Carbidopa+levodopa+entacapone
About Carbidopa+levodopa+entacapone
Carbidopa+levodopa+entacapone is used in treating Parkinson's disease and its symptoms, including tremors, spasms, muscle stiffness and poor muscle control. Parkinson's disease is a disorder of the central nervous system that affects movement and locomotion.
Carbidopa+levodopa+entacapone contains Carbidopa, Levodopa, and Entacapone, which work by maintaining the levels of dopamine in the brain. Thereby, it helps reduce symptoms of Parkinson's disease, such as tremors and stiffness.
The most common side effects of Carbidopa+levodopa+entacapone are nausea, vomiting, loss of appetite, light-headedness, lowered blood pressure, confusion, and dyskinesia (uncontrolled/involuntary muscle movement). If the side effects persist or worsen, please consult your doctor.
If you are known to be allergic to any of the components in Carbidopa+levodopa+entacapone, please tell your doctor. Consult your doctor if you are pregnant or breastfeeding. Keep your doctor informed about your medicines and health condition to rule out any side effects.
Uses of Carbidopa+levodopa+entacapone
Medicinal Benefits
- Carbidopa+levodopa+entacapone is used to treat Parkinson’s disease. It contains Carbidopa, Levodopa, and Entacapone.
- Levodopa converts into dopamine in the brain, helping control movement and motor functions.
- Carbidopa prevents the breakdown of Levodopa in the bloodstream, ensuring more reaches the brain for effective symptom relief.
- Entacapone inhibits the enzyme COMT, prolonging the action of Levodopa and maintaining sustained dopamine levels.
- Carbidopa+levodopa+entacapone reduces symptoms of Parkinson’s disease, including tremors, rigidity, stiffness, and slow movement.
- It enhances overall mobility and quality of life by improving the effectiveness and duration of Levodopa therapy.
- It supports overall neurological health, helping maintain a better quality of life for patients.
Directions for Use
- Take Carbidopa+levodopa+entacapone with or without food, or as advised by a doctor.
- Follow your doctor's instructions on the dosage and timing of this medication to ensure safety.
- Swallow the medicine as a whole with a glass of water.
- Do not crush, break, or chew it.
Storage
Side Effects of Carbidopa+levodopa+entacapone
- Nausea
- Muscle pain
- Diarrhoea
- Lightheadedness
- Dizziness
- Stomach upset
- Blurred vision
- Anaemia
- Hypotension (low blood pressure)
- Dyskinesias (uncontrolled movement)
- Urine discolouration
Drug Warnings
- Do not take Carbidopa+levodopa+entacapone if you are allergic to any of its ingredients.
- The use of Carbidopa+levodopa+entacapone is not recommended if a person takes monoamine oxidase inhibitors (MAOs) or antidepressant drugs like isocarboxazid, phenelzine, selegiline, and tranylcypromine because it can lead to a high blood pressure (hypertension) crisis.
- Do not stop taking Carbidopa+levodopa+entacapone suddenly without talking to your doctor. It may result in a serious neuroleptic malignant syndrome (NMS) that causes fever, muscle cramps or stiffness, unusual body movements, fast heartbeat, sweating, change in thinking, and confusion.
- Tell your doctor if you have/had diabetes, a heart attack, a mental illness, stomach ulcers, heart disease, or have recently undergone a surgical procedure.
- Carbidopa+levodopa+entacapone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position, especially when you start taking Carbidopa+levodopa+entacapone, so please get up gradually.
- Prolonged intake of Carbidopa+levodopa+entacapone may lead to greater chances of neuropathy (nerve damage).
- Carbidopa+levodopa+entacapone should be used with caution in patients with eye problems (narrow-angle glaucoma), irregular heartbeat (arrhythmia), gastrointestinal bleeding, and psychosis.
- Let your doctor know if you are taking any other medicines, including supplements and herbal products.
Drug Interactions
Drug-Drug Interactions: Carbidopa+levodopa+entacapone may have interaction with other antiparkinson’s drugs (rasagiline, selegiline, pramipexole, apomorphine), medicines used to treat depression (moclobemide, amitriptyline, desipramine, maprotiline, venlafaxine, paroxetine, rimiterole, isoprenaline), medicines used to treat respiratory diseases or allergic reactions (adrenaline, noradrenaline) medicines used to treat high blood pressure (methyldopa), water pills or diuretics (furosemide), high cholesterol-lowering drugs (atorvastatin), vitamins (pyridoxine), and anticonvulsants (phenytoin ), medicines used to relax the muscles (papaverine), dopamine D2 receptor blocker (metoclopramide, phenothiazines, butyrophenones, risperidone), antibiotics (erythromycin, rifampicin, ampicillin, chloramphenicol), a medicine used to treat TB (isoniazid).
Drug-Food Interactions: Carbidopa+levodopa+entacapone may interact with proteins in the food. Therefore, avoid intake of high-protein foods such as chicken, beef, pork, eggs, and fish, as they may reduce the effectiveness of Carbidopa+levodopa+entacapone. Do not take vitamin supplements with Carbidopa+levodopa+entacapone unless prescribed by a doctor. Also, avoid alcohol intake as it may increase side effects such as drowsiness, dizziness, or difficulty concentrating.
Drug-Disease Interactions: If you have glaucoma, asthma, nausea, dizziness, mental illness, breathing problems, daytime sleepiness, or involuntary muscle movements, inform your doctor before taking Carbidopa+levodopa+entacapone.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionAvoid consumption of alcohol with Carbidopa+levodopa+entacapone as it may increase the risk of adverse effects such as drowsiness, dizziness, or difficulty in concentrating.
Pregnancy
cautionCarbidopa+levodopa+entacapone is a pregnancy Category C medicine. It is unknown whether Carbidopa+levodopa+entacapone will affect pregnant women or the fetus. Hence, the intake of Carbidopa+levodopa+entacapone should be avoided if you are pregnant or planning to become pregnant, as it may harm the baby.
Breast Feeding
cautionCarbidopa+levodopa+entacapone is excreted in human milk, but the effect of Carbidopa+levodopa+entacapone on an infant is unknown. So, Carbidopa+levodopa+entacapone is given to a breastfeeding mother only if the doctor thinks the benefits outweigh the risks.
Driving
unsafeCarbidopa+levodopa+entacapone may cause drowsiness and make you fall asleep suddenly. Therefore, avoid driving if you feel drowsy after taking Carbidopa+levodopa+entacapone.
Liver
cautionTake Carbidopa+levodopa+entacapone with caution if you have a history of liver diseases/conditions. The dose may be adjusted by your doctor as required.
Kidney
cautionTake Carbidopa+levodopa+entacapone with caution if you have a history of kidney diseases/conditions. The dose may be adjusted by your doctor as required.
Children
cautionCarbidopa+levodopa+entacapone is not recommended for use in children, as safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
- Drink plenty of water to avoid headaches due to dehydration.
- Limit the consumption of sugar-containing food or food with too many calories but few nutrients, as it may cause tooth decay.
- Engaging in physical activity like dancing or exercising will boost the metabolism and make a person more energetic.
- Avoid intake of alcoholic beverages with Carbidopa+levodopa+entacapone as it can make a person dehydrated and may affect their sleep. This can make it harder for a person’s body to aid the system in fighting off infections.
Special Advise
- Do not exceed more than 1 dose (2 capsules) for any off period (recurring symptoms in between regular doses).
- If you have unusual urges like gambling, spending money, overeating, or increased sexual urges, please inform your doctor before taking Carbidopa+levodopa+entacapone.
Patients Concern
Disease/Condition Glossary
Parkinson’s disease: It is a disorder of the central nervous system that affects movement due to damage of nerve cells in the brain, which reduces the levels of dopamine and leads to symptoms such as stiffness, tremors in one hand, shaking, difficulty in walking, coordination and balance. This condition can last for many years or a lifetime. Treatment with medicines along with physiotherapy may help to control the symptoms and provide a quality of life for as long as possible.
FAQs
Carbidopa+levodopa+entacapone is used in the treatment of Parkinson's disease and helps relieve symptoms, including tremors, spasms, muscle stiffness and poor muscle control.
Carbidopa+levodopa+entacapone works by maintaining the levels of dopamine in the brain. Thereby, it helps reduce symptoms of Parkinson's disease, such as tremors and stiffness.
Take Carbidopa+levodopa+entacapone at the same time every day, as this will help you remember to take the medicine.
In some cases, prolonged intake of Carbidopa+levodopa+entacapone may lead to autoimmune haemolytic anaemia (red blood cells in the blood are destroyed earlier than normal). Levodopa in Carbidopa+levodopa+entacapone can cause the immune system to mistake your own red blood cells for foreign substances. The body responds by making antibodies to attack the body's own red blood cells. The antibodies attach to red blood cells and cause them to break down too early. So, your doctor might recommend regular blood tests while using Carbidopa+levodopa+entacapone.
You are recommended to avoid taking protein-rich food (such as chicken, beef, pork, eggs, meats, fish, dairy products, seeds, and nuts), iron supplements, or multivitamin tablets while taking Carbidopa+levodopa+entacapone as it may delay and reduce the absorption of levodopa. Thus, it reduces the effectiveness of Carbidopa+levodopa+entacapone. Please consult your doctor and do as advised for the best results.
Yes, orthostatic hypotension could be a side-effect of Carbidopa+levodopa+entacapone. Orthostatic hypotension is a sudden lowering of blood pressure leading to dizziness on standing. If you experience this, do not try to stand up suddenly or start walking; instead, lie down and get up slowly only when you feel better. People taking Carbidopa+levodopa+entacapone are advised to regularly monitor their blood pressure levels to avoid unpleasant events.
Consult your doctor before taking Carbidopa+levodopa+entacapone if you have glaucoma. Carbidopa+levodopa+entacapone is contraindicated in patients with narrow-angle glaucoma. Carbidopa+levodopa+entacapone may cause blindness on long-term use in the case of patients with narrow-angle glaucoma.
Hallucination is a medical condition in which a person may feel, hear, or believe things that are not true, see things that are not there, or feel unusually suspicious or confused. Carbidopa+levodopa+entacapone may cause hallucinations in some cases if taken for a prolonged time. So, if you experience hallucinations while taking Carbidopa+levodopa+entacapone, please talk to your doctor immediately.
It is advised not to stop taking Carbidopa+levodopa+entacapone without consulting your doctor, as it may lead to a severe condition called withdrawal-emergent hyperpyrexia with symptoms such as confusion, fever, muscle stiffness, changes in heartbeat, and breathing. Therefore, take Carbidopa+levodopa+entacapone for as long as your doctor has prescribed it, and if you experience any of these symptoms while taking Carbidopa+levodopa+entacapone, please consult your doctor so that the dose may be gradually reduced.
Carbidopa+levodopa+entacapone can be taken with or without food as advised by your doctor. Stay away from protein meals as it can delay the action of Carbidopa+levodopa+entacapone.
Yes, Carbidopa+levodopa+entacapone can turn the colour of your urine, sweat and saliva dark (brown, red, or black). Although it not harmful, it can sometimes stain your bedding and clothes.
