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Uses

What is carbidopa/levodopa/entacapone used for?

Carbidopa/levodopa/entacapone is commonly used to treat Parkinson’s disease, a condition that affects the part of your brain that controls your movements.

Carbidopa/levodopa/entacapone may also be used for other conditions as determined by your healthcare provider.

How does carbidopa/levodopa/entacapone work (mechanism of action)?

In people with Parkinson's disease, the brain does not have enough of a chemical called dopamine, which helps control movement. This makes it hard for people to move their bodies the way they want to.

Carbidopa, levodopa, and entacapone are medicines that work together to help people with Parkinson's disease.

Levodopa is a medicine that turns into dopamine in the brain. When levodopa is used by itself, it gets broken down too quickly, before it can reach the brain. Carbidopa and entacapone work to block the breakdown of levodopa so that more dopamine can get to the brain. This helps people with Parkinson's disease move more easily.

How is carbidopa/levodopa/entacapone supplied (dosage forms)?

Brands and other names

  • Stalevo 

Dosage forms and strengths

  • 12.5 mg/50 mg/200 mg oral tablets
  • 18.75 mg/75 mg/200 mg oral tablets
  • 25 mg/100 mg/200 mg oral tablets
  • 31.25 mg/125 mg/200 mg oral tablets
  • 37.5 mg/150 mg/200 mg oral tablets
  • 50 mg/200 mg/200 mg oral tablets

How should I store carbidopa/levodopa/entacapone?

Carbidopa/levodopa/entacapone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep the container tightly closed. 

Side Effects

What are the most common side effects of carbidopa/levodopa/entacapone?

The most common side effects of carbidopa/levodopa/entacapone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Uncontrollable, involuntary movements (see below)
  • Diarrhea (see below)
  • Nausea or vomiting
  • Stomach pain
  • Dry mouth
  • Changes in the color of your urine (pee)

There may be other side effects of carbidopa/levodopa/entacapone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of carbidopa/levodopa/entacapone?

While less common, the most serious side effects of carbidopa/levodopa/entacapone are described below, along with what to do if they happen.

Severe Allergic Reactions. Carbidopa/levodopa/entacapone may cause allergic reactions, which can be serious. Stop taking carbidopa/levodopa/entacapone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Sleepiness. Carbidopa/levodopa/entacapone can make you sleepy, sometimes very suddenly and without warning signs (also called a "sleep attack"). Do not drive or do other activities that require alertness or coordination until you know how carbidopa/levodopa/entacapone affects you. Tell your healthcare provider if you feel sleepy or drowsy while taking carbidopa/levodopa/entacapone.

Low Blood Pressure Upon Standing (Orthostatic Hypotension). Carbidopa/levodopa/entacapone may cause a sudden drop in blood pressure when standing up from a seated or lying position. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your healthcare provider right away if you have any of the following symptoms of orthostatic hypotension.

  • Dizziness, feeling lightheaded, or fainting upon standing
  • Blurred vision
  • Confusion
  • Feeling weak

Uncontrollable, Involuntary Movements (Dyskinesias). Carbidopa/levodopa/entacapone may cause involuntary movement problems, including shakiness, stiffness, or jerkiness. Call your healthcare provider right away if you develop any unusual or uncontrolled movements or if they get worse.

Depression and Suicidal Thoughts. Carbidopa/levodopa/entacapone may cause depression in a small number of people. If you having thoughts of harming yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior

Hallucinations or Psychotic-like Behaviors. Carbidopa/levodopa/entacapone may cause hallucinations or psychotic-like behaviors. Talk to your healthcare provider right away if you or someone you know notices that you have any of the following symptoms.

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
  • Delusional thoughts, such as false beliefs that you are being controlled
  • Disorganized thoughts, such as jumping between topics or having a hard time focusing
  • Sudden decline in self-care, such as personal hygiene or academic/work performance
  • Aggressive behavior

Unusual or Compulsive Behaviors. Carbidopa/levodopa/entacapone can cause some people to have strong unusual and uncontrolled urges (compulsions), including gambling, sex, shopping, or eating. Talk to your healthcare provider right away if you or someone you know notices that you have new or worsening strong urges or behaviors.

Diarrhea. Diarrhea is common with carbidopa/levodopa/entacapone. You may get diarrhea within a week of starting carbidopa/levodopa/entacapone or many months later. Call your healthcare provider right away if you have any of the following. 

  • Severe diarrhea
  • Diarrhea that does not go away
  • Diarrhea with weakness, dizziness, or fever

Muscle Problems. Carbidopa/levodopa/entacapone may cause muscle breakdown (rhabdomyolysis), which can be serious and rarely lead to kidney damage and death. Involuntary movements, which may be a side effect of carbidopa/levodopa/entacapone, may increase this risk. Get emergency help right away if you have any of the following symptoms of rhabdomyolysis.

  • Unexplained muscle pain, weakness, or tenderness
  • Dark-colored urine (pee)
  • Fever
  • Muscle cramps
  • Stomach pain
  • Nausea or vomiting

Warnings & Precautions

Who should not use carbidopa/levodopa/entacapone?

Allergies to Ingredients. People who are allergic to any of the following should not take carbidopa/levodopa/entacapone.

  • Levodopa
  • Carbidopa
  • Entacapone
  • Stalevo
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific carbidopa/levodopa/entacapone products they stock.

Drug Interactions. Carbidopa/levodopa/entacapone should not be taken while you are using or if you have recently used certain other medicines. Before taking carbidopa/levodopa/entacapone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Glaucoma. People with narrow-angle glaucoma should not take carbidopa/levodopa/entacapone.

What should I know about carbidopa/levodopa/entacapone before using it?

Do not take carbidopa/levodopa/entacapone unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share carbidopa/levodopa/entacapone with other people, even if they have the same condition as you. It may harm them.

Keep carbidopa/levodopa/entacapone out of the reach of children.

Do not chew, cut, or crush carbidopa/levodopa/entacapone.

Do not stop taking carbidopa/levodopa/entacapone without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Changes in your breathing or heart rate
  • Increased sweating
  • Confusion

You may notice a dark color in your saliva, sputum, urine, or sweat. This is a common side effect of carbidopa/levodopa/entacapone and is not believed to be harmful, although your clothes might get stained. However, dark urine can also be a sign of muscle problems, which is a rare but serious side effect of carbidopa/levodopa/entacapone. Get emergency help right away if you notice dark urine along with any other symptoms of muscle problems listed in the Side Effects section.

Carbidopa/levodopa/entacapone may cause you to feel sleepy, especially if you already have conditions that can make you drowsy. Carbidopa/levodopa/entacapone may also cause dizziness. Do not drive or do other activities that require alertness or coordination until you know how carbidopa/levodopa/entacapone affects you.

What should I tell my healthcare provider before using carbidopa/levodopa/entacapone?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if carbidopa/levodopa/entacapone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Mental health or behavior problems, including depression or any psychotic disorder (such as schizophrenia or delusional disorder)
  • Sleep problems
  • Any other movement disorders
  • Eye problems, such as glaucoma
  • Stomach problems, such as a stomach ulcer
  • Low blood pressure or feeling faint or dizzy, especially when standing up from a seated or lying position
  • Liver problems
  • Unusual urges, such as gambling, binge eating, compulsive shopping, or increased sex drive

Pregnancy. It is not known if or how carbidopa/levodopa/entacapone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. Levodopa, one of the medicines in carbidopa/levodopa/entacapone, passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take carbidopa/levodopa/entacapone while breastfeeding.

Interactions

Does carbidopa/levodopa/entacapone interact with foods or drinks?

You may take carbidopa/levodopa/entacapone with or without food. However, a high-fat, high-calorie meal may delay how fast the medicine works in your body. 

Additionally, a high-protein meal may affect how well your body absorbs levodopa (one of the medicines in carbidopa/levodopa/entacapone) and decrease how well carbidopa/levodopa/entacapone works. If you change the amount of protein in your diet, tell your healthcare provider.

It is unknown if drinking alcohol will affect carbidopa/levodopa/entacapone. However, the risk of drowsiness, sleepiness, and/or dizziness may be increased if you drink alcohol while taking carbidopa/levodopa/entacapone. 

Does carbidopa/levodopa/entacapone interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking carbidopa/levodopa/entacapone.

  • A nonselective monoamine oxidase inhibitor (MAOI) within the past 2 weeks, such as phenelzine (Nardil), tranylcypromine (Parnate), or isocarboxazid (Marplan), which is a medicine usually used for depression
  • Epinephrine, such as Epipen, which is a medicine used for severe allergic reactions 
  • A medicine for high blood pressure, including methyldopa
  • Apomorphine (Apokyn), which is a medicine used to treat Parkinson’s disease
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • Metoclopramide (Reglan and others), which is a medicine for certain stomach problems
  • An antipsychotic, such as haloperidol, chlorpromazine, thioridazine, fluphenazine, or risperidone, which is a medicine for certain mental health conditions
  • Isoniazid or rifampin, which is a medicine used to treat an infection called tuberculosis
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Papaverine, which is a medicine used for various blood flow problems, including chest pain
  • Iron supplements or other products (such as multivitamins) containing iron
  • Probenecid, which is a medicine commonly used for gout
  • A bile acid sequestrant, such as cholestyramine, which is a medicine to lower cholesterol
  • Erythromycin (Ery-Tab and others) or ampicillin, which is a medicine used for bacterial infections
  • Warfarin, which is a blood thinner
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Any other medicine that contains carbidopa or levodopa

Carbidopa/levodopa/entacapone may alter the blood levels of some other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with carbidopa/levodopa/entacapone. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much carbidopa/levodopa/entacapone?

If you or someone else has used too much carbidopa/levodopa/entacapone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of carbidopa/levodopa/entacapone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.