Carbidopa; Levodopa; Entacapone tablets

What are carbidopa; levodopa; entacapone tablets?

CARBIDOPA; LEVODOPA; ENTACAPONE (Stalevo™) is used to treat Parkinson's disease. Levodopa can help correct an imbalance of chemicals in the brain caused by Parkinson's disease. Levodopa will not cure Parkinson's disease, but will help to control the symptoms. Carbidopa and entacapone help levodopa to work better, and this can decrease some side effects, such as nausea. Generic carbidopa; levodopa; entacapone tablets are not available yet.

What should my health care professional know before I receive carbidopa; levodopa; entacapone?

They need to know if you have any of these conditions:

• asthma or lung disease

• depression or other mental illness

• diabetes

• dizzy or fainting spells

• glaucoma

• heart disease, including history of a heart attack

• irregular heart beat

• kidney disease

• liver disease

• low blood pressure

• melanoma or suspicious skin lesions

• seizure disorder

• stomach or intestinal ulcers

• an unusual or allergic reaction to levodopa, carbidopa, entacapone, other medicines, foods, dyes, or preservative

• pregnant or trying to get pregnant

• breast-feeding

How should this medicine be used?

Take your carbidopa; levodopa; entacapone tablets by mouth. Follow the directions on the prescription label. Do not crush or split the tablet; leave it whole. Swallow the tablet with a glass of water. It is best to take this medicine on an empty stomach, 30 minutes before you eat or 1 hour after you eat. If this medicine upsets your stomach, you can take it with a cracker or fruit. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not change your dosage regimen and do not add additional Parkinson's medications while taking this medication, unless under your provider's care. Do not stop taking this medicine without talking with your health care provider.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What drug(s) may interact with carbidopa; levodopa; entacapone?

• ampicillin

• apomorphine

• cholestyramine

• cocaine

• droperidol

• epinephrine

• erythromycin

• furazolidone

• iron supplements, such as those found in vitamins

• isoniazid, INH

• isoproterenol

• kava kava

• linezolid

• medicines for high blood pressure, including methyldopa

• medicines for depression, do not take those called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®)

• medicines for mental problems and psychotic disturbances

• metoclopramide

• papaverine

• phenytoin

• probenecid

• procarbazine

• s-adenosyl-l-methionine, SAM-e

• water pills

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking carbidopa; levodopa; entacapone?

Visit your prescriber or health care professional for regular checks on your progress. Continue to take your medicine on a regular schedule and do not stop taking except on your prescriber's advice. Do not take any additional medicines for Parkinson's disease without first consulting with your health care provider.

Entacapone may increase the side effects caused by Levodopa-Carbidopa such as nausea or restless movements. If you notice an increase in or the appearance of certain side effects that occurred only while you are taking Levodopa; Carbidopa, contact your physician. The dose of Levodopa-Carbidopa may need to be lowered. Do not decrease your medicine dose without your prescriber's advice.

You may get dizzy or have difficulty controlling your movements. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are older. This reduces the risk of dizzy or fainting spells. Alcohol or other medicines that make you tired can increase possible dizziness; avoid alcoholic drinks.

This medicine may make your mouth dry. Chewing sugarless gum, sucking hard candy, or drinking plenty of water may help.

You may experience a 'wearing off' effect prior to the time for your next dose of this medicine. You may also experience an 'on-off' effect where the medicine apparently stops working for anything from a minute to several hours, then suddenly starts working again. Tell your prescriber or health care professional if any of these symptoms happen to you, your dosage may need adjustment.

A high-protein diet can slow or prevent absorption of levodopa. Avoid high protein foods near the time of taking this medicine to help prevent this problem. Take this medicine at least 30 minutes before eating or 1 hour after meals. You may want to eat higher protein foods later in the day or in small amounts. Discuss your diet with your prescriber or nutritionist.

Do not take iron supplements within 2 hours of taking this medicine. The iron may decrease the amount of levodopa in your system and decrease the effectiveness of the drug

If you are diabetic, this medicine may interfere with the accuracy of some tests for sugar or ketones in the urine (does not interfere with blood tests). Check with your prescriber or health care professional before changing the dose of your diabetic medicine.

This medicine may discolor your urine, saliva or sweat, making it look darker or red in color; this is of no cause for concern. However, this may stain clothing or fabrics.

If you are going to have surgery, tell your prescriber or health care professional that you are taking carbidopa; levodopa; entacapone.

What side effects may I notice from receiving carbidopa; levodopa; entacapone?

Side effects that you should report to your prescriber or health care professional as soon as possible:

• confusion

• decrease in urination

• difficulty passing urine

• dizziness, lightheadedness, or fainting spells

• fainting spells or lightheadedness

• fast or irregular heartbeat (palpitations)

• fever

• hallucinations

• involuntary muscle movements

• mental depression, crying, extreme sadness

• mood changes such as aggressive behavior or hallucinations

• severe diarrhea

• sore muscles

• stomach pain

• uncontrolled movements of the mouth, head, hands, feet, shoulders, eyelids or other unusual muscle movements

• vomiting or nausea that does not go away

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• anxiety, confusion, or nervousness

• constipation

• diarrhea

• dizziness

• drowsiness

• dry mouth

• fatigue

• headache

• muscle twitches

• nausea

• nightmares, trouble sleeping

• unusual tiredness or weakness

• upset stomach or loss of appetite

• urine, sweat or saliva that is dark yellow to orange or brown in color (entacapone can change the color of your urine)

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15—30 degrees C (59—86 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.