STALEVO 200 Rx
Generic Name and Formulations:
Carbidopa 50mg, levodopa 200mg, entacapone 200mg; tabs.
Novartis Pharmaceuticals Corp
Indications for STALEVO 200:
In idiopathic Parkinson's disease: to substitute for equivalent doses of previously-administered carbidopa/ levodopa and entacapone; and to replace immediate-release carbidopa and levodopa in patients with end-of-dose "wearing-off" symptoms who are taking levodopa up to 600mg/day without having dyskinesias.
Swallow whole; max one tablet per dosing interval. Previously on carbidopa/levodopa and entacapone: substitute on a mg/mg basis. Stalevo 50, 75, 100, 125, 150: max 8 tabs/day; Stalevo 200: max 6 tabs/day. Others: individualize; see literature. Avoid abrupt cessation.
During or within 2 weeks of nonselective MAOIs (eg, phenelzine). Narrow-angle glaucoma. Undiagnosed skin lesions. History of melanoma.
Severe cardiovascular or pulmonary disease. Asthma. Dyskinesias. Renal, hepatic, or endocrine disorders. Biliary obstruction. Orthostatic hypotension. History of peptic ulcer or MI with residual arrhythmias. Suicidal tendencies. Psychosis. Chronic wide-angle glaucoma. Monitor cardiovascular, hematopoietic, renal and hepatic function, IOP. May stain body fluids. Elderly (>75yrs). Pregnancy (Cat.C). Nursing mothers.
Dopa-decarboxylase inhibitor + dopamine precursor + COMT inhibitor.
See Contraindications. Orthostatic hypotension with selegiline, antihypertensives. Antagonized by isoniazid, dopamine D2 receptor antagonists (eg, phenothiazines, butyrophenones, risperidone), phenytoin, papaverine; possibly iron, high protein diets, excessive gastric acidity. Hypertension, dyskinesias with tricyclics. Metoclopramide. May cause false (+) urinary ketone test or false (–) urinary glucose (glucose oxidase) test. Potentiates CNS depression with alcohol, other CNS depressants. Chelates iron. Cardiac effects with drugs metabolized by COMT (eg, epinephrine, isoproterenol, dopamine, dobutamine, methyldopa, apomorphine, bitolterol). Caution with drugs that interfere with biliary excretion, glucuronidation, or intestinal beta-glucuronidase (eg, probenecid, cholestyramine, erythromycin, rifampicin, ampicillin, chloramphenicol).
Dyskinesias, GI upset (esp. diarrhea), CNS disturbances (eg, hallucinations, confusion, depression, psychosis, dizziness, headache, abnormal dreams, insomnia, somnolence), hypo- or hypertension, syncope, dyspnea, on-off phenomena, blepharospasm (may indicate excess dose), urine discoloration, lab abnormalities, rhabdomyolysis, neuroleptic malignant syndrome, hyperpyrexia and confusion upon withdrawal.
Tabs 50, 100, 150—100, 250; 75, 125, 200—100
Clinical Pain Advisor Articles
- FDA Takes Steps to Reconcile Needs of Patients With Chronic Pain, Efforts to Curb Opioid Epidemic
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- Stat Consult: Chronic Low Back Pain
- Opioid Misuse May Help Predict Alcohol Dependence Treatment Outcomes
- Neuropathic Symptoms Worsen Quality of Life, Function in Hip, Knee Osteoarthritis
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- Switching From Buprenorphine-Naltrexone to XR-Naltrexone as Effective as XR-Naltrexone
- History of Migraine May Be Associated With Higher Risk for Cochlear Disorders
- Symptom Severity, Sensory Sensitivity May Indicate Pain Centralization in Chronic Overlapping Pain Conditions
- Human Diagnosis Project Aims to Address Challenges Among Uninsured
- Healthcare Technology Affects Younger Patient Satisfaction
- FDA Announces New Drug Shortages Task Force