Side Effects of Carbidopa-Levodopa-Entacapone

Diarrhea, nausea, and involuntary body movements are some of the most common side effects of carbidopa-levodopa-entacapone. Side effects are often minor, but many people will begin to experience significant and sometimes intolerable side effects over time. Potentially serious carbidopa-levodopa-entacapone side effects that should be reported to your healthcare provider right away include intestinal ulcers, fainting, and heart attack.

An Introduction to Side Effects of Carbidopa-Levodopa-Entacapone

As with any medicine, side effects are possible with carbidopa-levodopa-entacapone (Stalevo®). If side effects do occur, they are often minor and either require no treatment or can be easily treated by you or your healthcare provider. However, as with any levodopa therapy, many people will begin to experience significant and sometimes intolerable side effects of carbidopa-levodopa-entacapone over time.
 
(This article covers many, but not all, of the possible side effects with carbidopa-levodopa-entacapone. Your healthcare provider can discuss a more complete list of carbidopa-levodopa-entacapone side effects with you.)
 

Serious Side Effects of Carbidopa-Levodopa-Entacapone

Some side effects with carbidopa-levodopa-entacapone are potentially serious and should be reported immediately to your healthcare provider. Although most of these serious side effects are rare, a few may be common. Many of these side effects have occurred with carbidopa-levodopa products, which have been available for a long time, and are expected to also be a problem with carbidopa-levodopa-entacapone, which contains carbidopa-levodopa in combination with entacapone. These serious side effects of carbidopa-levodopa-entacapone (or of carbidopa-levodopa alone) include but are not limited to:
 
  • Severe diarrhea
  • Severe muscle pain
  • Psychiatric problems, such as:
 
    • Hallucinations
    • Delusions
    • Paranoia
    • Agitation
    • Anxiety
    • Depression
    • Suicidal thoughts or behaviors
 
  • Low blood pressure (hypotension) or high blood pressure (hypertension)
  • Fainting
  • Bleeding in the digestive tract
  • Intestinal ulcers (known as duodenal ulcers)
  • Low white blood cell, red blood cell, or blood platelet counts
  • Seizures
  • Heart attack
  • Intense, unusual urges, such as urges to gamble or engage in risky sexual activity
  • Malignant melanoma (a type of skin cancer)
  • A painful penile erection that does not go away (known as priapism)
  • Falling or balance problems
  • Symptoms of neuroleptic malignant syndrome (NMS), which may occur if carbidopa-levodopa-entacapone is stopped too abruptly, such as:
 
    • A high fever
    • Stiff muscles
    • Confusion
    • Irregular pulse or blood pressure
    • A fast heart rate (tachycardia)
    • Sweating
    • Irregular heart rhythms (arrhythmias)
 
  • Signs of an allergic reaction, such as:
 
    • An unexplained rash
    • Hives
    • Itching
    • Swelling of the mouth or throat
    • Wheezing
    • Difficulty breathing.
 

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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