CARBIDOPA, ENTACAPONE, AND LEVODOPA

(KAR bi DOE pa, en TAK a pone, LEE voe DOE pa) Brand: Stalevo 100, Stalevo 125, Stalevo 150, Stalevo 200, Stalevo 50, Stalevo 75

What is the most significant information I must know about carbidopa, entacapone, and levodopa?

• You must not use this medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the recent 14 days.

• You must not take this medicine if you are allergic to carbidopa (Lodosyn), entacapone (Comtan), or levodopa (Larodopa), or if you have narrow-angle glaucoma, unusual skin lesions, or a history of skin cancer.

• Speak your doctor about all of your medical conditions, especially heart malady, tall blood pressure, asthma or another breathing problems, liver or kidney malady, a hormonal malady, an ulcer, glaucoma, or mental diseases. Also speak your doctor about all the medications you use.

• It may take up to different weeks of using carbidopa, entacapone, and levodopa till your symptoms improve. Conversation with your doctor if your symptoms do not improve or if the effects of this medicine seem to wear off quickly in between doses.

• Do not stop using carbidopa, entacapone, and levodopa without first talking to your doctor.

What is carbidopa, entacapone, and levodopa?

• Levodopa is converted to a chemical called dopamine (DOE pa meen) in the brain. Symptoms of Parkinson's malady may be caused by low levels of dopamine in the brain. Carbidopa helps prevent the breakdown of levodopa till it can reach the brain and take effect. Entacapone increases levels of levodopa in the body.

• The combination of carbidopa, entacapone, and levodopa is used to treat Parkinson symptoms such as muscle stiffness, tremors, spasms, and poor muscle control.

• Carbidopa, entacapone, and levodopa may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking carbidopa, entacapone, and levodopa?

• Do not take this medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the recent 14 days.

• You must not take this medicine if you are allergic to carbidopa (Lodosyn), entacapone (Comtan), or levodopa (Larodopa), or if you have:

· narrow-angle glaucoma;

· unusual skin lesions that have not been checked by a doctor; or

· a history of malignant melanoma (skin cancer).

• To create certain you can safely take this medicine, speak your doctor if you have any of these another conditions:

· heart malady, tall blood pressure, coronary artery malady, a heart rhythm mess, or a prior heart attack;

· asthma, chronic obstructive pulmonary malady (COPD), or another breathing disorder;

· kidney malady, liver malady, or bile duct obstruction;

· an endocrine (hormonal) disease;

· a stomach or intestinal ulcer;

· glaucoma; or

· depression or another mental illness.

• You may have heighten sexual urges, unusual urges to gamble, or another intense urges while taking this medicine. Conversation with your doctor if you believe you have any intense or unusual urges while taking this medicine.

• Carbidopa, entacapone, and levodopa may reason hallucinations (the sensation of hearing or seeing something that is not there). Call your doctor if you experience hallucinations.

• Some people taking Parkinson's malady medications have developed skin cancer (melanoma). However, people with Parkinson's malady may have a higher risk of melanoma. Conversation to your doctor about this risk and what skin symptoms to watch for. You may need to have regular skin exams.

• FDA pregnancy category C. It is not known whether carbidopa, entacapone, and levodopa will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant while using this medication.

• Carbidopa, entacapone, and levodopa may pass into breast milk and could harm a nursing child. You must not breast-feed while you are taking carbidopa, entacapone, and levodopa.

How must I take carbidopa, entacapone, and levodopa?

• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label. Take your medication at regular intervals to hold a steady amount of the drug in your body at all times.

• Drink plenty of liquids while you are taking this medication.

• It may take up to different weeks till your symptoms improve. Hold using the medicine as directed and speak your doctor if your symptoms do not improve after a little weeks of treatment. Also speak your doctor if the effects of this medicine seem to wear off quickly in between doses.

• Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than normal. You can easily become dehydrated while taking this medicine, which can lead to severely low blood pressure or a serious electrolyte imbalance.

• Do not stop using carbidopa, entacapone, and levodopa without first talking to your doctor. You may need to use smaller and smaller till you stop the medicine completely.

• This medicine can reason unusual results with determined medical trials. Speak any doctor who treats you that you are using carbidopa, entacapone, and levodopa.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include weakness, loss of coordination, trouble breathing, fainting, or seizure (convulsions).

What must I avoid while taking carbidopa, entacapone, and levodopa?

• Carbidopa, entacapone, and levodopa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too quick from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

• Avoid taking iron supplements or eating a diet that is tall in protein (protein sources include meat, eggs, and cheese). These things can create it harder for your body to digest and absorb carbidopa, entacapone, and levodopa.

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What are the possible side effects of carbidopa, entacapone, and levodopa?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have a serious side effect such as:

· nausea, sweating, feeling like you might pass out (especially when you first start taking this medication);

· depression, confusion, hallucinations, unusual thoughts or behavior, thoughts about hurting yourself;

· worsening symptoms such as tremors, twitching or uncontrollable movements of your eyes, lips, tongue, person, arms, or legs;

· severe or ongoing diarrhea, extreme thirst, heighten urination, weight loss, leg discomfort, muscle weakness or limp feeling, uneven heart rate;

· feeling very thirsty or hot, being unable to urinate, hard sweating, or hot and dry skin;

· quick, pounding, or uneven heartbeats;

· chest pain or hard feeling, pain spreading to the hand or shoulder, common ill feeling;

· tight feeling in your chest, new or worsening cough, fever, trouble breathing;

· light bruising or bleeding, bloody or tarry stools, coughing up blood;

· pain or burning when you urinate; or

· unexplained muscle pain, tenderness, or weakness.

• Smaller serious side effects may include:

· stomach pain or upset, loss of appetite, constipation;

· dry mouth, changes in your sense of taste;

· unusual skin changes. mild rash or itching;

· dizziness or drowsiness, headache, blurred vision;

· muscle cramps, back pain; or

· agitation or anxiety, sleep problems (insomnia), strange dreams.

• You may announcement that your sweat, urine, or saliva appears dark in color, such as red, brown, or black. This is not a deleterious side effect, but it may reason staining of your clothes or bed sheets.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect carbidopa, entacapone, and levodopa?

• Cool or allergy medication, narcotic pain medication, sleeping pills, muscle relaxers, and medication for seizures, depression or anxiety can add to sleepiness caused by carbidopa, entacapone, and levodopa. Speak your doctor if you regularly use any of these another medicines, or any another Parkinson's medications.

• Speak your doctor about all another medicines you use, especially:

· apomorphine (Apokyn);

· cholestyramine (Prevalite, Questran);

· dobutamine (Dobutrex);

· epinephrine (Epi-Pen, and others);

· isoniazid (for treating tuberculosis);

· isoproterenol (Isuprel, Medihaler-Iso);

· methyldopa (Aldomet);

· metoclopramide (Reglan);

· papaverine (Pavabid, Papacon, Pavagen, Pavacot);

· phenytoin (Dilantin);

· probenecid (Benemid);

· blood pressure medication;

· an antibiotic such as ampicillin, chloramphenicol, erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole, and others), or rifampin (Rifadin, Rifater, Rifamate);

· an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), and others; or

· medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), prochlorperazine (Compazine), risperidone (Risperdal), and others.

• This list is not complete and another drugs may interact with carbidopa, entacapone, and levodopa. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about carbidopa, entacapone, and levodopa.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

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