Carbidopa / Entacapone / Levodopa Dosage
Applies to the following strength(s): 12.5 mg-200 mg-50 mg ; 25 mg-200 mg-100 mg ; 37.5 mg-200 mg-150 mg ; 50 mg-200 mg-200 mg ; 18.75 mg-200 mg-75 mg ; 31.25 mg-200 mg-125 mg
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Parkinson's Disease
Switching patients taking separate tablets of entacapone and carbidopa-levodopa: Give corresponding dosage of carbidopa/entacapone/levodopa.
Switching patients not currently taking entacapone who are experiencing the "wearing-off" effect on carbidopa-levodopa therapy: Patients should be first titrated with the individual product of entacapone and the carbidopa-levodopa product (ratio 1:4), and then transferred to a corresponding dosage combination product after symptoms are under control.
The maximum daily dosage of carbidopa/levodopa/entacapone is 8 tablets. Because there is limited experience with total daily doses of carbidopa greater than 300 mg, the maximum recommended daily dose of the carbidopa/entacapone/levodopa 200 tablets is six tablets.
Renal Dose Adjustments
Caution is recommended when using combination drug in patients with severe renal disease.
Liver Dose Adjustments
Caution is recommended when using combination drug in patients with moderate to severe hepatic disease.
Other recommended drugs for Parkinson's disease may be used concomitantly with carbidopa/levodopa/entacapone, although dosage adjustments may be required.
Patients receiving less than 70 to 100 mg of carbidopa per day are more likely to experience nausea.
Entacapone prolongs and enhances the effects of levodopa; thus, closely adjust each patient's dosage according to the desired therapeutic response.
Patients should be observed carefully if abrupt withdrawal or discontinuation of the carbidopa/levodopa/entacapone is required, particularly if the patient is receiving neuroleptics.
If there is a need to temporarily interrupt therapy, the patient should be observed for symptoms resembling neuroleptic malignant syndrome, and the usual dosage may be administered as soon as the patient is able to take oral medication.
Rapid withdrawal or abrupt reduction in the entacapone dose could lead to recurrence of signs and symptoms of Parkinson's disease, and may lead to hyperpyrexia and confusion, a symptom complex resembling the neuroleptic malignant syndrome. This syndrome should be considered in the differential diagnosis for any patient who develops a high fever or severe rigidity.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Data not available
The amount of entacapone in each of the tablets of the product combinations is 200 mg.
Each product combination contains a 1:4 ratio of carbidopa to levodopa. The numerical suffix on the product name is representative of the amount of carbidopa in the tablet.
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