①
Enter all Rytary capsules taken after BT (Beginning Time = CT − 6 hrs) in the "After BT" row. Enter the current dose (At CT) in the second row and toggle it in or out of totals.
②
Effective LD (Rytary) = Total Rytary LD ÷ 3. Reflects Rytary's extended-release bioavailability vs IR CD/LD (Mittur et al. 2017; FDA NDA 203312). A 245 mg capsule contributes ~82 mg effective LD equivalent.
③
6-hr Rytary lookback is conservative. Rytary ER-bead T½ is ~6–8 hrs; doses at the 5–6 hr tail contribute declining plasma LD. The window intentionally errs toward overinclusion. Your day-to-day dosing history and symptom state should also inform whether a borderline prior dose should be counted.
④
IR dose discount factors are derived from first-order elimination kinetics: F(t) = e^(−0.693/T½ × t), using IR levodopa T½ ~1.25 hrs (Lewitt 2011; Contin & Martinelli 2010). Buckets: 0–30 min ×0.75 (absorbing, pre-peak); 30–90 min ×1.0 (at/near Cmax — peak dyskinesia risk); 90–150 min ×0.5; 150 min–2.5 hr ×0.25. Enter total mg in each applicable bucket; effective IR = weighted sum across all buckets.
⑤
200–210 mg is a personalized clinical heuristic, not a population-derived guideline. No published PK model defines a universal dyskinesia threshold. This range was established empirically through your titration history with Dr. Yang and reflects your individual therapeutic window. It should not be extrapolated to other patients.
⑥
Approaching 200 mg — caution required. At ≥200 mg Total Effective LD, your dyskinesia risk rises significantly. Do not add further doses without considering symptom state and recent history.
⑦
DO NOT EXCEED 210 mg Total Effective LD. Exceeding this limit will trigger dyskinesia (jerking). If the banner is red, do not take the planned dose.
Rx
Regimen reference: 6:15 am 245+145+95 · ~10 am PRN ½ IR + 145 (~50% of mornings) · 12 pm 245+145+95 · 6 pm 245+145+145 · ~9 pm PRN ½ IR + 145 · 11:15 pm 245+145+95+95. All scheduled doses with Clonazepam 0.125 mg + Fluoxetine 20 mg (6:15 am only).