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Stalevo 50

Stalevo 50 is a combination medication containing levodopa, carbidopa, and entacapone. It is used to treat Parkinson’s disease, a progressive neurological disorder that affects movement. Levodopa is converted to dopamine in the brain, which helps improve muscle control and movement. Carbidopa prevents levodopa from breaking down before it reaches the brain, and entacapone prolongs the effects of levodopa by inhibiting an enzyme called COMT (catechol-O-methyltransferase). Together, these components help manage the motor symptoms of Parkinson’s disease, such as tremors, stiffness, and slowness of movement.

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Frequently Asked Questions

How long does it take for Stalevo 50 to start working?
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Stalevo 50 typically begins working within 30 to 60 minutes after taking a dose, but the exact time may vary depending on individual response.

Can I stop taking Stalevo 50 if I feel better?
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No, do not stop taking Stalevo 50 abruptly. Stopping suddenly can lead to serious side effects like neuroleptic malignant syndrome (NMS). Always consult your doctor before adjusting or stopping your medication.

What should I do if I miss a dose of Stalevo 50?
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If you miss a dose, take it as soon as you remember. However, if it is close to your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Does Stalevo 50 interact with food?
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Stalevo 50 can be taken with or without food, but it’s often recommended to take it with food to reduce nausea. Avoid high-protein meals, as they can affect the absorption of levodopa.

Can I take Stalevo 50 with other Parkinson’s medications?
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Yes, Stalevo 50 is often used in combination with other medications, such as dopamine agonists or MAO-B inhibitors, but always follow your doctor’s instructions to avoid drug interactions.

Comprehensive Drug Guide

How Does Stalevo 50 Work?

  • Levodopa: A precursor to dopamine, which crosses the blood-brain barrier and is converted to dopamine, helping to alleviate motor symptoms of Parkinson’s disease.
  • Carbidopa: Prevents the breakdown of levodopa in the bloodstream, ensuring more of it reaches the brain.
  • Entacapone: Inhibits the COMT enzyme, which breaks down levodopa, prolonging its availability and effects.

This combination helps to increase and maintain dopamine levels in the brain, improving motor function and reducing Parkinson’s symptoms.

Common Dosages

  • 50 mg of levodopa
  • 12.5 mg of carbidopa
  • 200 mg of entacapone

Typical Dosing

  • Stalevo 50 is usually taken up to 8 times daily, depending on the patient's needs and response to treatment. The dosing schedule will vary based on individual patient symptoms and the stage of Parkinson’s disease.
  • The medication is typically taken with or immediately after food to minimize gastrointestinal side effects.

Typical Dosing

FDA Approved Indications

  • Parkinson’s disease in patients experiencing "wearing-off" symptoms when levodopa’s effectiveness fades between doses.

Who Shouldn't Take Stalevo 50?

  • Narrow-angle glaucoma
  • Severe liver disease
  • Hypersensitivity to levodopa, carbidopa, entacapone, or any other components of the medication.
  • History of neuroleptic malignant syndrome (NMS) or rhabdomyolysis.

Advice From The Pharmacist

  • Take Stalevo 50 as prescribed, preferably with food to help prevent nausea.
  • Do not suddenly stop taking Stalevo 50, as this can lead to serious withdrawal symptoms, including neuroleptic malignant syndrome (NMS).
  • If you notice the return of symptoms (wearing-off effect) before your next dose, discuss this with your doctor to adjust your medication schedule.
  • Some patients may experience a change in the color of body fluids (such as urine, saliva, or sweat), which is harmless but may stain clothing.

Side Effects of Stalevo 50

Common Side Effects

  • Nausea
  • Dizziness or lightheadedness
  • Diarrhea
  • Fatigue
  • Dark-colored urine or saliva

Uncommon/Severe Side Effects

  • Neuroleptic malignant syndrome (NMS): Symptoms include high fever, muscle rigidity, and confusion.
  • Dyskinesia: Uncontrolled, involuntary movements.
  • Hallucinations or confusion, particularly in elderly patients.

Risks and Warnings of Stalevo 50

  • Neuroleptic Malignant Syndrome (NMS): Sudden discontinuation of Stalevo 50 can result in NMS, a life-threatening condition. Patients should taper the dose gradually under medical supervision.
  • Compulsive Behaviors: Stalevo has been associated with increased risk of compulsive behaviors, such as gambling or excessive eating. Report any changes in behavior to your healthcare provider.
  • Dyskinesia: Prolonged use of Stalevo 50 may cause or worsen involuntary movements, particularly in patients who have been on long-term levodopa therapy.

Interactions with Stalevo 50

Common Drug Interactions

  • Monoamine oxidase inhibitors (MAOIs): Using Stalevo 50 with MAO inhibitors (such as phenelzine) can lead to dangerously high blood pressure.
  • Antihypertensive medications: Stalevo 50 can enhance the effects of blood pressure-lowering medications, potentially causing low blood pressure and dizziness.
  • Iron supplements: Iron can reduce the absorption of Stalevo 50, so it is recommended to space out doses of iron supplements by at least 2 hours.

Alternatives to Stalevo 50

  • Sinemet (levodopa/carbidopa): A similar medication used for Parkinson’s disease without the COMT inhibitor entacapone.
  • Comtan (entacapone): Used in combination with levodopa/carbidopa for managing Parkinson’s disease.
  • Rytary: An extended-release formulation of levodopa/carbidopa that offers smoother symptom control.
  • Requip (ropinirole): A dopamine agonist that can be used as monotherapy or in combination with other Parkinson’s medications.