Carbidopa+levodopa+entacapone
About
Carbidopa+levodopa+entacapone belongs to a class of drugs called 'antiparkinson agents', a precursor of dopamine (chemical messenger in the brain) primarily used in treating Parkinson's disease with 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, which causes stiffness, shaking, and difficulty in walking, coordination and balance. In Parkinson's patients, there are low dopamine levels as the nerve cells of the brain (neurons) that produce dopamine begin to die.
Carbidopa+levodopa+entacapone contains Carbidopa, Levodopa, and Entacapone. Levodopa belongs to the central nervous system agents, while Carbidopa is a decarboxylase inhibitor. The medicinal component Levodopa changes into dopamine in the brain and helps to control movement. Carbidopa prevents the breakdown of Levodopa in the bloodstream so that more Levodopa can reach the brain. On the other hand, Entacapone belongs to a class of COMT (catechol-o-methyltransferase enzyme) inhibitors which causes higher and more sustained levels of Levodopa in the blood that more Levodopa can reach the brain, leading to greater relief from the symptoms of Parkinson's disease.
Take Carbidopa+levodopa+entacapone as prescribed by your doctor. You are suggested to take $ame as long as your doctor has prescribed it after checking your medical condition. 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). Most of these side effects of Carbidopa+levodopa+entacapone do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.
If you are known to be allergic to Carbidopa+levodopa+entacapone or any other medicines, please tell your doctor. Do not take Carbidopa+levodopa+entacapone if you are pregnant or breastfeeding unless prescribed by the doctor. Carbidopa+levodopa+entacapone should not be given to children as safety and effectiveness have not been established. Carbidopa+levodopa+entacapone may cause hallucinations (seeing or hearing things that are not there) 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. Keep your doctor informed about your medicines and health condition and rule out any side effects.
Uses of Carbidopa+levodopa+entacapone
Medicinal Benefits
Carbidopa+levodopa+entacapone is an antiparkinson agent that is used in the treatment of Parkinson’s disease. Carbidopa+levodopa+entacapone is a combination of three medicines: Carbidopa, Levodopa, and Entacapone. Levodopa belongs to the class of medications name as central nervous system agents, While Carbidopa falls in decarboxylase inhibitors. The medicinal component Levodopa changes into dopamine in the brain and helps to control movement. At the same time, Carbidopa acts by preventing the breakdown of Levodopa in the bloodstream so that more Levodopa can effectively reach the brain to block acetylcholine (a chemical messenger in the brain). Entacapone blocks a certain natural substance, catechol-o-methyltransferase (COMT) (an enzyme that breaks down the levodopa in the body), which causes higher and more sustained levels of levodopa in the blood, so that more Levodopa can reach the brain, leading to greater relief from the symptoms of Parkinson’s disease. This effect allows the levodopa to last longer in the body so that it doesn't wear off before the next dose.
Directions for Use
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
In-Depth Precautions and Warning
Drug Warnings
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. Do not take Carbidopa+levodopa+entacapone if you are allergic to Carbidopa+levodopa+entacapone or any of its ingredients. Tell your doctor if you have any medical history of diabetes, heart attacks, 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. Besides this, a prolonged intake of Carbidopa+levodopa+entacapone may lead to greater neuropathy chances (nerve damage). Carbidopa+levodopa+entacapone should be given with caution in patients with eye problems (narrow-angle glaucoma), irregular heartbeat (arrhythmia), gastrointestinal bleeding, and psychosis. The use of Carbidopa+levodopa+entacapone is restricted if a person takes monoamine oxidase inhibitors (MAOs) or antidepressant drugs like isocarboxazid, phenelzine, selegiline, and tranylcypromine because it can lead to high blood pressure (hypertension) crisis.
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 food 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 in 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 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, especially 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, especially 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 fewer 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 Carbidopa+levodopa+entacapone 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 the Carbidopa+levodopa+entacapone.
Patients Concern
Disease/Condition Glossary
Parkinson’s disease: It is a disorder of 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, tremor in one hand, shaking, difficulty in walking, coordination and balance. This condition can last for many years or life-long. Treatment with medicines along with physiotherapy may help to control the symptoms and provide a quality life for as long as possible.
FAQs
Carbidopa+levodopa+entacapone is a combination of three medicines namely; Carbidopa, Levodopa, and Entacapone. Levodopa belongs to the class of medications name as central nervous system agents, While Carbidopa fall in the category of decarboxylase inhibitors. The medicinal component Levodopa changes into dopamine in the brain and helps to control movement. While Carbidopa and Entacapone act by preventing the breakdown and causes higher and more sustained levels of Levodopa in the bloodstream so that more Levodopa can reach to brain.
Take Carbidopa+levodopa+entacapone medicine precisely as the doctor has directed. Take one dose on a regular basis. Try to take the tablets at the same time of day every day, as this will assist you in making sure to take them.
In some cases, prolonged intake of Carbidopa+levodopa+entacapone may lead to autoimmune hemolytic 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, reduce 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 in 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 the 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.
