Carbidopa / levodopa / entacapone

Class
Antiparkinsonian agents
Subclass
Aromatic L-amino acid decarboxylase inhibitor / dopamine precursor / catechol-O-methyltransferase inhibitor combination
Substance name
Carbidopa / levodopa / entacapone
Brand names
Stalevo®
Contains
Carbidopa
Entacapone
Levodopa
Common formulations
Film-coated tablet
See also
Carbidopa / levodopa (Sinemet®, Dhivy®, Duopa®)
Carbidopa / levodopa ER (Crexont®, Rytary®)
Dosage and administration
Adults patients
Treatment of Parkinson's disease
•
25/100/200 mg PO q3h
Indications for use
Labeled indications
Adults
•
Treatment of Parkinson's disease
Safety risks
Contraindications
Hypersensitivity to carbidopa / levodopa / entacapone or any of its components
Narrow-angle glaucoma
Concomitant use of nonselective MAOIs
Warnings and precautions
Diarrhea, microscopic colitis
•
Maintain a high level of suspicion as, entacapone has been associated with diarrhea moderate to severe, watery and non-bloody, at times associated with dehydration, abdominal pain, weight loss, and hypokalemia.
Exacerbation of dyskinesia
•
Use caution in patients with dyskinesia.
Exacerbation of peptic ulcer disease
•
Use caution in patients with a history of peptic ulcer.
Hallucinations
•
Use caution in patients with a psychotic disorder.
Hypotension, syncope, orthostatic hypotension
•
Use caution in patients who had had a prior episode of documented hypotension.
Impulsivity
•
Maintain a high level of suspicion as, there have been reports of intense urges to gamble, increased sexual urges, intense urges to spend money, binge eating, and/or other intense urges, and the inability to control these urges while taking carbidopa / levodopa / entacapone.
Neuroleptic malignant syndrome
•
Do not discontinue abruptly in all patients.
Rhabdomyolysis
•
Use caution in patients with myalgia and increased values of creatine phosphokinase and myoglobin.
Somnolence
•
Use extreme caution in patients performing activities requiring mental alertness, such as driving or operating machinery.
Suicidal ideation
•
Use caution in patients with past or current psychoses.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
No guidance available.
Renal replacement therapy
Any modality
•
No guidance available.
Hepatic impairment
Any severity
•
Use with caution.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B3
•
Avoid use. Evidence of fetal harm in humans.
Breastfeeding
Use with caution during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
Dyskinesia, nausea
Common 1-10%
•
Agitation, gastritis, hyperactivity, motor impairment, myocardial infarction, orthostatic hypotension, abdominal pain, anxiety, back pain, constipation, diarrhea, dizziness, dry mouth, dyspnea, fatigue, flatulence, indigestion, somnolence, vomiting, urine discoloration
Unknown frequency
•
Colitis, hepatitis, high cardiovascular risk, hypotension, neuroleptic malignant syndrome, neuropathy, prostate cancer, compulsive behavior, depression, hallucinations, syncope
Interactions
Drug(s)
Check Interactions
Reset

What did you think about this content?

Create free account

Sign up for free to access the full drug resource