What is carbidopa, entacapone, and levodopa?
Levodopa is converted to a chemical called dopamine (DOE pa meen) in the brain. Symptoms
of Parkinson's disease may be caused by low levels dopamine in the brain.
Carbidopa helps prevent the breakdown of levodopa before it can reach the brain and take
effect.
When used with carbidopa, entacapone, and levodopa (Atamet, Parcopa, Sinemet),
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 other purposes not listed in this
medication guide.
What should I discuss with my healthcare provider before taking carbidopa, entacapone, and levodopa?
Do not take this medication if you have used an MAO inhibitor such as isocarboxazid
(Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the past 14 days.
You should not take this medication if you are allergic to carbidopa (Lodosyn), entacapone
(Comtan), or levodopa (Larodopa), or if you have:
If you have certain conditions, you may need a dose adjustment or special
tests to safely take this medication. Before you take carbidopa, entacapone, and levodopa, tell your
doctor if you are allergic to any drugs, or if you have:
-
heart disease, high blood pressure, coronary artery disease, a heart
rhythm disorder, or a prior heart attack;
-
asthma, chronic obstructive pulmonary disease (COPD), or
other breathing disorder;
-
liver disease or bile duct obstruction;
-
kidney disease;
-
an endocrine (hormonal) disease;
-
a stomach or intestinal ulcer;
-
glaucoma; or
-
depression or other mental illness.
You may have increased sexual urges, unusual urges to gamble, or other
intense urges while taking carbidopa, entacapone, and levodopa. It is not known whether the medicine
actually causes this effect. Talk with your doctor if you believe you have any intense or unusual urges
while taking carbidopa, entacapone, and levodopa.
Carbidopa, entacapone, and levodopa may cause hallucinations (the sensation of hearing or
seeing something that is not there). Call your doctor if you experience hallucinations.
Some people taking medicines for Parkinson's disease have developed skin cancer
(melanoma). However, people with Parkinson's disease may have a higher risk than most people for
developing melanoma. Talk to your doctor about your specific 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 is harmful to an unborn baby. Before taking this medication, tell your doctor if you are
pregnant or plan to become pregnant during treatment.
Carbidopa, entacapone, and levodopa may pass into breast milk and could harm a nursing
baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take carbidopa, entacapone, and levodopa?
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or
for longer than recommended. Follow the directions on your prescription label.
Take your medicine at regular intervals to keep a steady amount of the drug in your body at all
times.
It may take up to several weeks of using carbidopa, entacapone, and levodopa before your
symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if
your symptoms do not improve after a few weeks of treatment.
Also tell your doctor if the
effects of this medication seem to wear off quickly in between doses.
To be sure this medication is helping your condition and not causing harmful side effects, your
doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.
Do not stop using carbidopa, entacapone, and levodopa without first talking to your doctor.
You may need to use less and less before you stop the medication completely.
This medication can cause you to have unusual results with certain medical tests. Tell any
doctor who treats you that you are using carbidopa, entacapone, and levodopa.
Store carbidopa, entacapone, and levodopa at room temperature away from moisture and
heat.
What happens if I miss a dose of carbidopa, entacapone, and levodopa?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait
until then to take the medicine and skip the missed dose.
Do not
take extra medicine
to make up the missed dose.
Where can I get more information about carbidopa, entacapone, and levodopa?
Your pharmacist has information about carbidopa, entacapone, and levodopa written for health professionals that you may read.
What are the possible side effects of carbidopa, entacapone, and levodopa?
You may notice that your sweat, urine, or saliva appears dark in color, such as red, brown, or
black. This is not a harmful side effect, but it may cause staining of your clothes or bed sheets.
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
-
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;
-
twitching or uncontrollable movements of your eyes, lips,
tongue, face, neck, arms, or legs;
-
tremor (uncontrolled shaking);
-
muscle pain, tenderness, or weakness with fever or flu
symptoms;
-
fast, pounding, or uneven heartbeats;
-
tight feeling in your chest, trouble breathing;
-
easy bruising or bleeding;
-
bloody or tarry stools, coughing up blood;
-
pain or burning when you urinate; or
-
chest pain or heavy feeling, pain spreading to the arm or
shoulder, general ill feeling.
Less serious side effects may include:
-
stomach pain or upset, loss of appetite, constipation;
-
dry mouth, changes in your sense of taste;
-
unusual skin changes;
-
dizziness or drowsiness;
-
headache, blurred vision;
-
sleep problems (insomnia), strange dreams;
-
agitation or anxiety;
-
muscle cramps, back pain; or
-
mild skin rash or itching.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about carbidopa, entacapone, and levodopa?
Do not take this medication if you have used an MAO inhibitor such as isocarboxazid
(Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the past 14 days.
You should not take this medication 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.
Tell your doctor about all of your medical conditions, especially heart disease, high blood
pressure, asthma or other breathing problems, liver or kidney disease, a hormonal disease, an ulcer,
glaucoma, or mental illness. Also tell your doctor about all the medications you use.
It may take up to several weeks of using carbidopa, entacapone, and levodopa before your
symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if
your symptoms do not improve after a few weeks of treatment.
Also tell your doctor if the
effects of this medication seem to wear off quickly in between doses.
You may have increased sexual urges, unusual urges to gamble, or other intense urges while
taking this medication. Talk with your doctor if you believe you have any intense or unusual urges while
taking carbidopa, entacapone, and levodopa.
Do not stop using carbidopa, entacapone, and levodopa without first talking to your doctor.
What should I avoid while taking carbidopa, entacapone, and levodopa?
Avoid taking iron supplements or eating a diet that is high in protein (protein sources include
meat, eggs, and cheese). These things can make it harder for your body to digest and absorb
carbidopa, entacapone, and levodopa. Talk with your doctor or nutrition counselor about the best
foods to eat while you are taking this medication.
Carbidopa, entacapone, and levodopa can cause side effects that may impair your thinking
or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly
and steady yourself to prevent a fall.
What other drugs will affect carbidopa, entacapone, and levodopa?
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and
medicine for seizures, depression or anxiety can add to sleepiness caused by carbidopa, entacapone,
and levodopa. Tell your doctor if you regularly use any of these other medicines, or any other
Parkinson's medications..
Before taking carbidopa, entacapone, and levodopa, tell your doctor if you are taking any of
the following medicines:
-
apomorphine (Apokyn);
-
bitolterol (Tornalate);
-
cholestyramine (Prevalite, Questran);
-
dobutamine (Dobutrex);
-
epinephrine (Epi-Pen, and others);
-
isoetharine (Bronkosol, Bronkometer);
-
isoniazid (for treating tuberculosis);
-
isoproterenol (Isuprel, Medihaler-Iso);
-
methyldopa (Aldomet);
-
metoclopramide (Reglan);
-
papaverine (Pavabid, Papacon, Pavagen, Pavacot);
-
phenytoin (Dilantin);
-
probenecid (Benemid); or
-
an antibiotic such as ampicillin, chloramphenicol,
erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, and others), or rifampin (Rifadin, Rifater,
Rifamate).
-
blood pressure medication;
-
an antidepressant such as amitriptyline (Elavil, Etrafon),
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 there may be other drugs that can interact with
carbidopa, entacapone, and levodopa. Tell your doctor about all your prescription and
over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other
doctors. Do not start a new medication without telling your doctor.
What happens if I have an overdose of carbidopa, entacapone, and levodopa?
