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Stalevo 125 (carbidopa / entacapone / levodopa) Disease Interactions

There are 9 disease interactions with Stalevo 125 (carbidopa / entacapone / levodopa):

Major

Carbidopa (Includes Stalevo 125) ↔ Glaucoma

Severe Potential Hazard, Moderate plausibility

Applies to: Glaucoma (Narrow Angle)

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

Major

Dopamine Agonists (Includes Stalevo 125) ↔ Cardiac Disease

Severe Potential Hazard, Low plausibility

Applies to: 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.

References

  1. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  2. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  3. Shah PK, Amin DK, Horn E "Adverse clinical and hemodynamic effects of oral levodopa in chronic congestive heart failure." Am Heart J 110 (1985): 488-9
  4. Broderick G, Rajfer SI "The use of levodopa, an oral dopamine precursor, in congestive heart failure." Basic Res Cardiol 84 (1989): 187-90
  5. Chamsi-Pasha H, Horsley M, Barnes PC "Levodopa and congestive cardiomyopathy." Br J Hosp Med 41 (1989): 489
  6. Benaim ME "Levodopa and arrhythmias." Br Med J 4 (1972): 50-1
View all 6 references
Major

Dopamine Agonists (Includes Stalevo 125) ↔ Hypotension

Severe Potential Hazard, Moderate plausibility

Applies to: Hypotension, Hypotension, Hypotension

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.

References

  1. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  3. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  4. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  5. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
View all 6 references
Major

Dopamine Agonists (Includes Stalevo 125) ↔ Neuroleptic Malignant Syndrome

Severe Potential Hazard, Low plausibility

Applies to: Neuroleptic Malignant Syndrome

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.

References

  1. Gibb WR, Griffith DN "Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome." Postgrad Med J 62 (1986): 59-60
  2. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  3. Rainer C, Scheinost NA, Lefeber EJ "Neuroleptic malignant syndrome. When levodopa withdrawal is the cause." Postgrad Med 89 (1991): 175-8,
  4. Friedman JH, Feinberg SS, Feldman RG "A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal." JAMA 254 (1985): 2792-5
  5. Genis D "Neuroleptic malignant syndrome: impaired dopaminergic systems?" Neurology 35 (1985): 1806
View all 5 references
Major

Dopamine Agonists (Includes Stalevo 125) ↔ Psychoses/Depression

Severe Potential Hazard, Moderate plausibility

Applies to: 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.

References

  1. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  2. Nausieda PA, Glantz R, Weber S, Baum R, Klawans HL "Psychiatric complications of levodopa therapy of Parkinson's disease." Adv Neurol 40 (1984): 271-7
  3. Maricle RA, Nutt JG, Carter JH "Mood and anxiety fluctuation in parkinson's disease associated with levodopa infusion: preliminary findings." Mov Disord 10 (1995): 329-32
  4. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  5. Friedman JH "The management of the levodopa psychoses." Clin Neuropharmacol 14 (1991): 283-95
  6. Ko GN, Leckman JF, Heninger GR "Induction of rapid mood cycling during L-dopa treatment in a bipolar patient." Am J Psychiatry 138 (1981): 1624-5
  7. Ryback RS, Schwab RS "Manic response to levodopa therapy. Report of a case." N Engl J Med 285 (1971): 788-9
  8. Banerjee AK, Falkai PG, Savidge M "Visual hallucinations in the elderly associated with the use of levodopa." Postgrad Med J 65 (1989): 358-61
  9. Harsch HH, Miller M, Young LD "Induction of mania by L-dopa in a nonbipolar patient." J Clin Psychopharmacol 5 (1985): 338-9
  10. Vazquez A, Jimenez-Jimenez FJ, Garcia-Ruiz P, Garcia-Urra D ""Panic attacks" in Parkinson's disease. A long-term complication of levodopa therapy." Acta Neurol Scand 87 (1993): 14-8
  11. Glantz RH, Bieliauskas L, Paleologos N "Behavioral indicators of hallucinosis in levodopa-treated Parkinson's disease." Adv Neurol 45 (1987): 417-20
View all 11 references
Major

Dopaminergic Antiparkinson Agents (Includes Stalevo 125) ↔ Psychosis

Severe Potential Hazard, Moderate plausibility

Applies to: Psychosis, Psychosis, Psychosis

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.

Major

Levodopa (Includes Stalevo 125) ↔ Glaucoma

Severe Potential Hazard, High plausibility

Applies to: 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.

References

  1. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  2. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
Moderate

Carbidopa (Includes Stalevo 125) ↔ Depression

Moderate Potential Hazard, Moderate plausibility

Applies to: Depression

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

Moderate

Entacapone (Includes Stalevo 125) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: 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.

Stalevo 125 (carbidopa / entacapone / levodopa) drug Interactions

There are 963 drug interactions with Stalevo 125 (carbidopa / entacapone / levodopa)

Stalevo 125 (carbidopa / entacapone / levodopa) alcohol/food Interactions

There are 3 alcohol/food interactions with Stalevo 125 (carbidopa / entacapone / levodopa)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

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

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