Stalevo®

levodopa + carbidopa + entacapone tablets

Key points about Stalevo

  • Stalevo is used to treat Parkinson’s disease. 
  • Stalevo contains 3 medicines in 1 tablet – levodopa + carbidopa + entacapone.
  • Find out how to take it safely and the possible side effects. 

 

 

 

Head and shoulders of older man outside
Print this page

Stalevo is a combination of 3 medicines in 1 tablet – levodopa, carbidopa and entacapone. They're used together to treat the symptoms of Parkinson’s disease such as tremor, shakiness, stiffness, and difficulty moving.

Levodopa works by changing into dopamine, a chemical in the brain that helps control movement. This helps to restore the level of dopamine in the brain.

Carbidopa stops levodopa from changing to dopamine in areas of the body that aren’t the brain. This means more levodopa can enter the brain. It also helps to lessen some of the side effects such as nausea (feeling sick) and vomiting (being sick). 

Entacapone blocks an enzyme that breaks down levodopa. This allows the levodopa to last longer so it doesn't wear off before the next dose.

Levodopa becomes less effective over time. This is because it treats the symptoms of Parkinson's but can’t stop the dopamine-producing cells from being lost. As these cells are lost you will continue to get symptoms and need more frequent doses over time. 

Your brain can’t become resistant to levodopa. People with Parkinson’s will benefit from medications containing levodopa throughout their lifetime.

In Aotearoa New Zealand Stalevo is only available on a prescription from a prescriber.

In Aotearoa New Zealand Stalevo is available as tablets in 4 different strengths depending on the amount of levodopa, carbidopa and entacapone in each tablet:

  • Stalevo 50 mg / 12.5 mg / 200 mg
  • Stalevo 100 mg / 25 mg / 200 mg
  • Stalevo 150 mg / 37.5 mg / 200 mg
  • Stalevo 200 mg / 50 mg / 200 mg

 

Image credit: Healthify He Puna Waiora


Check with your healthcare provider which strength you’re taking. If your medicine looks different to what you were expecting, ask your pharmacist about it.

  • The dose and how often you take Stalevo will be different for different people and depends on your symptoms of Parkinson’s disease and any medicine you may have been taking for Parkinson’s before.
  • The dose prescribed for you may start low and change depending on your symptoms.
  • Over time, you may change how often you take each dose or change to a stronger tablet.
  • Only take 1 tablet for each dose. How often you take 1 tablet may change but the maximum daily dose of the ingredient levodopa is 1500 mg.
  • Always take your Stalevo exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much Stalevo to take, how often to take it and any special instructions.

  • Take the tablet whole: Swallow your tablets whole with water. Don’t cut, crush or chew them.
  • Timing: Take your tablets at the same times each day.
  • Food: You can take Stalevo with or without food, but it’s best NOT to take doses immediately after a large meal. 
  • Protein: For some people with Parkinson’s, protein (which is found mainly in meat, fish, eggs, cheese, beans and pulses) seems to affect how well the body absorbs this medicine. It may be better not to take your tablet near a meal with protein. Talk to your healthcare provider if you think this applies to you. 
  • Missed dose: If you forget to take your dose and there’s more than an hour until your next dose, take the dose now and the next dose at the usual time. If there’s less than an hour until your next dose, take the dose now and the next dose in 1 hour. Then take your following doses at the usual time. Never take double the dose. If you’re not sure what to do, ask your healthcare provider.
  • It's important to take it as prescribed: See tips to help you remember to take your medicines regularly.

Here are some things to know when you're taking Stalevo. Other things may be important as well, so ask your healthcare provider what you should know about.

  • The effects of Stalevo don't occur straight away: It may take up to 3 months before you feel the full effects of the medicine.
  • Alcohol: Stalevo can make you feel dizzy. Limit or avoid drinking alcohol while taking Stalevo as it may make it worse.
  • Driving: Stalevo can make you feel dizzy. Be careful when driving or using tools until you know how this medicine affects you.
  • Other medicines: Stalevo interacts with some medicines (eg, MAOI antidepressants and phenytoin), herbal supplements and rongoā Māori, so check with your healthcare provider before starting Stalevo and before starting any new products.
  • Iron: If you also take iron supplements, take them at least 2 hours before or after you take your Stalevo.
  • Don't stop taking Stalevo suddenly: Talk to your doctor before stopping.
  • Keep taking Stalevo regularly: Treatment with Stalevo is usually long-term. You should continue to take it unless you're advised by your prescriber to stop. Talk to your healthcare provider before stopping as the dose may need to be gradually reduced before stopping completely. This may help reduce the possibility of withdrawal symptoms such as muscle stiffness, fever and mental changes.
  • Monitoring: You may have your weight checked and blood tests to check how well your heart, kidneys and liver are working.
  • Pregnancy or breastfeeding: Talk to your healthcare provider if you're pregnant, planning a pregnancy or want to breastfeed.

Like all medicines, Stalevo can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine. 

Side effects What should I do?
  • Feeling sick (nausea)
  • Not wanting to eat
  • Changes in taste
  • Dry mouth
  • Pain in your muscles
  • Runny poo (diarrhoea) or finding it hard to poo (constipation)
  • These are very common when you first start taking Stalevo.
  • Try taking your doses after a light meal or with a low protein snack such as crackers.
  • Tell your doctor if these bother you or if these continue.
  • Feeling dizzy
  • Feeling tired or drowsy
  • These are common.
  • Don't drive or use tools until you know how this medicine affects you and until these side effects have stopped happening.
  • Tell your doctor if these bother you.
  • Don't drink alcohol because this can also make you feel dizzy, tired and drowsy.
  • Feeling light headed or dizzy when you stand up
  • This can be common in the first few days or after your dose has been increased.
  • Be careful when getting up from either lying down or sitting to avoid falls.
  • Tell your doctor if this bothers you.
  • Uncontrollable jerky movements such as tremor, head bobbing and fidgeting
  • Switching suddenly from being able to move to being immobile
  • This is common.
  • Tell your doctor.
  • Changes in the colour of your urine, sweat or saliva – it may turn red, brown or black 
  • This is common.
  • It’s harmless and you don’t need to worry about it.
  • Changes in your mood such as feeling anxious, nervous or agitated, or feeling excited or depressed
  • Impulsive types of behaviour or intense urges that are difficult to control such as binge eating, gambling and increased sexual urges
  • These are not common.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Falling asleep suddenly during daily activities (such as talking on the phone, or driving)
  • This sleep effect can occur without any feelings of drowsiness beforehand, and can happen anytime during treatment with this medication, including up to 1 year after starting the medication
  • This is not common.
  • Tell your doctor.
  • Don’t drive or use tools until you know how this medicine affects you and until these have stopped happening.
  • Avoid drinking alcohol.
  • Signs of an allergic reaction, such as skin rash, itching, swelling of the face, lips or mouth, or problems breathing
  • This is rare.
  • Tell your doctor immediately or ring Healthline 0800 611 116.


Read more about medicines and side effects and reporting a reaction you think might be a side effect. 

Parkinson's overview | Mate pākenetana
Medicines for Parkinson's disease

The following link has more information on Stalevo. 

Stalevo(external link) Medsafe Consumer Information Sheet, NZ 


Brochures

Medicines and side effects(external link) Healthify He Puna Waiora, NZ, 2024
5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)


Apps

Medication reminder apps
Parkinson’s apps
Swallowing difficulty apps


References

  1. levodopa + carbidopa + entacapone(external link) New Zealand Formulary
  2. Stalevo(external link) Medsafe datasheet, NZ 
  3. The management of Parkinson’s disease – which treatments to start and when? (external link)BPAC, NZ, 2014 
  4. Decision to fund levodopa with carbidopa and entacapone combination tablets for people with Parkinson disease(external link) Pharmac, NZ, 2024 
  5. Medication used in the treatment of Parkinson’s(external link) Parkinson’s New Zealand 

Medicines and side effects
Healthify He Puna Waiora, NZ, 2024

5 questions to ask about your medications

5 questions to ask about your medications

Health Quality and Safety Commission, NZ, 2019 English, te reo Māori

Free helplines

Healthline logo

Text 1737 Helpline logo

Healthpoint logo

Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

Last reviewed:

Page last updated:

Read more at: https://healthify.nz/medicines-a-z/s/stalevo
Healthify is brought to you by Health Navigator Charitable Trust