Drug Interactions between Stalevo 100 and zuranolone
This report displays the potential drug interactions for the following 2 drugs:
- Stalevo 100 (carbidopa/entacapone/levodopa)
- zuranolone
Interactions between your drugs
levodopa entacapone
Applies to: Stalevo 100 (carbidopa / entacapone / levodopa) and Stalevo 100 (carbidopa / entacapone / levodopa)
The side effects of levodopa may be increased when it is used in combination with entacapone. You may need a dose adjustment if you have been taking levodopa and are starting or stopping treatment with entacapone. Contact your doctor if your condition changes or if you experience movement difficulties, increased drowsiness, dizziness, lightheadedness, flushing, and/or fainting. Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
levodopa zuranolone
Applies to: Stalevo 100 (carbidopa / entacapone / levodopa) and zuranolone
Consumer information for this interaction is not currently available.
GENERALLY AVOID: Coadministration with central nervous system (CNS) depressants (e.g., alcohol, benzodiazepines, opioids) or antidepressants may enhance the sedative effect of zuranolone and increase the likelihood or severity of sedation-related adverse reactions. Zuranolone may cause CNS depressant effects such as somnolence, confusion, dizziness, and gait disturbance. In clinical trials, somnolence, dizziness, or confusion were reported at a higher percentage in patients treated with zuranolone compared to placebo which required a dosage reduction of zuranolone, treatment interruption, or cessation. One clinical study reported somnolence in 36% of patients treated with 50 mg zuranolone compared to 6% of patients treated with placebo.
MANAGEMENT: Concomitant use of zuranolone with CNS depressants should generally be avoided. Caution and close monitoring of CNS depressant effects is recommended if concomitant use of zuranolone with CNS depressants, antidepressants, or other agents that can cause sedation is required. If coadministration with another CNS depressant is considered unavoidable or if the patient experiences CNS depressant adverse effects within the 14 days treatment course, a dose reduction to 40 mg once daily for the remainder of the course is recommended. Patients should also be cautioned against driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until at least 12 hours after administration of zuranolone.
References
- "Product Information. Zurzuvae (zuranolone)." Biogen Inc. (2023):
entacapone zuranolone
Applies to: Stalevo 100 (carbidopa / entacapone / levodopa) and zuranolone
Consumer information for this interaction is not currently available.
GENERALLY AVOID: Coadministration with central nervous system (CNS) depressants (e.g., alcohol, benzodiazepines, opioids) or antidepressants may enhance the sedative effect of zuranolone and increase the likelihood or severity of sedation-related adverse reactions. Zuranolone may cause CNS depressant effects such as somnolence, confusion, dizziness, and gait disturbance. In clinical trials, somnolence, dizziness, or confusion were reported at a higher percentage in patients treated with zuranolone compared to placebo which required a dosage reduction of zuranolone, treatment interruption, or cessation. One clinical study reported somnolence in 36% of patients treated with 50 mg zuranolone compared to 6% of patients treated with placebo.
MANAGEMENT: Concomitant use of zuranolone with CNS depressants should generally be avoided. Caution and close monitoring of CNS depressant effects is recommended if concomitant use of zuranolone with CNS depressants, antidepressants, or other agents that can cause sedation is required. If coadministration with another CNS depressant is considered unavoidable or if the patient experiences CNS depressant adverse effects within the 14 days treatment course, a dose reduction to 40 mg once daily for the remainder of the course is recommended. Patients should also be cautioned against driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until at least 12 hours after administration of zuranolone.
References
- "Product Information. Zurzuvae (zuranolone)." Biogen Inc. (2023):
Drug and food interactions
levodopa food
Applies to: Stalevo 100 (carbidopa / entacapone / levodopa)
Alcohol can increase the nervous system side effects of levodopa such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with levodopa. You may experience reduced effectiveness of levodopa in the presence of foods or enteral (tube) feedings with a high protein content. This may make the symptoms of Parkinson's disease worse. Talk with your doctor or nutrition counselor about the best foods to eat while you are taking this medication. Contact your doctor if your condition changes.
entacapone food
Applies to: Stalevo 100 (carbidopa / entacapone / levodopa)
Alcohol can increase the nervous system side effects of entacapone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with entacapone. Do not use more than the recommended dose of entacapone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
zuranolone food
Applies to: zuranolone
Consumer information for this interaction is not currently available.
ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of zuranolone. When administered with a low-fat meal (e.g., 400 to 500 calories, 25% fat), zuranolone peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 3.5- and 1.8-fold, respectively, compared to administration under fasted conditions. Zuranolone was administered with food in the premarketing study population. The efficacy of zuranolone when administered in the fasted state is unknown.
GENERALLY AVOID: Concomitant use of zuranolone with central nervous system (CNS) depressants, including alcohol, may potentiate adverse effects such as somnolence, confusion, dizziness, and gait disturbance.
MANAGEMENT: Zuranolone must be administered with fat-containing food (e.g., 400 to 1,000 calories, 25% to 50% fat) according to the manufacturer. Patients should also be advised to avoid or limit consumption of alcohol and to avoid activities requiring mental alertness such as driving or operating hazardous machinery until at least 12 hours after administration of zuranolone.
References
- "Product Information. Zurzuvae (zuranolone)." Biogen Inc. (2023):
levodopa food
Applies to: Stalevo 100 (carbidopa / entacapone / levodopa)
Levodopa and multivitamin with minerals should not be taken orally at the same time. Products that contain iron may interfere with the absorption of levodopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Contact your doctor if your Parkinson symptoms worsen. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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