What Is Carbidopa-Levodopa-Entacapone Used For?

Carbidopa-levodopa-entacapone is used for replacing carbidopa-levodopa tablets and entacapone tablets in people who are already taking these medications for Parkinson's disease. It can also be used as a replacement for carbidopa-levodopa in people experiencing "wearing-off" symptoms who take 600 mg or less of levodopa who are not experiencing dyskinesia. At this time, there are no carbidopa-levodopa-entacapone uses approved for children.

 

What Is Carbidopa-Levodopa-Entacapone Used For? -- An Overview

Carbidopa-levodopa-entacapone (Stalevo®) is a prescription medication used to treat Parkinson's disease. It is approved for use in the following situations:
 
  • As a replacement for carbidopa-levodopa in people experiencing "wearing-off" symptoms (when the medication stops working before the next dose) who take 600 mg of levodopa per day or less and who are not experiencing dyskinesia (a movement disorder that is a side effect of carbidopa-levodopa).
     
  • As a substitute for carbidopa-levodopa (Sinemet®) tablets and entacapone (Comtan®) tablets in people already taking these medications.
     
Parkinson's disease is a progressive neurological disorder that results from the loss of neurons in a region of the brain that controls movement. This creates a shortage of the brain-signaling chemical (neurotransmitter) known as dopamine, causing the movement problems characteristic of Parkinson's disease. The exact cause of Parkinson's disease is not currently known.
 
Although early symptoms of Parkinson's disease may be subtle, people will eventually develop a characteristic tremor (trembling or shaking) of a limb, especially when the body is at rest. As the disease progresses, symptoms may worsen and new ones may appear.
 
Depending on the severity of a person's symptoms, Parkinson's disease treatment can include:
 
Although carbidopa-levodopa (Sinemet) is an effective Parkinson's medication, its usefulness is often limited to about a few years, when it may begin to lose its effectiveness and cause intolerable side effects. It is not clear at this time why this might occur; some people think it is simply a manifestation of the worsening of the disease that normally happens over time. Replacing carbidopa-levodopa with carbidopa-levodopa-entacapone has been shown to decrease the "off" times (when the medication does not work well) and increase the "on" times (when the medication works well).
 
If you currently take carbidopa-levodopa without entacapone and experience problems with dyskinesia or take a levodopa dosage higher than 600 mg per day, carbidopa-levodopa-entacapone is not recommended for you. Instead, your healthcare provider should add entacapone separately and adjust your dose of the medications separately until the right dose is found for you. Then, you may switch to carbidopa-levodopa-entacapone if desired. This extra step is necessary because people taking high doses of levodopa or people experiencing dyskinesia are likely to need adjustment of their carbidopa-levodopa dose when entacapone is added.
 
(What Is Carbidopa-Levodopa-Entacapone Used For? Continued: Page 2)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;