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Stalevo is a combination antiparkinsonian drug, with the main ingredients being levodopa, carbidopa and entacapone. To know more about the benefits, uses and precautions when using the drug, please refer to the article below.1. What is Stalevo?
Stalevo is a prescription medication that contains Levodopa, Carbidopa and Entacapone as the main ingredients. Stalevo is available in the form of film-coated tablets. This drug is used to treat patients with Parkinson's disease and motor fluctuations that are not stabilized on monotherapy with levodopa or a dopa decarboxylase inhibitor.The symptoms of Parkinson's disease have been found to be related to a decrease in dopamine in the striatum of the brain. Dopamine is not able to cross the blood-brain barrier. Levodopa is a precursor of dopamine, which can cross the blood-brain barrier and relieve symptoms of the disease. Because levodopa is extensively metabolized peripherally when administered, only a small fraction of a given dose reaches the CNS when levodopa is administered without an ACE inhibitor.
Carbidopa are peripheral dopa decarboxylase (DDC) inhibitors that reduce the peripheral conversion of levodopa to dopamine, resulting in increased levodopa availability to the brain. When levodopa reduction is reduced by concomitant administration of DDCs, lower doses of levodopa can be used and help reduce the incidence of adverse drug reactions.
In combination with the decarboxylase inhibitor by a DDC inhibitor, catechol-O-methyl transferase (COMT) again becomes the major peripheral metabolic pathway that catalyses the conversion of levodopa to 3-O- methyldopa (3-OMD), which is a potentially harmful metabolite of levodopa. In addition, Entacapone is a reversible COMT inhibitor with predominantly peripheral effects. Administration of Entacapone helps to slow the clearance of levodopa from the blood and helps the clinical response to each enhanced and prolonged dose of levodopa.
The combination of the above 3 ingredients increases the therapeutic effect of the drug and reduces the risk of unwanted effects.
2. Uses of Stalevo
Stalevo is indicated for use in the following patients:All forms of Parkinson's syndrome (except cases caused by drug-induced extrapyramidal syndromes). Idiopathic Parkinson's disease, following encephalitis; Parkinson's syndrome due to hardening of the cerebral arteries. Parkinson's after central nervous system damage due to carbon monooxide or manganese intoxication. Stalevo is contraindicated in the following cases:
Hypersensitivity to the main active ingredients of the drug or to any of the excipients of the drug. Severe liver failure. Narrow angle glaucoma; Pheochromocytoma. Do not use concomitantly with a non-selective monoamine oxidase inhibitor (MAO-A and MAO-B). If used, these inhibitors must be discontinued at least 2 weeks before starting treatment with Stalevo. History of neuroleptic malignant syndrome or non-traumatic rhabdomyolysis.
3. Dosage and usage of Stalevo
Usage: The drug is taken orally. The drug can be taken with or without food, should be taken with food to reduce stomach irritation. This tablet should be swallowed whole with a full glass of water.Dosage: The patient's optimal daily dose must be determined by performing careful titration of levodopa in each patient.
Only 1 Stalevo tablet should be used per dose. The dose should be titrated to the patient. The maximum total daily dose of levodopa administered as Stalevo should not exceed 1500mg. Overdose: When using Levodopa at least 10000mg and with Entacapone dose at least 40000mg can cause overdose with symptoms such as agitation, confusion, coma, bradycardia, or cause ventricular tachycardia, patterned breathing. Cheyne Stokes, changes in skin color, tongue, conjunctiva and abnormally colored urine. In case of overdose, the patient should be hospitalized, gastric lavage, activated charcoal, carefully monitored respiratory, circulatory and renal systems.
4. Undesirable effects of the drug Stalevo
When using Stalevo, you may experience unwanted effects:Anemia, weight loss, decreased appetite. Depression, hallucinations, confusion, unusual dreams, anxiety, or drowsiness, insomnia, mental decline, dizziness, blurred vision. Dyskinesia, exacerbation of Parkinson's disease, tremor and on-off phenomenon, dystonia. Cardiac events are as common as ischemic events other than myocardial infarction ; arrhythmia, headache, orthostatic hypotension, hypertension, dyspnea. Diarrhea or constipation, vomiting, indigestion, abdominal pain, irritability, dry mouth, rash, increased sweating. Myalgia, muscle spasms, arthralgia, dysuria, chest pain, peripheral edema, easy to fall, change in gait imbalance, weakness, fatigue. Impulse control disorder: Addiction to something such as pathological gambling, increased libido or excessive sexual activity, excessive spending or impulsive purchases, overeating and uncontrolled eating Control may occur in patients treated with dopamine agonists including Stalevo. If there are signs of side effects, monitor them and if they persist or are dangerous, notify your doctor or go to a medical facility immediately.
5. Precautions when using Stalevo
This medicine is to be used only as prescribed by a doctor. Before taking tell your doctor if you are allergic to any agent. Special caution and monitoring is required in patients with cardiovascular disease, bronchial asthma, severe lung disease, kidney disease, liver disease or endocrine disorders, history of peptic ulcer disease, seizures, history of myocardial infarction or ventricular arrhythmia. Elderly people are often more sensitive to the side effects of drugs than younger people, so monitoring and dose reduction in the elderly is more important than usual. When taking the drug, it is necessary to monitor the occurrence of mental changes such as hallucinations and psychosis, depression with suicidal tendencies, self-harm; Periodic assessment of liver, hematopoietic, cardiovascular, and renal function is recommended. The patient's ability to drive and use machines may be affected as the drug may cause dizziness and symptoms associated with standing. Therefore, caution should be exercised when driving or using machinery. While taking the drug avoid the use of alcohol or alcoholic beverages, because it increases the risk of causing side effects of the drug. Pregnancy: There are no adequate data on the use of the combination of levodopa/carbidopa/entacapone in pregnant women. The potential hazards to humans are unknown. Stalevo should not be used during pregnancy. Lactation: Levodopa may be excreted in human milk and there is also evidence that lactation is suppressed during levodopa therapy. The safety of levodopa, carbidopa, or entacapone in neonates is unknown. Women should not breast-feed during treatment with Stalevo. Drug interactions: May cause interactions with doctors such as antihypertensive drugs; Tricyclic antidepressants, imipramine, meclobemide; The absorption of Stalevo may be reduced in some patients taking a high-protein diet; Stalevo and iron-rich preparations should be taken at least 2-3 hours apart. This drug also interacts with other medications, so tell your doctor about any medications you take or plan to take. Storage: Store Stalevo in a cool, dry place, away from light, at a temperature below 300C. Make sure medicines are out of reach of children. Hopefully, with the information about the drug Stalevo you have understood the use and note when using the drug. If any abnormality occurs during treatment, notify your doctor immediately.Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
