Carbidopa Levodopa Entacapone

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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

  1. abdominal pain
  2. agitation
  3. agranulocytosis
  4. akinesia
  5. alopecia
  6. angioedema
  7. anorexia
  8. anxiety
  9. asthenia
  10. ataxia
  11. back pain
  12. blepharospasm
  13. blurred vision
  14. bullous rash
  15. chest pain (unspecified)
  16. colitis
  17. confusion
  18. constipation
  19. cough
  20. depression
  21. diarrhea
  22. diplopia
  23. dizziness
  24. drowsiness
  25. dysgeusia
  26. dyskinesia
  27. dyspepsia
  28. dysphagia
  29. dyspnea
  30. dystonic reaction
  31. edema
  32. elevated hepatic enzymes
  33. euphoria
  34. fatigue
  35. fever
  36. flatulence
  37. flushing
  38. gastritis
  39. GI bleeding
  40. hallucinations
  41. headache
  42. hemolytic anemia
  43. hiccups
  44. hoarseness
  45. hot flashes
  46. hyperbilirubinemia
  47. hyperhidrosis
  48. hyperkinesis
  49. hypertension
  50. hyperthermia
  51. impulse control symptoms
  52. increased urinary frequency
  53. infection
  54. insomnia
  55. involuntary movements
  56. leukopenia
  57. libido increase
  58. malaise
  59. memory impairment
  60. muscle cramps
  61. mydriasis
  62. myocardial infarction
  63. nausea
  64. neuroleptic malignant syndrome
  65. nightmares
  66. orthostatic hypotension
  67. palpitations
  68. paranoia
  69. paresthesias
  70. peptic ulcer
  71. peripheral neuropathy
  72. phlebitis
  73. priapism
  74. pruritus
  75. psychosis
  76. pulmonary fibrosis
  77. purpura
  78. pyrosis (heartburn)
  79. rash
  80. rhabdomyolysis
  81. seizures
  82. stroke
  83. sudden sleep onset
  84. suicidal ideation
  85. syncope
  86. teeth grinding (bruxism)
  87. thrombocytopenia
  88. tremor
  89. trismus
  90. urinary incontinence
  91. urinary retention
  92. urine discoloration
  93. urticaria
  94. vitamin B6 deficiency
  95. vomiting
  96. weight gain
  97. weight loss
  98. 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

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