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Bad generic cdopa/ldopa?

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Unread 12-27-2011, 02:55 PM   #1
reverett123
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Default Bad generic cdopa/ldopa?

Anyone else had trouble that might have been bad meds lately? After two weeks of misery, today I realized that it all began when I picked up my latest script for cdopa/ldopa.Tested it against some known to be good. Somebody owes me for Christmas!

Purchased at the loal CVS pharmacy. Cdopa/Ldopa 10-100. Blue, round, scored tablet marked 93-292. Powdery finish. Manufactured by Teva USA
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Born in 1953, 1st symptoms and misdiagnosed as essential tremor in 1992. Dx with PD in 2000.
Currently (2011) taking 200/50 Sinemet CR 8 times a day + 10/100 Sinemet 3 times a day. Functional 90% of waking day but fragile. Failure at exercise but still trying. Constantly experimenting. Beta blocker and ACE inhibitor at present. Currently (01/2013) taking ldopa/carbadopa 200/50 CR six times a day + 10/100 form 3 times daily. Functional 90% of day. Update 04/2013: L/C 200/50 8x; Beta Blocker; ACE Inhib; Ginger; Turmeric; Creatine; Magnesium; Potassium. Doing well.
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Unread 12-27-2011, 05:25 PM   #2
paula_w
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Originally Posted by reverett123 View Post
Anyone else had trouble that might have been bad meds lately? After two weeks of misery, today I realized that it all began when I picked up my latest script for cdopa/ldopa.Tested it against some known to be good. Somebody owes me for Christmas!

Purchased at the loal CVS pharmacy. Cdopa/Ldopa 10-100. Blue, round, scored tablet marked 93-292. Powdery finish. Manufactured by Teva USA

.....for name brand. Teva doesn't work.
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Unread 12-27-2011, 09:34 PM   #3
stevem53
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TEVA didn't work for me either..It was very unpredictable to say the least
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Unread 12-29-2011, 12:37 PM   #4
madamlash
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Default Anyone suggest a better brand?

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Originally Posted by reverett123 View Post
Anyone else had trouble that might have been bad meds lately? After two weeks of misery, today I realized that it all began when I picked up my latest script for cdopa/ldopa.Tested it against some known to be good. Somebody owes me for Christmas!

Purchased at the loal CVS pharmacy. Cdopa/Ldopa 10-100. Blue, round, scored tablet marked 93-292. Powdery finish. Manufactured by Teva USA
Yes!!!! Big issues with TEVA C/L 25-100. I thought it was just me. Anyone have a suggestion for an alternative?
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Unread 12-30-2011, 05:08 PM   #5
geraldo
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I had the same experence with TEVA's generic sinemet. My neuro.changed me to the the brand named sinemet. the mfg was BMS It has worked fine for several years. The last time I reordered The clerk that I ordered from changed my script from BMS mfg to Merc and even though it still says its a brand name it seems to be act more like a generic than what I have been taking. Due to the holadays I cannot talk to my neuro. I have adjusted my schedule by a 1/2 hour shorter time between doses and 1/2 more sinemet per dose. I'm now researching the difference between mfg's formula and why one works and the other dose not. It sure is a drag that we constantly have to watch what they do to our meds.

take care,
Geraldo

Update; My drug provider informed me that BMS was bought by Merc and BMS will no longer make Sinemet.
Too bad that the new owners Merc will not provide the same formulation for their version of Sinemet. Thats big pharma. for ya. They don't care they don't have to!!!!

Last edited by geraldo; 12-30-2011 at 06:42 PM.
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Unread 12-31-2011, 01:32 AM   #6
soccertese
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i split the teva 25/250 in half, works fine for me but have never tried brand name.''
half table on an empty stomach changes me from a shuffle/freeze to pretty smooth pain free movement in about 30 min. lasts about 2hrs and wears off fast
so i take a 50/200 ER an hr after the teva.
i do choose to take as little meds as possible, try to take less than 500mg/day so stop meds in the evening if i haven't much to do.
take 5mg selegiline every other day, it does add a little energy, 5mg twice a day is normal, guess i'm just worried about being too dependent on it, silly maybe.
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Unread 12-31-2011, 12:28 PM   #7
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Has this happened with the "yellow" Sinemet too? I noticed that TEVA doesn't work for me either, and I now take a yellowish brown CR at night. This seems to work okay, but the regular 25/100 yellow don't seem to stay down.

They stay in my gut like lead, I throw them up and I then have nothing. I never had that happen before. I noticed too that this particular batch, or the last two batches, have been very chalky, almost powdery in texture. I wonder if we're being cheated. The pills are coming from some third-world country and are being sold under a trade name! (Paranoia setting in). We may as well as purchase our drugs from Online.pharms.com if this is the case.

It never dawned on me to mention this to my neuro regarding the medication other than it wasn't working for me like it did before. We've made other changes too to my med schedule so I was blaming the barfiness on that.

John
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Unread 12-31-2011, 01:02 PM   #8
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There are two issues with different formulations of Levodopa/Carbidopa - aside from differences between the long acting and regular versions.

1. There is quite a large leeway allowable between the formulation for generics as to branded (+/-)

2. The tablet base ingredient or carrier may be more or less soluble.

Merck recently changed the presentation of it's branded Sinemet tablets in the USA, though not apparently everywhere in the world.

There are good reasons why PD drugs should be more tightly manufactured:

1.We are sensitive to changes in dose, and a relatively small amount of the active ingredient reaches our brain. What doesn't get to our brains may be implicated in the development of dyskinesias.

2.Levodopa is absorbed in the gut and it is crucial that tablets are soluble enough to be absorbed in the right place, otherwise the dose might fail. This is especially important for older PwP who may have impaired digestion too.

I have tried without success to confront the problem of variability with a manufacturer; there needs more awareness. I had a batch of branded tablets that did not do the same as anything I had taken before, they simply did not work. Following an official complaint I was 'reassured' by the manufacturer that they could find nothing wrong with that batch. They were not interested in looking at the actual tablets I had been prescribed, yet anything could have happened between manufacture and being dispensed by my pharmacy, and in fact here in Europe many drugs cross borders several times to add market value (don't ask me how it works, I do not understand it!) often coming into the UK, being sent elsewhere, and then re-imported. There were similar problems around at the time as are being discussed on this thread! It does raise an issue of how they test for efficacy, because they sure do not test them on us

Having said the above, I don't think it is always a problem of good v bad, it is can be about what each of us is accustomed to. These are powerful drugs, and our personal adjustment to them is very fine. Changes can take a while to adjust to, sometimes weeks, and we lose quality time to manufacturing variability, something that apparently pharma is barely aware of, and seems to have little intention of tackling.

The BMS and Merck (MSD) branded tablets should be the same, but they can be different, not just in effect, but even the actual tablets. Here in the UK we are still getting oval yellow 100/25's; sometimes they are much more crumbly than other times. There is a difference between these, but when I try and put it in words that a non-PDer might understand it sounds pretty subjective. Both work, but differently. I described the bad batch as the difference between a good wine and cheap and nasty plonk! One made me feel better, and the other left me incapacitated... And therein lies the real problem........ we are the only people who know what we are talking about !

John, I have had a return of nausea after several years of none, makes a bad start to the day. No sickness though. All mine are yellow....
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Unread 12-31-2011, 01:15 PM   #9
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I wonder too, like anything that is manufactured, there are quality-control specifications. The companies manufacture the medication within their quality specification, but not necessarily at the best end of the range. I say this coming from a quality-control background, and a test/technician background. Even though my background is in electronics, the testing principles are the same. There are plus/minus percentages allowed in a batch, and as long as the material is within the percentage range, the product is considered a good quality product.

As you say Lindy, we're more sensitive to this plus/minus balance. Trying to explain this to a non-Parkie and a manufacturer, and they'll think we're loosing our brains to the ducks in the pond!

What is it with the nausea? I was good for 5 years. Never had it even in the beginning, now I feel like I have the flu, barfy all the time, just plain blah!

John
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Unread 12-31-2011, 10:22 PM   #10
madamlash
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Quote:
Originally Posted by jcitron View Post
I wonder too, like anything that is manufactured, there are quality-control specifications. The companies manufacture the medication within their quality specification, but not necessarily at the best end of the range. I say this coming from a quality-control background, and a test/technician background. Even though my background is in electronics, the testing principles are the same. There are plus/minus percentages allowed in a batch, and as long as the material is within the percentage range, the product is considered a good quality product.

As you say Lindy, we're more sensitive to this plus/minus balance. Trying to explain this to a non-Parkie and a manufacturer, and they'll think we're loosing our brains to the ducks in the pond!

What is it with the nausea? I was good for 5 years. Never had it even in the beginning, now I feel like I have the flu, barfy all the time, just plain blah!

John
Just a suggestion in case you missed the threads regarding aloe. I found that aloe juice totally eliminated my nausea and took care of constipation plus it's cheap. There are lots of brands... Some much tastier than others.
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