned before I am so sensitive to meds) Best wishes to you, let us know how it goes.

Rotigotine patch: 4,5 (specialist initiation recommended)
Licensed to treat Parkinsons disease, either used alone or as an adjunct to
levodopa with dopa-decarboxylase inhibitor.

British National Formulary (2009) British National Formulary 58. Available at
www.bnf.org. (Accessed 18 January 2010

National Institute for Clinical excellence (2006) NICE clinical guideline 35
PARKINSONS DISEASE National clinical guideline for diagnosis and
management in primary and secondary care. Available at : www.nice.org.uk
(Accessed 18 January 2010).

Here is a site in USA to find info about the Neupro patch. Talks about the different dosages and it comes in 1,2,3,4,6,8 mg.

http://www.rxlist.com/neupro-drug/indications-dosage.htm

Best wishes to you Paula----

hey all thanks for your responses and input... Blue Saph, thanks for looking up the dosages. What he told me is 3 is usually used for restless leg syndrom and he wants to get me to 4 so he can take away some of the sinemet. That's what I'm aiming for. I think no matter what the change is it causes some anxiety in me. Maybe because I get secure in feeling a little normal then the ole PD makes his move and the med change is just another reality of his constant pursuit.

It should be noted that in the clinical assessment doses are expressed as initial dose contained in
the patches while product information refers to the apparent dose

The nominal (apparent dose) patches of 2, 4, 6 and 8 mg of rotigotine /24 hours contain
respectively 4.5 mg, 9.0 mg, 13.5 mg and 18.0 mg of rotigotine. Rotigotine is efficacious in controlling PD symptoms in the range of doses from 4.5 mg/d to 18
mg/d.

Some indications of antidepressant activity have been found for rotigotine (0.5-5 mg/kg s.c.),

From studies in
the rat and monkey, the prostate gland and the adrenals were identified as pharmacokinetic target
organs for potential compound-related side effects when in clinical use.

The compound binds to melanin giving rise to high concentrations of compound in the pigmented eye
and skin.

The abuse potential of rotigotine in humans is considered to be low.

..........rotigotine does not seem to pose a
carcinogenic risk for man.

Neupro contains rotigotine, a new dopamine agonist, and is formulated as 10 cm2, 20 cm2, 30
cm2 and 40 cm2 transdermal patches containing respectively 4.5 mg, 9.0 mg, 13.5 mg and 18.0 mg of
rotigotine, and designed to release respectively 2 mg, 4 mg, 6 mg and 8 mg of rotigotine per 24 hours.
Treatment should be initiated at 2 mg/24 h and then increased in weekly increments of 2 mg/24 h to an
effective dose up to a maximal dose of 8 mg/24 hr.

Note: approximately 1/2 of the drug in the patch is lost to waste thus the confusing appearance of the actual versus available amount of the drug.

www.ema.europa.eu

Brer T

Right now I feel so confused everything gives me apprehnsion. I am trying to find a new Dr my other one and I just can't talk and some times when I have question I wind up not getting an answer so. Don't give up it will all work out