carbidopa, entacapone, and levodopa

What is the most important information I should know about carbidopa, entacapone, and levodopa?

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

What is carbidopa, entacapone, and levodopa (Stalevo)?

Carbidopa, entacapone, and levodopa (Stalevo) is a combination medicine used to treat Parkinson symptoms such as muscle stiffness, tremors, spasms, and poor muscle control.

Stalevo may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Stalevo?

• narrow-angle glaucoma.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor if you have ever had:

• glaucoma;
• depression or other mental illness;
• a stomach ulcer; or
• liver disease.

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Ask your doctor about skin symptoms to watch for.

Tell your doctor if you are pregnant or breastfeeding.

How should I take Stalevo?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take only a single tablet at each dosing time. Do not take more than 1 tablet at a time or take a portion of a broken tablet. Combining more than one tablet or tablet portions may cause an overdose.

Take your doses at regular intervals to keep a steady amount of the drug in your body at all times. Ask your doctor about whether you should take Stalevo with or without food.

Tell your doctor if the effects of this medicine seem to wear off quickly in between doses.

Do not take any other medications for Parkinson's disease that your doctor has not prescribed.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Stalevo.

Do not stop using Stalevo suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include rapid heartbeats and feeling light-headed.

What should I avoid while taking Stalevo?

Avoid taking iron supplements without your doctor's advice. Also avoid increasing the amount of protein in your diet (protein sources include meat, eggs, and cheese). Taking iron or eating too much protein can make it harder for your body to digest and absorb Stalevo.

What are the possible side effects of Stalevo?

• worsening symptoms such as tremors, twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;
• depressed mood, thoughts about hurting yourself;
• hallucinations, unusual behaviors;
• severe nausea and vomiting;
• severe or ongoing diarrhea, diarrhea that is watery;
• unexplained muscle pain, tenderness, or weakness;
• a light-headed feeling, like you might pass out;
• fluid build-up in or around the lungs --pain when you breathe, feeling short of breath while lying down, wheezing, gasping for breath, cough with foamy mucus, cold, clammy skin, anxiety, rapid heartbeats; or
• severe nervous system reaction --very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats.

This medicine may cause you to fall asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

You may notice that your sweat, urine, or saliva appears dark in color, such as red, brown, or black. This is not a harmful side effect, but it may cause staining of your clothes or bed sheets.

Common side effects may include:

• involuntary muscle movement;
• diarrhea;
• nausea, vomiting, stomach pain;
• discolored urine; or
• dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Stalevo?

Many drugs can affect Stalevo. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about carbidopa, entacapone, and levodopa.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2023 Cerner Multum, Inc. Version: 5.01. Revision date: 10/14/2019.