Carbidopa/levodopa/entacapone, sold under the brand name Stalevo among others, is a dopaminergic fixed-dose combination medication that contains carbidopa, levodopa, and entacapone for the treatment of Parkinson's disease.[5]
Combination of | |
---|---|
Carbidopa | DOPA decarboxylase inhibitor |
Levodopa | dopamine precursor |
Entacapone | catechol-O-methyltransferase inhibitor |
Clinical data | |
Trade names | Stalevo, Corbilta, Carlevent |
AHFS/Drugs.com | Professional Drug Facts |
MedlinePlus | a601068 |
License data |
|
Pregnancy category |
|
Routes of administration | By mouth |
ATC code |
|
Legal status | |
Legal status | |
Identifiers | |
CAS Number |
|
PubChem CID |
|
ChemSpider |
|
KEGG |
|
(verify) |
Carbidopa/levodopa/entacapone is indicated for the treatment of Parkinson's disease.[5]
In the European Union it is indicated for the treatment of adults with Parkinson's disease and end-of-dose motor fluctuations not stabilized on levodopa/dopa decarboxylase (DDC) inhibitor treatment.[6]
Sometimes a wearing off effect may occur at the end of the dosing interval, where a patient may feel Parkinson's symptoms. Urine, saliva, or sweat may be discolored (dark color such as red, brown, or black) after taking carbidopa/levodopa/entacapone.[8]
Carbidopa/levodopa/entacapone is contraindicated in patients taking a class of antidepressant drugs known as non-selective monoamine oxidase (MAO) inhibitors such as phenelzine and tranylcypromine.[9]
Carbidopa/levodopa/entacapone may be combined with the drugs rasagiline or selegiline. These drugs are a different type of MAO inhibitor known as selective MAO inhibitors that are often prescribed for Parkinson's disease.[8] Many drug interactions involving selegiline are theoretical, primarily based on interactions with non-selective MAO inhibitors; at oral doses the risk of these interactions may be very low. However, transdermal selegiline, known by its trade name Emsam, is still contraindicated.[9] Transdermal selegiline results in higher plasma levels at which it behaves like a non-selective MAO inhibitor. Concominant use of entacapone, a component of carbidopa/levodopa/entacapone, with MAO inhibitors may increase toxicity of MAO inhibitors. Levodopa, also a component of carbidopa/levodopa/entacapone, in combination with MAO inhibitors may result in hypertensive reactions.[10]
Levodopa is the immediate precursor to dopamine. Entacapone is a selective, reversible catechol-O-methyltransferase (COMT) inhibitor that prevents the degradation of levodopa. Entacapone does not cross the blood–brain barrier. Carbidopa is a peripheral aromatic L-amino acid decarboxylase (AADC) inhibitor. Carbidopa, which also does not cross the blood–brain barrier, is combined with levodopa to prevent its conversion to dopamine in the periphery.[11][unreliable medical source?]
Carbidopa/levodopa/entacapone was approved by the US Food and Drug Administration (FDA) in June 2003.[12][13]
It may help decrease a change of response to Parkinson's medications.[14]