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Stalevo 200 Disease Interactions

There are 13 disease interactions with Stalevo 200 (carbidopa / entacapone / levodopa).

Major

Carbidopa (applies to Stalevo 200) glaucoma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma (Narrow Angle)

Carbidopa-levodopa products are contraindicated in patients with narrow-angle glaucoma.

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Major

Dopamine agonists (applies to Stalevo 200) cardiac disease

Major Potential Hazard, Low plausibility. Applicable conditions: Cardiovascular Disease

Cardiac irregularities occur infrequently in patients on dopamine agonists. The initial administration and titration is recommended to occur under close cardiac monitoring in a facility equipped for intensive cardiac care. Adverse cardiac affects may include palpitation, sinus tachycardia, ventricular tachycardia, extrasystole, atrial flutter or fibrillation, or block of AV conduction.

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Major

Dopamine agonists (applies to Stalevo 200) hypotension

Major Potential Hazard, Moderate plausibility.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

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Major

Dopamine agonists (applies to Stalevo 200) neuroleptic malignant syndrome

Major Potential Hazard, Low plausibility.

The use of dopamine agonists is contraindicated in patients with neuroleptic malignant syndrome (NMS). NMS is characterized by hyperthermia, muscle rigidity, altered mental status, irregular pulse or blood pressure, tachycardia, and diaphoresis. The syndrome may rarely be precipitated by abrupt discontinuation of the dopamine agonist.

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Major

Dopamine agonists (applies to Stalevo 200) psychoses/depression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

The use of dopamine agonists has been associated with psychiatric effects such as hallucinations, psychosis, confusion, anxiety, mania, hypomania, depression, rapid mood cycling, nightmares, and hypersexuality. Therapy with dopamine agonists should be administered cautiously in psychotic patients and all patients should be carefully observed for development of depression and suicidal tendencies.

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Major

Dopaminergic antiparkinson agents (applies to Stalevo 200) psychosis

Major Potential Hazard, Moderate plausibility.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

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Major

Levodopa (applies to Stalevo 200) glaucoma

Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension

The use of levodopa is contraindicated in patients with acute closed-angle glaucoma. Levodopa (with or without carbidopa) may be used in patients with open-angle glaucoma who are receiving appropriate therapy.

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Major

Levodopa (applies to Stalevo 200) liver/renal

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease, Renal Dysfunction

The pharmacokinetics of levodopa have not been studied in patients with hepatic or renal impairment. Therapy with levodopa should be administered cautiously in patients with liver or disease. Periodic monitoring of hepatic and renal function is recommended during extended therapy.

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Major

Levodopa (applies to Stalevo 200) melanoma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Skin Cancer

The use of levodopa is considered by manufacturers to be contraindicated in patients with a history of melanoma or in patients with suspicious, undiagnosed skin lesions. Levodopa reportedly may activate malignant melanoma, although some investigators have found a causal relationship to be tenuous.

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Major

Levodopa (applies to Stalevo 200) reactive airway disease

Major Potential Hazard, Low plausibility. Applicable conditions: Asthma, Chronic Obstructive Pulmonary Disease

Because of the risk of bronchospasm, use of levodopa in patients with asthma, COPD, or other chronic underlying lung disease is not recommended.

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Moderate

Carbidopa (applies to Stalevo 200) depression

Moderate Potential Hazard, Moderate plausibility.

Caution and observation is recommended when treating patients with carbidopa, as depression with concomitant suicidal tendencies may develop or be exacerbated.

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Moderate

Entacapone (applies to Stalevo 200) hepatic impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Entacapone should be used with caution in patients with hepatic impairment, as the AUC and Cmax of the drug approximately doubled in patients with documented liver disease compared to patients with normal liver function.

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Moderate

Levodopa (applies to Stalevo 200) GI bleeding

Moderate Potential Hazard, Low plausibility. Applicable conditions: Gastrointestinal Hemorrhage

The use of levodopa, especially in combinations with carbidopa, has been associated with an increase in the frequency of gastrointestinal hemorrhage. Therapy with levodopa should be administered cautiously in patients with a history of peptic ulcer disease or gastrointestinal hemorrhage.

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Stalevo 200 drug interactions

There are 503 drug interactions with Stalevo 200 (carbidopa / entacapone / levodopa).

Stalevo 200 alcohol/food interactions

There are 2 alcohol/food interactions with Stalevo 200 (carbidopa / entacapone / levodopa).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.