Carbidopa Levodopa Entacapone

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