I guess people have problems with upset stomach when beginning the sinemet. As quoted from WebMD: Sinemet is made up of levodopa and another drug called carbidopa. Levodopa enters the brain and is converted to dopamine while carbidopa increases its effectiveness and prevents or lessens many of the side effects of levodopa, such as nausea, vomiting, and occasional heart rhythm disturbances. It is generally recommended that patients take Sinemet on an empty stomach, at least 30 minutes before, or one hour after meals.
My neuro had me gradually go on the sinemet so that it wouldnt affect my stomach. She gave me a schedule as this: 1/2 a pill for 3 days; then 1/2 pill 2x a day for 3 days; then 1/2 pill 3x a day for 3 days; then 1 pill a day plus 1/2 a pill 2x a day for 3 days and on and on building up to 3 pills a day. Also you should never take yourself off of Sinemet cold turkey if for some reason you want to come off of sinemet do it gradually.
I felt a difference right away in my eye sight and choking when asleep. It took about a week for the pain from rigidity to disappear or until, I guess, I was on the full dose of 1 sinemet 3x a day. I know PeachyBum always said it took her almost a full 3 months to feel better after starting Sinemet but once she started feeling better it was all good.
Has anyone heard from PeachyBum???? If you have tell her I said Hi! Peach I really miss you!!!!!
I started Sinemet in 9/2011 and I cant remember the exact periods it was increased but the dr. increased it to 4 pills a day then a big jump to 6 pills a day and that is what I have been taking for about a year now. My first medication was Azilect I take 1 mg a day still which really helped me with the symptoms but only for about 6 months. This past Feb or March the doctor put me on a 2 mg dose of the neuro patch which helps with the wearing off periods of the sinemet.
Since I started taking Sinemet people sometimes forget that I even have PD. I have vivid dreams from my meds I would scream out loud and wake everyone up in the house it is a shattering scream (interesting but my vivid dreams have stopped since starting the neuro patch). Scared my sister to death when I visited her!!! I dont know if I have any other side effects. I know if I make a mistake and take too many pills which is easy to do when you take 6 a day I get very sick to my stomach and very tired and just feel sick. But I also feel this way when I do too much or am too stressed or too busy or all of these things.
Good luck.

So, debfromnj; had you tried other alternatives before Sinemet aside from the Azilect? Did those work as well for you?

Also... I made the mistake of drinking Pepsi too close to my second dose of Sinemet and was jittery ALL DAY. I mean; I felt like I was crawling out of my skin! Has anyone else had this problem or noticed something similar?

You are not supposed to take it with protein but my doc said to take with food until up to max dosage. I try to take it on empty tummy now and no problems there. I began with 1/2 pill once daily like Deb taking MANY weeks to get up to six daily.

I wrote to you a while back. FOR about 5-6 ? years I took Amantadine only. It really only works well for 12 to 15 months. I take several herbs now. My leg almost never drags. I have no tremor. Yes the Sinemet worked pretty well YOU MAY BE NAUSEATED for many weeks. It made me feel rocky for a good while. It works in many ways for me but I do have some really bad days and occasionally a really good one. I would never make it without the SUPER HERBS...I can t ype like the WIND. No balance issues, no bladder issues, no constipation, no trouble with voice or swallowing, GREAT upper body strength but VERY low stamina for walking etc.

Yes, I tried to do it without meds using exercise. From April 2010 until November 2010 I was taking Yoga 3x a week, walking 14 miles a week, taking Tai Chi and Pilates 2x a week. I did not try herbs but have always been a vitamin user and a moderate exerciser since my early 30's. I've always taken one a day but also extra B's, C's in the evening, joint complexes, etc. But I think that is why my symptoms were not so overpowering through the pre-diagnosis years - but by the time I was diagnosed my PD was rampant (although my neruo says I am one of her best cases). By the time I was diagnosed the pain started in Sept. and October and then the rigidity and I didn't want to lose my job. By that time I needed help and fast. I started with the azilect in Nov. 2010 and that eased the symptoms almost right away but it only lasted about 6 months and then I started with the simenet. There are many post in this discussion group and others on the web that tell of their use of herbs, exercise, etc. to hold off taking the meds. Many are very inspirational and I sure will help you make you decision.