Doctor insights on:
Carbidopa And Levodopa And Entacapone Medication
What is the difference between Parkinson's drug sinemet and stalevo (carbidopa and levodopa and entacapone)?
COMT inhibitor: Entacaptone is a selective catecholamine-o methyl transferase (comt) inhibitor that increases the bioavailabilty of dopamine. Like Carbidopa in sinemet it does not cross the blood brain barrier. Stalevo (carbidopa and levodopa and entacapone) is a combination of l dopa, Carbidopa and entacaptone. Sinemet is a combination of Carbidopa and l-dopa. ...Read more
Before I take Stalevo, (carbidopa and levodopa and entacapone) I'm on but shortly after, I suddenly go off. What's causing this?
See a physician: Your questions is not very clear, but is important to see your doctor for accurate reason for your symptoms ...Read more
Which is more likely to increase psychoses. Increasing stalevo (carbidopa and levodopa and entacapone) from 125 to 150 on the same schedule or changing the dosage from 6 to 7 per day?
Less risk by inc frq: In the treatment of Parkinson's patients with Sinemet (carbidopa and levodopa) it is generally believed that increased frequency of medication dosage is preferable for a variety of reasons including less risk of precipitating psychoses by the medication. Having said that-the most honest answer is "you will never know until you try it." ...Read more
Does the use of the neupro patch and stalevo (carbidopa and levodopa and entacapone) 125 lessen the incidence of psycosis?
Parkinson's Disease: These are both medications used to treat parkinson's disease, not psychosis. Some antipsychotic medications can induce parkinsonism in movements -- not true parkinson's disease. Sometimes these meds used to treat parkinson's may cause psychotic symptoms. Late-stage parkinson's disease can also involve a type of dementia with hallucinations as well. ...Read more
I take requip & stalevo (carbidopa and levodopa and entacapone) 6 times a day. Sometimes I can see improvement and other times I can't. How can I insure that the meds are absorbed every time?
Take meds: Take meds before meals, about 1/2 hour before. ...Read more
Is the risk of psychoses greater with adding 1mg requip or 125mg stalevo (carbidopa and levodopa and entacapone)?
Is Stalevo (carbidopa and levodopa and entacapone) superior to Sinemet for Parkinson’s? Is one better than the other?
Superiority?: All of the drugs in this class attempt to increase the levels of circulating dopamine. Sinemet is a combination of 2 drugs whereas Stalevo (carbidopa and levodopa and entacapone) is a combination of 3. There is currently an ongoing study at the Mayo Clinic to answer this question - but right now - there isn't any data to demonstrate if one is 'better' than the other. The best treatment is the one that works for you. Hope that helps! ...Read more
Taking Stalevo (carbidopa and levodopa and entacapone) 125X6, Requip 6mg X2. What sinus medicine can I take?
Hard to know: Are you referring to prescription medication or over the counter formulations? Do you have a specific one in mind? You can also ask your local pharmacist and they should be able to help you answer this question. ...Read more
Dr. Pappas...Compared to 5 x 3 mg of requip & 6x 125 stalevo (carbidopa and levodopa and entacapone) will 8mg neupro & 6x 125 stalevo (carbidopa and levodopa and entacapone) be less likely to cause psycosis?
Variable: Hello -- great question -- and you're basically asking about the difference between Neupro (rotigotine) ; requip. The data I've seen shows that Neupro (rotigotine) had a 7-14% incidence of hallucinations in clinical trials. This effect was dose-related, also. Requip had 5% incidence of hallucinations. Results may vary by individual too. I'll refer this question to some neurology colleagues for input also. Thanks. ...Read more
Does seroquel or escitalipram interfere with stalevo (carbidopa and levodopa and entacapone) and/or requip?
Rephrasing my question. My Stalevo (carbidopa and levodopa and entacapone) controls my Parkinson's but some times when I take it, I get stiff and have trouble moving. What is causing this?
Parkinsonism: Some medications for Parkinson's disease are more effective for tremor control than for the rigidity and bradykinesia (slowness of movement) seen in that disease. Perhaps your neurologist will change or add to your current treatment program if you report this problem with him/her. ...Read more
Is it safe to take stalevo (carbidopa and levodopa and entacapone) while pregnant or breastfeeding?
Probably not: This medication is used to treat the effects of Parkinson's disease. It does cross the placenta. It is listed as a category c which means there is not a lot of data about its use during human pregnancy, but it did cause deformities in lab animals when used at concentration far higher than what is used in humans. So, it should be used only if benefit to mom outweighs potential risks. ...Read more
How can I prevent random off incidents with parkinson's. Taking stalevo (carbidopa and levodopa and entacapone) 125, requip 3mg. I am 14 years into the desease.
DBS unit: Your medication is not a promising solution and you may do better with implantation of a dbs unit. Sometimes, Apomorphine injections a temporary abortive approach. ...Read more
Taking 6 300mg gabapenten dail y with stalevo (carbidopa and levodopa and entacapone) does GABA affect vision? I have difficulty reading, just got new bifocals june tx
Yes: All meds have side effects and some are dose related. Because you already wear bifocals, you may need to have them strengthened. This med can also effect processing centrally and affect the need at near. ...Read more
14 years with parkinson's. Have a dbs implant, taking stalevo (carbidopa and levodopa and entacapone) 125 x 6, requip 2mg x 5. How can I control the random "off" occurrences?
Readjust DBS unit: One of the potent values of your stimulator is the benefit of modifying the settings to more fully control the on/off episodes. Contact your neurologist and readjust dbs function. Rather unlikely that you will achieve success with modifying your current meds. In some cases, if "off" episode a problem, use of Apomorphine could be solution. ...Read more
Carbidopa/levodopa: Sinemet (carbidopa and levodopa) is a combination drug that contains Carbidopa and levodopa. It is most commonly prescribed for parkinson's disease but may also be prescribed for other conditions including restless legs syndrome. ...Read more
Dosages: Dosages are adjusted for the specific needs of each patient - there is no standard dose for any specific time period. Sinemet (carbidopa and levodopa) comes in carbadopa-levodopa doses of 10-100, 25-250, and 25-100. These can be combined and given at various times throughout the day to best relieve the symptoms of parkinson's disease. If you are not sure of your dose or the dose of someone you are caring for, you need to call the doctor that prescribed the medication to clarify. Good luck! ...Read more
My mom, Safia, 60 years old, resident of Pakistan has drug induced parkinsonism, which is bothering a lot & worsening. Sinemet (carbidopa and levodopa) 25/250 every 4.5 hours?
Tachyphylaxis.: Dosing of Sinemet (carbidopa and levodopa) is a little strange, requiring front loading in the day and a long gap at night without dosing. If taken like most other medications, on a more regular dosing interval, tachyphylaxis develops, which essentially means the efficacy of the medication reduces. ...Read more
Is it safe to take clonazepam for sleep with sinemet (carbidopa and levodopa) for Parkinsons patient? Are there any drug interactions?
Probably safe...: ...but not especially the best choice! Although medications in that class (benzodiazepines) allay anxiety and can relax muscle spasm, they also interfere with normal sleep architecture and increase the risk of falling. I would certainly advise that you discuss this with your neurologist or a psychiatrist trained in sleep disorders or with additional training in geropsychiatry. ...Read more
Sinemet-CR: This has to be determined by careful titration thru your doctor. Initial dose is usually 50-200. Consult your Neurologist. ...Read more
See below: Sinemet® (carbidopa-levodopa) is a combination of Carbidopa and Levodopa for the treatment of parkinson's disease and syndrome. Sinemet® cr (carbidopa-levodopa) is a sustained-release combination of Carbidopa and Levodopa for the treatment of parkinson's disease and syndrome. ...Read more
Sinemet (carbidopa and levodopa): Not sure what milligram each, but if that's what your doctor prescribed & your symptoms are under control & you are tolerating the medication well, then you should be ok. ...Read more
Variable, but: In my experience, the maximum Sinemet (carbidopa and levodopa) dosing is the 25/250 tab four times daily, and if this seems to wear off, one can add Comtan (entacapone). Problem with going too high with L-DOPA is incidence of dyskinesias. ...Read more
Yes: But the GI side effects would make it intolerable. ...Read more
It depends: Because of cost considerations its worth trying it for a while. Watch for peak dose dyskinesis and dose failures or wearing off. ...Read more
Neither: Generic drugs are held to standards where the manufacturer must prove "bioequivalence" to the branded drug. The molecules must be structurally the same, and the same standard of quality and purity must be met. The pills and the packaging themselves may look different, but the active ingredient is the same. It can be thought of as the difference between clorox bleach and safeway brand bleach. ...Read more
On sinemet (carbidopa and levodopa) 2 times per day 62.5. I want off this to try other alternatives first how do I safely do this. I do not agree with my diagnosis of pd.?
See your doctor: If you can't find any common ground then it's best to part ways and find a physician you feel mors comfortable with. That said, you should negotiate a time period during which you can try alternatives before resuming orthodox therapy. Your doctor will help wean you. ...Read more
When switching from regular Sinemet (carbidopa and levodopa) to CR, do you need to add little more CR to achieve the same dose of the regular Sinemet (carbidopa and levodopa)?
Not usually: You can usually use the same dose of Sinemet (carbidopa and levodopa) CR as you had of the regular Sinemet (carbidopa and levodopa). You may not feel it "kick in" as strongly but it should work just as effectively and hopefully last longer for you. Good luck. ...Read more
Slowly: Depends on dosing/schedule, but its very important to taper very slowly. It would be best to call your prescribing doctor and have them give you a clear tapering schedule. ...Read more
Slow taper: If sinemet (carbidopa and levodopa) needs to be stopped, depending on the amount and indication for the medication, the most desire able way is to taper the medication. Parkinson's patients can have severe side effects if sinemet (carbidopa and levodopa) is abruptly stopped. ...Read more
Probably not bad: I had to look up rhodiola as that was one I had never heard of. There are no reasons, at least theoretically, that the two should be a problem. I did a literature search and there are no articles in the medical literature looking at rhodiola and sinemet (carbidopa and levodopa). There are some laboratory papers that suggest rhodiola should be helpful in pd, but I could not find any clinical studies in people. ...Read more
Depends...: Regretfully, there is no typical Sinemet (carbidopa and levodopa) dose following DBS, given that each patient is different and their need for treatment varies. Discuss this with your neurologist. ...Read more
Typical- Misnomer...: Quite honestly, as a neurologist I've found LESS AND LESS TYPICAL starting doses of any of the anit-parkinsonian medications as I get farther into my career. Oh, sure there are textbook numbers but when the actual DIAGNOSIS of PD cannot be firmly made at times for years after presentation should there really be such as a thing as a TYPICAL starting dose of Sinemet (carbidopa and levodopa)? Commonly seen is 25/100 3x/day. ...Read more
Sometimes: Sinemet (carbidopa and levodopa) should be tapered slowly over many weeks to months foll. The combination of DBS and meds usually works better than either alone. There may be some sinemet (carbidopa and levodopa) reduction with a single DBS, and even more with a second DBS. The target allowing the most med reduction is STN. Every patient needs a different approach and everyone is different so it is hard to say how much it can be reduced. ...Read more
May: Help symptoms associated with parkinson diseaseGet a more detailed answer ›
No: Not without increasing other side effectsGet a more detailed answer ›