Stalevo 125

— THERAPEUTIC CATEGORIES —
  • Parkinsonism

Stalevo 125 Generic Name & Formulations

General Description

Carbidopa 31.25mg, levodopa 125mg, entacapone 200mg; tabs.

Pharmacological Class

Dopa-decarboxylase inhibitor + dopamine precursor + COMT inhibitor.

How Supplied

Tabs—100

Generic Availability

YES

Stalevo 125 Indications

Indications

In idiopathic Parkinson's disease: to substitute for equivalent doses of previously-administered carbidopa/ levodopa and entacapone; and to replace immediate-release carbidopa and levodopa in patients with end-of-dose "wearing-off" symptoms who are taking levodopa up to 600mg/day without having dyskinesias.

Stalevo 125 Dosage and Administration

Adult

Swallow whole; max one tablet per dosing interval. Previously on carbidopa/levodopa and entacapone: substitute on a mg/mg basis. Stalevo 50, 75, 100, 125, 150: max 8 tabs/day; Stalevo 200: max 6 tabs/day. Others: individualize; see full labeling. Avoid abrupt cessation.

Children

Not established.

Stalevo 125 Contraindications

Contraindications

During or within 2 weeks of nonselective MAOIs (eg, phenelzine, tranylcypromine). Narrow-angle glaucoma.

Stalevo 125 Boxed Warnings

Not Applicable

Stalevo 125 Warnings/Precautions

Warnings/Precautions

Risk of falling asleep during activities of daytime living and somnolence; discontinue if occurs or avoid potential dangerous activities. Dyskinesia. Biliary obstruction. Orthostatic hypotension. History of peptic ulcer. Depression. Suicidal tendencies. Psychosis. Impulse control and/or compulsive behavior: consider dose reduction or discontinuation if develops. Discontinue and treat if prolonged diarrhea is suspected; consider colonoscopy and biopsies if cause is unclear. Renal or hepatic impairment. Elderly (>75yrs). Pregnancy. Nursing mothers.

Stalevo 125 Pharmacokinetics

See Literature

Stalevo 125 Interactions

Interactions

See Contraindications. Orthostatic hypotension with antihypertensives. Antagonized by isoniazid, dopamine D2 receptor antagonists (eg, metoclopramide, phenothiazines, butyrophenones, risperidone), phenytoin, papaverine; possibly iron, high protein diets, excessive gastric acidity. Hypertension, dyskinesia with tricyclics. May cause false (+) urinary ketone test or false (–) urinary glucose (glucose oxidase) test. Potentiates CNS depression with alcohol, other CNS depressants. Chelates iron. Cardiac effects with drugs metabolized by COMT (eg, epinephrine, isoproterenol, dopamine, dobutamine, methyldopa, apomorphine, bitolterol). Caution with drugs that interfere with biliary excretion, glucuronidation, or intestinal beta-glucuronidase (eg, probenecid, cholestyramine, erythromycin, rifampicin, ampicillin, chloramphenicol) or other drugs metabolized via CYP2C9. Monitor INR with warfarin.

Stalevo 125 Adverse Reactions

Adverse Reactions

Dyskinesias, hyperkinesia, diarrhea, nausea, abdominal pain, vomiting, dry mouth, urine discoloration; hypotension, syncope, CNS disturbances (eg, hallucinations, confusion, depression, psychosis), rhabdomyolysis, hyperpyrexia and confusion upon withdrawal, fibrotic complications, lab abnormalities.

Stalevo 125 Clinical Trials

See Literature

Stalevo 125 Note

Not Applicable

Stalevo 125 Patient Counseling

See Literature