Stalevo Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Stalevo Tablet is a prescription combination medicine containing carbidopa, levodopa, and entacapone, used to treat symptoms of Parkinson's disease in adults. It helps with muscle stiffness, tremors, spasms, and poor muscle control, and helps manage end-of-dose wearing-off symptoms. It works by increasing the amount of levodopa that reaches the brain to improve movement control. It comes as a tablet in several strengths and must be taken exactly as prescribed.

What is Stalevo Tablet

Stalevo is a prescription combination tablet containing three medicines — carbidopa, levodopa, and entacapone — used to treat the symptoms of Parkinson's disease in adults.

Stalevo Tablet uses

• Treats symptoms of Parkinson's disease in adults, such as muscle stiffness, tremors, spasms, and poor muscle control.
• Treats Parkinson's disease.
• Helps manage end-of-dose wearing-off symptoms.
• Improves slowness of movement (bradykinesia).
• Helps reduce muscle stiffness and rigidity.
• Helps control tremors associated with Parkinson's disease.
• Reduces periods of decreased mobility between medication doses.

Benefits of Stalevo Tablet

• Improves muscle stiffness, tremors, spasms, and poor muscle control.
• Helps smooth out dopamine levels so symptom control is steadier throughout the day and reduces 'off' time.
• Combines three separate medicines into one tablet, so you don't need to take as many pills.
• Available in several strengths so your doctor can adjust your dose.

How Stalevo Tablet works

Levodopa turns into dopamine in the brain to control movement. Carbidopa and entacapone both block enzymes that would otherwise break down levodopa before it reaches the brain, so more of the medicine gets through and lasts longer, which helps control Parkinson's symptoms.

Stalevo Tablet dosage

Stalevo can be taken with or without food, but avoid taking it with a high-fat, high-calorie, or high-protein meal (such as avocados, cheese, or peanut butter), since these can slow how the medicine is absorbed. If you get nauseous, you can take it with small low-protein snacks like biscuits or fruit juice.

Swallow the tablet whole — do not crush, chew, split, or break it. Only take one tablet at a time at each dosing time; do not combine tablets or take broken tablet portions. Take doses at regular, evenly spaced times to keep a steady amount of medicine in your body.

Space iron supplements at least 2 hours apart from your dose, since iron can reduce how well the medicine is absorbed. Do not increase protein in your diet around dosing, as high protein can reduce absorption.

Do not stop taking this medicine suddenly — stopping or lowering the dose too fast can cause a dangerous withdrawal reaction; follow your doctor's instructions if you need to stop.

If you miss a dose, take it as soon as you remember, but skip it if it's almost time for the next dose — do not double up doses.

Available forms and strengths

Stalevo is available as a tablet.

Side effects of Stalevo Tablet

Common

• Involuntary movements (dyskinesia)
• Nausea and vomiting
• Diarrhea
• Abdominal/stomach pain
• Dizziness
• Fatigue/tiredness
• Dry mouth
• Discolored urine, sweat, or saliva (red, brown, or black — harmless but can stain clothes)
• Constipation
• Back pain
• Drowsiness
• Restlessness

Serious

• Hallucinations, confusion, or unusual behavior
• Severe depression or suicidal thoughts/behavior
• Intense or uncontrollable urges, such as compulsive gambling, shopping, eating, or hypersexuality
• Severe or ongoing diarrhea, possibly from inflamed colon (colitis), which can cause weight loss or dehydration
• Low blood pressure (hypotension) causing dizziness or fainting, especially when standing up
• Falling asleep suddenly during daily activities like talking, eating, or driving
• Severe muscle damage (rhabdomyolysis) — muscle pain, swelling, dark urine
• Low vitamin B6 levels — numbness/tingling, sore or swollen tongue, cracked mouth corners, confusion, seizures
• Withdrawal reaction with high fever, confusion, severe muscle stiffness, and irregular heartbeat if the medicine is stopped suddenly
• Severe allergic reaction — swelling of face, lips, tongue, or throat, difficulty breathing, hives
• Signs of stomach bleeding — severe stomach pain, vomiting or coughing up blood, black tarry stools
• Liver injury — dark urine, pale stools, yellowing of skin or eyes

Warnings and precautions

• Do not take this medicine if you've used a nonselective MAOI antidepressant in the past 14 days — this combination can be dangerous.
• Do not stop taking this medicine suddenly, as it can trigger a dangerous withdrawal reaction with high fever and confusion. Follow your doctor's plan for adjusting or stopping the dose.
• This medicine should not be used if you have narrow-angle glaucoma.
• People with Parkinson's disease may have a higher risk of skin cancer (melanoma); ask your doctor what skin symptoms to watch for.
• This medicine can cause low vitamin B6 levels, which in serious cases can lead to depression, confusion, or seizures that may not respond to usual seizure medicines.
• If you have a history of stomach ulcers, this medicine may raise your risk of new ulcers or stomach bleeding.
• It isn't known if it's safe to take Stalevo during pregnancy. Talk with your doctor before taking it if you're pregnant or planning to become pregnant.
• Treatment with Stalevo is not recommended while breastfeeding. Talk with your doctor about other options.
• Stalevo is okay to take if you have kidney problems.
• Liver problems may make it harder for your body to clear this medicine. Tell your doctor about any past liver problems; they may check your liver function during treatment.
• Drinking alcohol can make side effects like drowsiness, dizziness, or low blood pressure worse. Talk with your doctor before drinking alcohol during treatment.
• This medicine can cause sudden sleepiness or falling asleep during activities, even driving. Don't drive or do anything requiring full attention until you know how it affects you.

Storage

• Store at room temperature away from moisture and heat.
• Keep the bottle tightly closed when not in use.
• Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.
• Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.

When to see a doctor

• Get emergency help right away for signs of a severe allergic reaction, such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.
• Call your doctor immediately for worsening tremors or uncontrollable movements, depressed mood or thoughts of self-harm, hallucinations or unusual behavior, severe nausea/vomiting, severe or watery diarrhea, unexplained muscle pain or weakness, feeling like you might pass out, signs of fluid in the lungs, or a severe nervous system reaction with stiff muscles, high fever, sweating, confusion, and irregular heartbeat.
• Seek medical advice right away if you notice signs of withdrawal when lowering or stopping the dose, such as fever, confusion, severe muscle stiffness, not caring about things, anxiety, depression, tiredness, trouble sleeping, sweating, or pain.
• Stop the medicine and see your doctor right away if you notice signs of liver injury, such as dark brown urine, pale/clay-colored stools, or yellowing of skin or eyes.
• If you think you're having a medical emergency or symptoms seem life-threatening, call emergency services immediately.

Alternatives

• Crexont
• Opicapone
• Rasagiline
• Safinamide