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What is Carbidopa, entacapone, and levodopa?
Carbidopa combined with entacapone and levodopa is used to treat Parkinson's symptoms, such as muscle stiffness and spasms. Stalevo can be used in other ways not mentioned in this guide.
Side effects of Carbidopa, entacapone, and levodopa
If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: hives, difficulty breathing, swelling of your lips, face, tongue, or throat.
Carbidopa and entacapone can cause serious side effects. If you experience:
- If you experience worsening symptoms, such as uncontrollable movements or twitching of your lips, tongue, eyes, arms, or legs,
- Depressed mood and thoughts of harming yourself
- Hallucinations and unusual behaviour;
- Vomiting and severe nausea
- Symptoms of severe or persistent diarrhoea include watery diarrhoea;
- Unexplained muscle tenderness or weakness,
- A feeling of lightheadedness, as if you could pass out.
- Fluid buildup around or in the lungs causes pain when you breathe or feel short of breath. Wheezing, feeling gasping for air, a foamy cough, and cold skin with clammy mucus. Anxiety and rapid heartbeats.
- Severe nervous system reaction: very stiff (rigid muscles), high temperature, and sweating
You may fall asleep while doing normal activities during the day, such as driving, working, talking, or eating. Even though you feel alert, you may suddenly fall asleep. You should tell your doctor if there are any issues with daytime sleepiness or drowsiness.
While taking this medication, you may experience increased sexual desire, urges to gamble, or other intense desires. If this happens, talk to your doctor. Your urine, saliva, or sweat may appear dark, like red, brown, or black. It is not harmful, but your clothing or bedsheets may be stained.
Side effects that may occur from carbidopa, entacapone, and levodopa include:
- Involuntary muscular movement
- Diarrhoea;
- Nausea, vomiting, and stomach pain;
- Discoloured urine
- Dry Mouth.
There may be other side effects. Call your physician immediately if experiencing side effects; otherwise contact the FDA's Hotline at 1-800-FDA-1088 if reporting them directly.
Similar/related drugs
Ropinirole, pramipexole, benztropine, carbidopa/levodopa , Exelon, and Gocovri
Warnings
This medicine should not be used if you suffer from narrow-angle glaucoma. If you have taken an MAO inhibitor within 14 days (such as isocarboxazid or linezolid), such as phenelzine rasagiline selegiline or tranylcypromine phenelzine rasagiline selegiline or tranylcypromine then do not take this medication.
Before you take this drug
If you are allergic to levodopa or carbidopa or have any of the following:
- Narrow-angle glaucoma.
You should not take this medication if you've taken an MAO inhibitor in the last 14 days. It is possible that a dangerous drug interaction will occur. MAO inhibitors are isocarboxazid (linezolid), phenelzine (phenelzine injection), rasagiline (selegiline), methylene blue injection, and others.
Tell your doctor about any of the following:
- Glaucoma;
- Mental illness such as depression
- A stomach ulcer,
- Liver disease.
Skin tumours are more common in people with Parkinson’s disease (melanoma). Ask your doctor what skin symptoms you should be aware of. Inform your doctor if you are pregnant or nursing.
How to take Carbidopa, entacapone, and levodopa?
Read all the instructions or guides that come with your medication and follow the directions. Sometimes, your doctor will change the dose. You must take the medication exactly as prescribed. Do not chew or crush the tablet.
Do not take more than one tablet per dose. Take only one tablet or a small portion of one broken tablet. Overdosing can occur if you combine more than one tablet or portions of a tablet.
To ensure that you always have the same amount of drug in your system, take your doses regularly. Stalevo can be taken with or without eating. Ask your doctor for advice. If the effects of your medicine seem to fade quickly between doses, tell your doctor.
If you have diarrhoea or vomiting or are sweating more often than normal, call your doctor. Vomiting or diarrhoea can cause dehydration. If you're sick, drink plenty of fluids. You should not take any medication for Parkinson's that has not been prescribed by your doctor. It can interfere with certain medical tests. Stalevo can affect the results of certain medical tests.
You may experience unpleasant withdrawal symptoms if you suddenly stop taking Stalevo. You should ask your doctor about how to safely discontinue this medication. Store away from heat and moisture at room temperature. When not in use, keep the bottle tightly shut.
Details on dosage
Adult dosage for Parkinson's disease:
Converting to Entacapone, Levodopa, and Carbidopa:
Switch to a combination tablet providing an equivalent dose.
Converting to Levodopa from Carbidopa
Patients with dyskinesias that are moderate to severe and taking levodopa at doses greater than 600 mg will likely require a lower dose of levodopa when entacapone has been added.
-Titrate the patient to a given dose by using a separate levodopa/carbidopa tablet plus entacapone. Then switch to the corresponding single-combination tablets.
Reduce the dose of levodopa by reducing tablet strength or increasing the time between doses.
Administering other anti-Parkinson drugs concurrently:
This drug or concomitant medication may need to be dose adjusted.
MAXIMUM DAILY DOSE
Do not exceed eight tablets per 24-hour period.
Stavo 200: Maximum 6 tablets per 24 hours
Comments:
Conversions to carbidopa and levodopa rely on the combination of carbidopa and levodopa in a ratio of 1:4. There is no experience in switching patients away from products not combined in this ratio or extended-release formulations.
The optimal dose can be determined through careful titration. Therapy should be tailored to each individual and adjusted according to the desired clinical response.
Use: To treat Parkinson's disease
As a replacement for the equal strengths of each component
If dyskinesias and signs of "wearing off" at the end of the dose are present, then levodopa, 600 mg daily or less, can be substituted for carbidopa or levodopa.
What happens if I miss the dose?
If you are almost due for your next dose, skip the missed one. Never take two doses of the same medicine at once.
What happens if I overdose?
Call 1-800-222-1222 for poison help or seek immediate medical attention. Rapid heartbeat and lightheadedness are two symptoms of overdose.
What should be avoided?
Do not drive or engage in hazardous activities until you have a better understanding of how levodopa and carbidopa affect you. You may have impaired reactions. You may feel dizzy if you get up quickly from a seated or lying position.
Do not take iron supplements without consulting with your physician first. Avoid increasing your intake of protein (proteins include eggs, cheese, meat, and other sources). Iron or too much protein may make it difficult for your body's ability to absorb and digest Stalevo.
Interaction with other drug
Stalevo can make you more drowsy if taken with other drugs. Before taking an opioid, a sleeping tablet, a muscle-relaxing medication, or medicine to treat anxiety or seizures, consult your doctor. Stalevo can be affected by many drugs. These include prescription and over-the-counter medicines, vitamins, and herbal products. This list does not include all possible interactions. Inform your doctor of all medications you are currently taking and those that you will stop or start using.