Carbidopa Levodopa Entacapone Brand Name– Stalevo
What is Carbidopa Levodopa Entacapone
Carbidopa levodopa entacapone is a combination product for the treatment of idiopathic Parkinson’s disease in adult patients who experience the end-of dose ‘wearing off’ effect of levodopa.
Carbidopa Levodopa and Entacapone have been used together successfully as separate dosage formulations.
Carbidopa levodopa entacapone is indicated as a substitution (with equivalent strengths) for patients previously taking these drugs separately, and is also indicated to replace immediate-release carbidopa/levodopa therapy when entacapone-naive patients experience the end-of dose ‘wearing off’ effect.
Three 24-week pivotal trials demonstrated increased ‘on’ time, reduced ‘off’ time, improved motor function and improved activities of daily living with carbidopa; levodopa; entacapone.
Patients who receive carbidopa; levodopa; entacapone should have previously been receiving levodopa 600 mg/day or less and have no associated dyskinesias.
The FDA granted approval for carbidopa levodopa entacapone as a combination product in 2003.
Indications
- Parkinson’s disease
Side Effects
- abdominal pain
- agitation
- agranulocytosis
- akinesia
- alopecia
- angioedema
- anorexia
- anxiety
- asthenia
- ataxia
- back pain
- blepharospasm
- blurred vision
- bullous rash
- chest pain (unspecified)
- colitis
- confusion
- constipation
- cough
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysgeusia
- dyskinesia
- dyspepsia
- dysphagia
- dyspnea
- dystonic reaction
- edema
- elevated hepatic enzymes
- euphoria
- fatigue
- fever
- flatulence
- flushing
- gastritis
- GI bleeding
- hallucinations
- headache
- hemolytic anemia
- hiccups
- hoarseness
- hot flashes
- hyperbilirubinemia
- hyperhidrosis
- hyperkinesis
- hypertension
- hyperthermia
- impulse control symptoms
- increased urinary frequency
- infection
- insomnia
- involuntary movements
- leukopenia
- libido increase
- malaise
- memory impairment
- muscle cramps
- mydriasis
- myocardial infarction
- nausea
- neuroleptic malignant syndrome
- nightmares
- orthostatic hypotension
- palpitations
- paranoia
- paresthesias
- peptic ulcer
- peripheral neuropathy
- phlebitis
- priapism
- pruritus
- psychosis
- pulmonary fibrosis
- purpura
- pyrosis (heartburn)
- rash
- rhabdomyolysis
- seizures
- stroke
- sudden sleep onset
- suicidal ideation
- syncope
- teeth grinding (bruxism)
- thrombocytopenia
- tremor
- trismus
- urinary incontinence
- urinary retention
- urine discoloration
- urticaria
- vitamin B6 deficiency
- vomiting
- weight gain
- weight loss
- xerostomia
Monitoring Parameters
- LFTs
- neurologic function
Contraindications
- abrupt discontinuation
- behavioral changes
- biliary obstruction
- breast-feeding
- children
- closed-angle glaucoma
- coadministration with other CNS depressants
- colitis
- depression
- diabetes mellitus
- diarrhea
- driving or operating machinery
- dyskinesia
- ethanol ingestion
- geriatric
- GI bleeding
- hepatic disease
- hyperthermia
- hypotension
- impulse control symptoms
- infants
- jaundice
- laboratory test interference
- MAOI therapy
- melanoma
- mental status changes
- nausea/vomiting
- orthostatic hypotension
- peptic ulcer disease
- pheochromocytoma
- pregnancy
- psychosis
- pulmonary fibrosis
- retroperitoneal fibrosis
- rhabdomyolysis
- suicidal ideation
- surgery
- syncope
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Alfentanil
- Alprazolam
- Amantadine
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Amphetamine; Dextroamphetamine Salts
- Ampicillin
- Ampicillin; Sulbactam
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- atypical antipsychotic
- Azelastine
- Azelastine; Fluticasone
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Beta-blockers
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Brentuximab vedotin
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Bupropion
- Bupropion; Naltrexone
- Calcium-channel blockers
- Cannabidiol
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cenobamate
- Central-acting adrenergic agents
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chloral Hydrate
- Chloramphenicol
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Cholestyramine
- Clobazam
- Clonazepam
- Clonidine
- Clorazepate
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine; Probenecid
- Dacarbazine, DTIC
- Darifenacin
- Deutetrabenazine
- Dexmedetomidine
- Dexmethylphenidate
- Dextromethorphan; Promethazine
- Diazepam
- Dicyclomine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dobutamine
- Dopamine
- Doxazosin
- Dronabinol
- Droperidol
- Droxidopa
- Enflurane
- Ephedrine
- Epinephrine
- Eplerenone
- Epoprostenol
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esketamine
- Estazolam
- Eszopiclone
- Ethanol
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Etomidate
- Fentanyl
- Flibanserin
- Fluphenazine
- Flurazepam
- food
- Fosphenytoin
- Fospropofol
- Furazolidone
- Gabapentin
- General anesthetics
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanabenz
- Guanfacine
- Haloperidol
- Halothane
- Heterocyclic antidepressants
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Iloperidone
- Iloprost
- Indacaterol; Glycopyrrolate
- Iron
- Iron Salts
- Isocarboxazid
- Isoflurane
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Ketamine
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lofexidine
- Loop diuretics
- Lorazepam
- Loxapine
- Lurasidone
- Macimorelin
- Maprotiline
- Mecamylamine
- Melatonin
- Meperidine
- Meperidine; Promethazine
- Meprobamate
- Mesoridazine
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methscopolamine
- Methyldopa
- Methylphenidate
- Metoclopramide
- Metronidazole
- Metyrosine
- Midazolam
- Mirtazapine
- Molindone
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nefazodone
- Norepinephrine
- Opiate Agonists-Antagonists
- Oxazepam
- Oxybutynin
- Oxycodone
- Oxymorphone
- Papaverine
- Perampanel
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenothiazines
- Phenoxybenzamine
- Phenylephrine; Promethazine
- Phenytoin
- Pimozide
- Polysaccharide-Iron Complex
- Potassium-sparing diuretics
- Pramipexole
- Prazosin
- Pregabalin
- Prilocaine; Epinephrine
- Probenecid
- Procarbazine
- Prochlorperazine
- Promethazine
- Propantheline
- Propofol
- Pyridoxine, Vitamin B6
- Quazepam
- Racepinephrine
- Ramelteon
- Rasagiline
- Remifentanil
- Reserpine
- Rifampin
- Rotigotine
- Safinamide
- Sapropterin
- Scopolamine
- Sedating H1-blockers
- Selegiline
- Sevoflurane
- Skeletal Muscle Relaxants
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Sodium Oxybate
- Solifenacin
- Solriamfetol
- Sufentanil
- Suvorexant
- Tapentadol
- Tasimelteon
- Tedizolid
- Temazepam
- Tetrabenazine
- Thalidomide
- Thiazide diuretics
- Thiethylperazine
- Thioridazine
- Thiothixene
- Tizanidine
- Tramadol
- Tranylcypromine
- Trazodone
- Treprostinil
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Vasodilators
- Warfarin
- Zaleplon
- Zolpidem
