Carbidopa/levodopa/entacapone (By mouth)

Introduction

Carbidopa (kar-bi-DOE-pa), Entacapone (en-TAK-a-pone), Levodopa (lee-voe-DOE-pa)

Treats symptoms of Parkinson's disease.

Brand Name(s)

Stalevo 100, Stalevo 150, Stalevo 50, Stalevo 125, Stalevo 75, Stalevo 200

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to carbidopa, levodopa, or entacapone. Do not use this medicine if you are also using the MAO inhibitor Marplan® (isocarboxazid), Nardil® (phenelzine), or Parnate® (tranylcypromine). You should not use this medicine if you have narrow-angle glaucoma. You should not use this medicine if you think you might have melanoma (skin cancer) or if you have a history of melanoma.

How to Use This Medicine

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• You may take this medicine with or without food.Do not crush, chew, or break the tablet. Swallow it whole.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using the MAO inhibitor selegiline (Eldepryl®), isoproterenol (Isuprel®), dopamine (Intropin®), dobutamine (Dobutrex®), methyldopa (Aldomet®, Aldoril®), bitolterol (Tornalate®), phenytoin (Dilantin®), papaverine (Pavabid®), metoclopramide (Reglan®), probenecid (Benemid®), cholestyramine (Questran®), a phenothiazine medicine (such as Compazine®, Phenergan®, Serentil®, Thorazine®), or vitamin supplements that contain iron.
• If you are using any medicine to treat high blood pressure, depression, an infection, or a mental disorder such as schizophrenia, tell your doctor. Some blood pressure medicines are atenolol, lisinopril, metoprolol, Cozaar®, Diovan®, Lotrel®, Norvasc®, Prinivil®, Toprol®, or Zestril®. Hydrochlorothiazide (HCTZ) is another blood pressure medicine that might be used by itself or combined with other medicines (such as bisoprolol, lisinopril, losartan, triamterene, valsartan). Some medicines for depression are amitriptyline and nortriptyline. Haldol® and Risperdal® are medicines used to treat mental disorders. Medicines to treat an infection are antibiotics, such as erythromycin, rifampin, ampicillin, chloramphenicol.
• Make sure your doctor knows about all other medicines you are using to treat Parkinson's disease.
• Avoid eating a high-protein diet while you are using this medicine.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine

• Tell your doctor if you are pregnant or breast feeding, or have a history of mental or emotional problems. Your doctor needs to know if you have kidney disease, liver disease, lung disease (including asthma), gallstones, glaucoma, or a stomach ulcer. If you have problems with your endocrine system, tell your doctor. This system is made up of glands that produce hormones to control body functions. Endocrine system problems include diabetes, thyroid problems, or growth problems. Tell your doctor if you have had a heart attack, or if you have heart disease or low blood pressure.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests, including tests often used by people who have diabetes. Stalevo? may also affect medicines that are used during an emergency or in the hospital (such as during surgery).
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• Tell your doctor if your Parkinson's symptoms start to come back between doses.
• This medicine may make you dizzy. Stand up slowly. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• This medicine might cause your saliva, sweat, or urine to become dark red, brown, or black. This is not anything to worry about, but it could stain your clothes.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Depression, thoughts of hurting yourself.
• Hallucinations (seeing or hearing things that are not truly there).
• High fever, severe muscle pain or stiffness, confusion, fainting.
• Lightheadedness or fainting, or fast heartbeat.
• Repetitive movements you cannot control (either new or worse than usual).
• Severe diarrhea.
• Trouble breathing.

If you notice these less serious side effects, talk with your doctor:

• Mild diarrhea, nausea, stomach pain.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088