Parkinson’s disease

Stalevo contain levodopa 100 mg,, carbidopa 25 mg and entacapone 200 mg. Levodopa is able to circulate in the plasma and cross the blood-brain-barrier (BBB), where it is converted by striatal enzymes to dopamine. Carbidopa: Inhibits the peripheral plasma breakdown of levodopa by inhibiting its decarboxylation; increases available levodopa at the BBB. Entacapone: Alters the pharmacokinetics of levodopa, resulting in more sustained levodopa serum levels and increased concentrations available for absorption across the BBB.

Swallow tablet whole; do not crush, break, or chew. Only 1 tablet should be administered at each dosing interval, with or without food; the maximum daily dose: 8 tab

Hypersensitivity to levodopa, carbidopa and entacapone; narrow angle glaucoma, Pheochoromocytoma, concomitant use of a non-selective monoamine oxidase inhibitor (e.g.phenelzine, tranylcypromine)

C

Avoided

Abdominal pain, Diarrhea (mild to moderate), nausea, confusion, dizziness, somnolence, hallucination, Urine may be discoloured reddish-brown by entacapone but this is a harmless phenomenon

(currently taking carbidopa/levodopa AND entacapone) patients currently taking entacapone 200 mg with each dose of immediate-release carbidopa/levodopa can be directly switched to corresponding strength of carbidopa/levodopa/entacapone that contains same amounts of carbidopa and levodopa MAX daily dose is based on levodopa component: 50 to 150 mg, MAX is 8 tablets/day; levodopa 200 mg component, MAX is 6 tablets/day; limited experience with doses of entacapone above 1600 mg/day; patients receiving less than 70 to 100 mg of the carbidopa component may experience nausea and vomiting