What is Carbidopa, levodopa, entacapone used for :
This medication consists of three active ingredients; carbidopa, levodopa and entacapone all in one tablet. It is used for the treatment of Parkinson’s disease. Parkinson’s disease is triggered by decreased levels of dopamine in the brain. Levodopa acts by increasing the amount of dopamine, whereas carbidopa and entacapone act by enhancing the effects of levodopa against Parkinson disease. It is usually used for the following cases of Parkinson disease:
• To replace immediate-release carbidopa/levodopa and entacapone that you were previously taking in separate tablets by substituting your tablets with one tablet equivalent strength of each of the three components.
• To substitute immediate-release carbidopa/levodopa therapy (without entacapone) that you were previously taking when you start feeling that your medication is not as effective as when you started it. This applies only if your dose of levodopa did not exceed 600 mg per day and you were not experiencing dyskinesias (abnormality or impairment of voluntary movement).
Do not take Carbidopa, levodopa, entacapone :
• If you are allergic to Carbidopa, levodopa, entacapone, or any of the ingredients in this medicine. Tell your doctor about the allergy and what signs you had.
• If you are taking nonselective monoamine oxidase (MAO) inhibitors (used to treat depression). These medications must be discontinued at least two weeks before initiating therapy with this one.
• If you have narrow-angle glaucoma (increased eye pressure).
• If you have suspicious, undiagnosed skin lesions or a history of melanoma (type of skin cancer).
Warnings and Precautions :
• Talk to your doctor or pharmacist if you develop allergic reactions such as shortness of breath, skin rash, swelling of the face or neck, decreased blood pressure and dizziness.
• Talk to you doctor if you experience central nervous system effects, like, dyskinesia (involuntary movements), mental disturbances, depression, suicidal thoughts.
• Talk to your doctor if you previously had or currently have psychoses (seeing, hearing, or believing things that aren't real).
• Talk to you doctor if you have heart, kidney, liver or lung problems. Follow up tests and exams may be needed depending on your case.
• Talk to you doctor if you have asthma (a respiratory problem that affects the airways and causes episodes of wheezing, cough and shortness of breath) or endocrine (hormonal) diseases.
• Talk to you doctor if you previously had or currently have a peptic ulcer (a sore that forms in your stomach, esophagus or intestine).
Possible side effects of Carbidopa, levodopa, entacapone :
Possible side effects of Carbidopa, levodopa, entacapone include allergic reaction, hallucinations, psychosis, confusion, agitation, dizziness, somnolence, dream abnormalities including nightmares, difficulty sleeping, headache, memory loss, nervousness, disorientation, memory impairment, increased sexual desire, convulsions, depression, violent jerking of muscles, very rigid muscles, tremors, changes in your blood pressure, intense urges to gamble, increased sexual urges, and other intense urges, chest pain, palpitations, syncope, irregular heart rhythms, increased urinary frequency, painful or difficult urination, occasional, dark colored (red, brown, or black) saliva, urine, or sweat, nausea, increase in dyskinesia (abnormality or impairment of voluntary movement), vomiting, diarrhea, abdominal pain, constipation, flatulence, hiccups, indigestion, dry mouth, changes in taste, back, shoulder and leg pain, gait changes, difficulty breathing, cough, throat pain, respiratory tract infections, hot flashes, increased sweating, hair loss, alterations in your laboratory tests results, weight gain or loss, edema, numbness and tingling in peripheries, skin cancer, double or blurred vision, priapism (prolonged erection of the penis) and fatigue.
Other medicines and Carbidopa, levodopa, entacapone :
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications.
• If you are taking medications for hypertension (used for high blood pressure).
• If you are taking IMAO inhibitors (used for depression).
• If you are taking Tricyclic antidepressants (used for depression).
• If you are taking Dopamine D2 receptor antagonists like, phenothiazines (used for nausea and vomiting), risperidone (used for psychosis).
• If you are taking isoniazid (used for tuberculosis).
• If you are taking phenytoin (used for convulsions).
• If you are taking papaverine (used to improve blood flow).
• If you are taking iron salts.
• If you are taking metoclopramide (used for nausea and vomiting).
• If you are taking antibiotics, like, erythromycin, rifampicin, ampicillin and chloramphenicol.
• If you are taking probenecid (used for gout).
• If you are taking cholestyramine (used for high blood cholesterol).
How to take Carbidopa, levodopa, entacapone :
The recommended daily dose is individualized and specified by careful titration for each patient depending on how you respond on the medication. Make sure to strictly follow your doctor’s directions. The maximum recommended daily dose of carbidopa 12.5 mg, levodopa 50 mg, entacapone 200 mg tablets, carbidopa 18.75 mg, levodopa 75 mg, entacapone 200 mg tablets, carbidopa 25 mg, levodopa 100 mg, entacapone 200 mg tablets, carbidopa 31.25 mg, levodopa 125 mg, entacapone 200 mg tablets, and carbidopa 37.5 mg, levodopa 150 mg, entacapone 200 mg tablets is eight tablets per day. The maximum recommended daily dose of carbidopa 50 mg, levodopa 200 mg, entacapone 200 mg tablets is six tablets per day.
• Do not divide the tablet into multiple doses
• Take only one tablet at each dose
• The medication may be taken with or without food. Try not to take it with, or shortly after eating protein-rich food (such as meats, fish, dairy products, seeds and nuts).
• Take tablet with a full glass of water.
• This medication is expected to start releasing the ingredients within 30 minutes after taking it. Take at the same time every day.
• Do not take for more or less than prescribed by your doctor.
• Do not add any other Parkinson medications without first consulting your doctor.
• Make sure to tell your doctor if you feel that the medication has started to lose its effectiveness.
How to store Carbidopa, levodopa, entacapone :
• Store at 15 to 30°C
• Keep out of the reach of children and pets
• Do not use beyond the expiry date mentioned on the box
• Keep medication in its original pack to protect it from moisture and light
• Do not use damaged pills
• Do not dispose medication in the wastewater or household waste