December 2nd, 2020 Casino, NSW


Stalevo to Madopar


The three weeks to wean off from Stalevo 125 (levodopa / carbidopa / entacapone tablet 125mg/31.25mg/200mg) has now happened.


In that mix of ingredients, it is the Entacapone that is the culprit for Ann.  The most common side effects experienced by patients taking Entacapone are dyskinesia (involuntary movements), urine discoloration, diarrhea, nausea, muscle spasms, abdominal pain, vomiting, and dry mouth. 


Ann had the Dyskinesia, urine discoloration and nausea.


The Dyskinesia is gone, as are the “off periods” but there is the return of some slight tremor. And the urine discoloration is gone as well.


In the first two weeks, there was certainly a decrease in overall mobility. That appears to have reversed itself with a return to exercise at both the Gym, and at home making a contribution.


There are just so many variables in dealing with PD it is often difficult to nail down exactly what causes what, but we do know that Ann is far better off with the Stalevo medication being replaced with the standard Madopar medication. 


Remember, Madopar is the brand name for the UK and EU Parkinson’s medication, Sinemet is the brand name for the USA Parkinson’s medication.  Both contain Levodopa. The UK medication uses Benserazide as an adjunct to the Levodopa. It slows the breakdown of Levodopa before it reaches the brain 


The adjunct in Sinemet, Carbidopa, does the same thing.


Benserazide is not used in Sinemet because Benserazide is not approved by the FDA.


Bladder Botox.


Another successful Bladder Botox on the 13th November.  Took effect within 6 days, which is normal.


After 7 Botox injections into the bladder over the last 6 years, Ann has the youngest looking Bladder in Casino – guaranteed.


What is interesting, we have personally gathered 5 more female converts to the process through some minor activity with Parkinson’s Support groups. None of them had heard of the procedure before, which as far as we are concerned, highlights how the bladder issues faced mostly by women really are swept under the carpet and just not discussed – even by GPs it would seem.


Urologist rang up three days after, to not only check how it all was going, but to make an appointment for the next set of injections for mid next year.




Largely fixed by the use of a different over the counter preparation.  Constipation adversely effects the ability of the Levodopa to escape the stomach and begin its journey to the brain where it is needed. And of course, constipation is common with PD as it is caused by the PD medications itself.




Ann has just commenced a, new to her, medication called Circadin – which contains 2mg of melatonin to address the shortened sleep cycle.  So, there is a way to go with that medication.