- To substitute for carbidopa-levodopa (Sinemet®) plus entacapone (Comtan®) in people already taking these medications
- To replace carbidopa-levodopa in people experiencing "wearing-off" symptoms (when the medication stops working before the next dose) who take 600 mg of levodopa per day or less and who are not experiencing dyskinesia (a movement disorder that is a side effect of carbidopa-levodopa).
Stalevo is made by Orion Corporation, Inc. and marketed by Novartis Pharmaceuticals Corporation.
Dopamine deficiency, caused by a loss of dopamine-producing cells in certain parts of the brain, may be responsible for many of the symptoms of Parkinson's disease. Although it would make sense to give dopamine to help treat Parkinson's, this does not work, since dopamine cannot cross the blood-brain barrier.
Stalevo contains the following three medications:
- Levodopa -- Levodopa is a precursor of dopamine, which means that the body can use it to make dopamine. Unlike dopamine, levodopa crosses the blood-brain barrier.
- Carbidopa -- Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain, preventing or diminishing some of the side effects that often accompany levodopa therapy. Carbidopa also reduces the amount of levodopa needed for Parkinson's disease treatment.
- Entacapone -- Entacapone inhibits an enzyme (catechol-O-methyltransferase or COMT) that breaks down levodopa before it has a chance to reach the brain. Entacapone increases the level of levodopa in the body and helps it to work longer.
Levodopa is the "real" medication in Stalevo that treats Parkinson's disease. The other two medications help levodopa work better and longer.
In clinical studies, Stalevo has been shown to be more effective than
carbidopa-levodopa for Parkinson's treatment. In these studies, people who were experiencing wearing-off fluctuations of their
carbidopa-levodopa therapy were given either
entacapone or a placebo (a "sugar pill" with no active ingredient) to take with each dose of their carbidopa-levodopa. These studies showed that entacapone helped the carbidopa-levodopa work longer, with shorter "off" periods (when the medication did not work well) and longer "on" periods (when the medication worked well).
When and How to Take Stalevo
General considerations for when and how to take Stalevo include the following:
- The medication comes in tablet form. It is taken by mouth usually three or four times a day (or however frequently you were taking carbidopa-levodopa).
- The protein in food can decrease the absorption of Stalevo into the body. Some healthcare providers recommended taking the drug on an empty stomach or with a low-protein diet. Officially, the manufacturer states that Stalevo can be taken either with or without food.
- Make sure to take Stalevo at the same times each day to maintain an even level in your blood.
- For the medication to work properly, it must be taken as prescribed. Stalevo will not work if you stop taking it. Do not stop taking the drug suddenly without first talking to your healthcare provider.
Dosing Information for Stalevo
The dose of Stalevo your healthcare provider recommends will vary, depending on a number of factors, including:
- Your current carbidopa-levodopa dose
- How you respond to Stalevo (especially if you develop bothersome side effects)
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Stalevo. Most people tolerate it relatively well at first, especially if the dose is increased slowly. If side effects do occur, in many cases, they are minor and either require no treatment or can be treated easily by you or your healthcare provider. As time goes by, it is common for more bothersome and serious side effects of Stalevo to occur.
Common side effects include but are not limited to:
- Involuntary movements (dyskinesia)
- Nausea
- Diarrhea
- Urine discoloration
- Dizziness.
(Click Stalevo Side Effects to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
Drug Interactions With Stalevo
Stalevo: What Should I Tell My Healthcare Provider?
Talk with your healthcare provider prior to taking Stalevo if you have:
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose of Stalevo?
People who take too much Stalevo may experience symptoms such as:
If you happen to take too much Stalevo, seek immediate medical attention.
How Should Stalevo Be Stored?
Stalevo tablets should be stored at room temperature, away from moisture, heat, and light. Keep Stalevo and all other medications out of the reach of children.
What Should I Do If I Miss a Dose of Stalevo?
If you forget to take a dose of Stalevo, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Stalevo tablets are available in the following strengths:
- Stalevo 50 (12.5 mg of carbidopa, 50 mg of levodopa, and 200 mg of entacapone)
- Stalevo 100 (25 mg of carbidopa, 100 mg of levodopa, and 200 mg of entacapone)
- Stalevo 150 (37.5 mg of carbidopa, 150 mg of levodopa, and 200 mg of entacapone)
- Stalevo 200 (50 mg of carbidopa, 200 mg of levodopa, and 200 mg of entacapone).
At this time, Stalevo is not available in generic form
(see Generic Stalevo).
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