Levodopa/Carbidopa/Entacapone, Oral

What are other names for this medicine?

Type of medicine: anti-Parkinson's

Generic and brand names: levodopa/carbidopa/entacapone, oral; Stalevo

What is this medicine used for?

This medicine is a combination of 3 medicines taken by mouth to treat Parkinson's disease.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• an endocrine disorder such as Addison's disease or diabetes
• breathing problems or lung disease such as asthma
• depression or hallucinations
• glaucoma
• heart disease or a heart attack
• liver or kidney disease
• peptic ulcers
• skin cancer or skin moles that haven't been checked for cancer

Do not take this medicine and an MAO inhibitor antidepressant within 14 days of each other.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval. You may have to reduce your dosage gradually.

It may take several weeks for you to feel the full effects of the medicine.

It is best to take this medicine on an empty stomach. However, if stomach upset occurs you may take it with food. If stomach upset continues, tell your healthcare provider. Do not eat a high-protein diet while you are taking this medicine because it may change the way the medicine works. Talk with your provider about this.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is within 2 hours of the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: irregular or fast heartbeat, lightheadedness, dizziness, nausea, diarrhea, vomiting, weakness, fainting, confusion, hallucinations, muscle twitching, restlessness.

What should I watch out for?

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. This medicine increases the effects of alcohol and medicines that slow down your nervous system. Do not drink alcohol or take medicines such as narcotics, muscle relaxants, or allergy medicines unless your healthcare provider approves.

This medicine may darken saliva, urine, and sweat. This is not harmful but it may stain clothing.

Tell your provider if your Parkinson's symptoms get worse or come back between doses.

Do not change your diet while taking this medicine without your healthcare provider's approval. Certain foods may change the way this medicine works.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Diabetics: This medicine may affect urine sugar test results. Talk to your healthcare provider before you change your diet or dosage of diabetes medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Hallucinations (seeing or hearing things that are not there), seizures, unexplained fever, rigid muscles, trouble urinating, depression, fast or irregular heartbeat, severe muscle pain, eye or body twitching, weakness, severe confusion, dizziness after you stand or sit up quickly (especially if it occurs several times), fainting, nausea that continues, severe diarrhea.

Other: Diarrhea, constipation, dark urine or saliva, dry mouth, nausea, gas, headaches, nightmares, change in sense of taste, drowsiness, nervousness, tiredness, loss of appetite.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• alpha blockers such as prazosin (Minipress), doxazosin (Cardura), and terazosin (Hytrin)
• antibiotics such as ampicillin (Omnipen, Polycillin, Totacillin Principen), erythromycin (E.E.S., Ery-Tab), isoniazid (Nydrazid), chloramphenicol (Chloromycetin), and rifampin (Rifadin, Rimactane)
• antinausea medicines such as prochlorperazine (Compazine), metoclopramide (Reglan), and promethazine (Phenergan)
• bupropion (Wellbutrin, Zyban)
• cholestyramine (Questran)
• beta blockers such as atenolol (Tenormin), acebutolol (Sectral), betaxolol (Kerlone), carteolol, bisoprolol (Zebeta), pindolol, metoprolol (Lopressor, Toprol XL), timolol, sotalol (Betapace), nadolol (Corgard), propranolol (Inderal), labetalol (Normodyne, Trandate), and carvedilol (Coreg)
• calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiamate, Tiazac), nicardipine (Cardene), nifedipine (Procardia, Adalat), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and verapamil (Calan, Isoptin, Verelan)
• ephedrine
• iron medicines and multi-vitamins containing iron such as Feosol, Fer-Iron, Fer-In-Sol, Feostat, Ircon, and Vitron-C
• isoniazid
• kava
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• medicine to treat breathing problems such as epinephrine (Adrenalin, AsthmaNefrin, Vaponefrin, Primatene), and isoproterenol (Isuprel)
• medicine to treat heart and circulation problems such as norepinephrine (Levophed), dopamine, and dobutamine
• metoclopramide (Reglan)
• methyldopa
• other Parkinson's medicine such as apomorphine (Apokyn) and entacapone (Comtan)
• papaverine
• phenytoin (Dilantin) and fosphenytoin (Cerebyx)
• probenecid (Benemid)
• procarbazine (Matulane)
• selegiline (Eldepryl)
• tricyclic antidepressants such as amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), doxepin (Sinequan), trazodone (Desyrel), amoxapine (Asendin), and desipramine (Norpramin, Pertofrane)

Diets high in protein and highly acid foods (citrus fruits) may interfere with the body's response to this medicine. Do not change your diet without your healthcare provider's approval.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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