Your healthcare provider will consider several factors before recommending a carbidopa-levodopa-entacapone dosage, including your current dose of the medication and whether you are taking entacapone. The maximum daily dose for most of the strengths is eight tablets per day. Dosing for the 200 strength should not exceed six tablets per day.
The dose of carbidopa-levodopa-entacapone (Stalevo®) your healthcare provider recommends will vary, depending on a number of factors, including:
- Your current carbidopa-levodopa (Sinemet®) dose
- Whether you currently take entacapone (Comtan®)
- How you respond to carbidopa-levodopa-entacapone (especially if you develop bothersome side effects)
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
Carbidopa-levodopa-entacapone tablets are available in the following strengths:
- Carbidopa-levodopa-entacapone 50 (12.5 mg of carbidopa, 50 mg of levodopa, and 200 mg of entacapone)
- Carbidopa-levodopa-entacapone 75 (18.75 mg of carbidopa, 75 mg of levodopa, and 200 mg of entacapone)
- Carbidopa-levodopa-entacapone 100 (25 mg of carbidopa, 100 mg of levodopa, and 200 mg of entacapone)
- Carbidopa-levodopa-entacapone 125 (31.25 mg of carbidopa, 125 mg of levodopa, and 200 mg of entacapone)
- Carbidopa-levodopa-entacapone 150 (37.5 mg of carbidopa, 150 mg of levodopa, and 200 mg of entacapone)
- Carbidopa-levodopa-entacapone 200 (50 mg of carbidopa, 200 mg of levodopa, and 200 mg of entacapone).
Notice that all the strengths contain the same amount of entacapone. For this reason, it is recommended that each dose of carbidopa-levodopa-entacapone consist of just one tablet (not multiple tablets or half tablets), so as to not disrupt the dose of entacapone. The maximum daily dose for carbidopa-levodopa-entacapone 50, 100, or 150 tablets is eight tablets per day, since the maximum dose of entacapone is 1600 mg per day. The maximum daily dose for carbidopa-levodopa-entacapone 200 is six tablets per day, since the maximum dose of carbidopa is 300 mg per day.
Most people need at least 70 to 100 mg of carbidopa a day in order to avoid severe nausea and vomiting due to the levodopa component of carbidopa-levodopa-entacapone. Doses that provide less than 70 mg of carbidopa per day are likely to cause nausea and vomiting.
Do not stop taking carbidopa-levodopa-entacapone suddenly, as a serious group of side effects, known as neuroleptic malignant syndrome (NMS) may occur. Symptoms of NMS include:
- A high fever
- Stiff muscles
- Irregular pulse or blood pressure
- A fast heart rate (tachycardia)
- Irregular heart rhythms (arrhythmias).
Your starting carbidopa-levodopa-entacapone dose will depend on whether you currently take just carbidopa-levodopa or whether you also currently take entacapone.