What is this medication for?

Stalevo tablet contains three medications (Carbidopa, Levodopa and Entacapone). Stalevo is used for the treatment of Parkinson’s disease.

Parkinson’s disease is a progressive disorder of the nervous system that affects movement. This medication helps to improve muscle control and allows more normal body movements.

How should I take/use this medication?

• This medicine can be taken with or without food

• Avoid taking Stalevo with or after protein rich food (such as meats, fish, dairy products) as it may affect the absorption of the medication

• Stalevo should be swallowed whole and not to be crushed
  

• Do not stop taking Stalevo without checking with your healthcare professional.
  When you stop this medication, you may have signs of withdrawal. If you need to stop this medication, follow how to stop it as your doctor has told you. Seek medical advice immediately if you have any of these signs when lowering the dose or stopping this medication: fever, confusion, severe muscle stiffness, not caring about things, anxiety, depression, feeling tired, trouble sleeping, sweating, or pain.
  

What should I do if I forget to take/use this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication

• You have glaucoma (high eye pressure), heart, liver, kidney or mental health condition

• You have phaechromocytoma (a tumour of the adrenal gland which is found on top of the kidneys)

• You are pregnant, planning to become pregnant, or breastfeeding

• You are taking any other medications, including supplements, traditional medications and herbal remedies.

What are some common side-effects of this medication?

• May cause sweat, urine and saliva to appear orange in colour
• Do not be alarmed as this is a normal reaction by your body to the medication
• Nausea or vomiting
• Can take Stalevo with small snacks low in protein (like biscuits, fruit juice)
• Low blood pressure resulting in dizziness when getting up from a lying or sitting position

• Get up slowly from a lying or sitting position to reduce chances of dizziness

• Avoid driving or operating machinery

• Drowsiness

  • Avoid driving or operating machinery

• Uncontrolled movements of the body
  

  • Discuss with your doctor if these involuntary movements persist

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue

• Difficulty in breathing

• Itchy skin rashes over your whole body

Some rare but serious side effects includes

• New or worsening behaviour or agitation

• Hallucinations (seeing or hearing things that are not there)

• Change in eyesight, eye pain

• Strong urge that are hard to control (such as eating, gambling, spending money)

• Breakdown of muscles

  • Unexplained severe muscle pain that does not go away, muscle weakness or cramps all over your body, or dark brown urine

• Liver injury

  • Dark brown urine, light coloured stools (pale grey/clay coloured), yellowing of skin or eyes

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What food or medication should I avoid when I take this medication?

Iron supplements (e.g. ferrous gluconate, ferrous sulphate, iron polymaltose) may decrease the absorption of Stalevo. Space Stalevo at least 2 hours apart from iron supplements.

Certain medications used for treatment of depression (e.g. Desipramine, Venlafaxine, Paroxetine, Moclobemide) may interact with Stalevo. Do not take Stalevo if you have taken a medication for depression called a “non-selective monoamine oxidase inhibitor” (MAOI) in the last 14 days. These medicines include Isocarboxazid and Phenelzine. Discuss with your healthcare professional regarding alternative medication.

Metoclopramide, a medication used for vomiting or digestion, may affect the efficacy of Stalevo. Discuss with your healthcare professional regarding alternative medication.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Mar 2023