STALEVO 200 Rx
Generic Name and Formulations:
Carbidopa 50mg, levodopa 200mg, entacapone 200mg; tabs.
Novartis Pharmaceuticals Corp
Indications for STALEVO 200:
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.
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 literature. Avoid abrupt cessation.
During or within 2 weeks of nonselective MAOIs (eg, phenelzine). Narrow-angle glaucoma. Undiagnosed skin lesions. History of melanoma.
Severe cardiovascular or pulmonary disease. Asthma. Dyskinesias. Renal, hepatic, or endocrine disorders. Biliary obstruction. Orthostatic hypotension. History of peptic ulcer or MI with residual arrhythmias. Suicidal tendencies. Psychosis. Chronic wide-angle glaucoma. Monitor cardiovascular, hematopoietic, renal and hepatic function, IOP. May stain body fluids. Elderly (>75yrs). Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Orthostatic hypotension with selegiline, antihypertensives. Antagonized by isoniazid, dopamine D2 receptor antagonists (eg, phenothiazines, butyrophenones, risperidone), phenytoin, papaverine; possibly iron, high protein diets, excessive gastric acidity. Hypertension, dyskinesias with tricyclics. Metoclopramide. 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).
Dopa-decarboxylase inhibitor + dopamine precursor + COMT inhibitor.
Dyskinesias, GI upset (esp. diarrhea), CNS disturbances (eg, hallucinations, confusion, depression, psychosis, dizziness, headache, abnormal dreams, insomnia, somnolence), hypo- or hypertension, syncope, dyspnea, on-off phenomena, blepharospasm (may indicate excess dose), urine discoloration, lab abnormalities, rhabdomyolysis, neuroleptic malignant syndrome, hyperpyrexia and confusion upon withdrawal.
Tabs 50, 100, 150—100, 250; 75, 125, 200—100
Endocrinology Advisor Articles
- Soluble Klotho Levels Predictive of Kidney Failure in Type 2 Diabetes
- HbA1c Levels Predictive of Liraglutide Treatment Response in T2D
- Clinicians May Be Overtreating Older Patients With Diabetes
- Comorbid and Pharmacologic Factors Increase Risk for Gastrointestinal Disorders in Diabetes
- Obesity Risk in Infants Born to Women With Diabetes
- Diabetes May Decrease Ability to Feel Acid Regurgitation
- Autism Does Not Affect Metabolic Control in Type 1 Diabetes
- Hormonal Contraceptives May Adversely Affect Psychological Health in Adolescent Girls
- Obesity Can Negatively Effect Liver in Children as Young as 8
- Recommendations Developed on Gender Equity in Medicine