Stalevo

Generic Name: Carbidopa, levodopa, and entacapone

  • What is Stalevo?

    Stalevo contains a combination of 3 drugs: carbidopa, levodopa, and entacapone. It is used to help relieve symptoms of Parkinson's disease, including tremors, muscle stiffness and rigidity, slowness of movement, and poor balance or coordination.

    Stalevo can be used instead of carbidopa-levodopa or entacapone by people who are taking those medicines separately or when the benefits of levodopa are not lasting as long as they used to.

  • What is the most important information I should know about Stalevo?

    You should never take Stalevo with certain antidepressants known as monoamine oxidase (MAO) inhibitors, such as phenelzine and tranylcypromine. Combining Stalevo with these drugs could cause serious—possibly life-threatening—side effects. MAO inhibitors should be stopped at least 2 weeks before starting therapy with Stalevo. However, Stalevo may be combined with the drugs rasagiline or selegiline. These drugs are a different type of MAO inhibitor that is often prescribed for Parkinson's disease. Always check with your doctor before taking any type of MAO inhibitor.

    It is important to take Stalevo at regular intervals according to the schedule outlined by your doctor. Sometimes a weaning off effect may occur at the end of the dosing interval, where you may feel your Parkinson's symptoms. Contact your doctor if the medication is not controlling properly controlling your symptoms

    Your urine, salvia, or sweat may be discolored (dark color such as red, brown, or black) after taking Stalevo.

  • Who should not take Stalevo?

    Do not take Stalevo if you are sensitive to any component of the drug; if you have glaucoma (high pressure in the eye); or if you have any suspicious, undiagnosed skin lesion or mole or a history of melanoma (skin cancer). Do not take Stalevo with certain MAO inhibitors such as phenelzine and tranylcypromine.
  • What should I tell my doctor before I take the first dose of Stalevo?

    Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Stalevo. Also, talk to your doctor about your complete medical history, especially if you have: asthma, diabetes or thyroid disorders, glaucoma, liver or kidney disease, severe heart or lung disease, or skin cancer. Also tell your doctor if you have a history of bile duct blockage, mental or emotional problems, or heart attacks or ulcers.
  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Your doctor will tailor your individual dosage carefully, depending on your response to previous therapy and symptoms. If you are already taking carbidopa/levodopa and entacapone as 2 separate medications, you will start a Stalevo regimen that matches what you were previously taking.

    Adults: Stalevo may be taken up to 8 times a day. It is available in 3 different strengths: 12.5 milligrams (mg) carbidopa/50 mg levodopa/200 mg entacapone; 25 mg carbidopa/100 mg levodopa/200 mg entacapone; 37.5 mg carbidopa/150 mg levodopa/200 mg entacapone

  • How should I take Stalevo?

    Stalevo may be taken with or without food. Never chew, crush, or break the tablets. Do not increase or decrease the dose or add any other Parkinson's drugs without first talking to your doctor.
  • What should I avoid while taking Stalevo?

    Low blood pressure may occur especially when starting therapy or when the dosage is increased. Use caution when rising rapidly after sitting or lying down. Give yourself plenty of time to understand how Stalevo affects you before you attempt to drive a car or operate machinery.

    Avoid increasing the amount of protein in your diet. Do not take iron products or vitamin or mineral supplements that contain iron without first talking to your doctor. The effects of Stalevo may be reduced by iron.

  • What are possible food and drug interactions associated with Stalevo?

    If Stalevo is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Stalevo with the following: ampicillin, antipsychotic drugs (such as chlorpromazine, droperidol, haloperidol, and perphenazine), apomorphine, bitolterol, blood-pressure drugs, chloramphenicol, cholestyramine, dobutamine, dopamine, epinephrine or norepinephrine, erythromycin, iron, isoniazid, isoproterenol, isoetherine, MAO inhibitors (such as phenelzine and tranylcypromine), methyldopa, metoclopramide, papaverine, phenytoin, probenecid, pyridoxine, rifampicin, risperidone, tricyclic antidepressants (such as amitriptyline and imipramine)
  • What are the possible side effects of Stalevo?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: abdominal pain; constipation; diarrhea; dizziness; dyskinesia (unwanted or uncontrollable movements); fatigue; hallucinations; harmless discoloration of urine, sweat, and/or saliva; hyperkinesias (excessive muscle movements); hypokinesia (slow movements); nausea; pain, symptoms resembling neuroleptic malignant syndrome (a condition characterized by fever and muscle stiffness)

    Stalevo may cause or worsen depression, hallucinations, psychosis, or suicidal thoughts. If you develop any of these symptoms, tell your doctor right away.

  • Can I receive Stalevo if I am pregnant or breastfeeding?

    The effects of Stalevo during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding. Use caution if you are breastfeeding while you are taking Stalevo.
  • What should I do if I miss a dose of Stalevo?

    Take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not take 2 doses at once.
  • How should I store Stalevo?

    Store at room temperature.