Stalevo (carbidopa/levodopa/entacapone) is a brand-name drug prescribed for Parkinson’s disease in adults. Stalevo comes as an oral tablet that’s taken as directed by your doctor. The dosage can vary depending on several factors.
Stalevo is approved by the Food and Drug Administration (FDA) to treat Parkinson’s disease (PD) in adults in the following circumstances:
- Changing from taking two separate tablets to one tablet. Instead of taking carbidopa/levodopa and entacapone separately, you’ll take one tablet that contains all three drugs.
- Replacing carbidopa/levodopa therapy (without entacapone) when “wearing off” occurs. “Wearing off” describes a worsening of PD symptoms as the drug wears off. Stalevo may be prescribed when the total daily dose of levodopa is 600 milligrams (mg) or less with no dyskinesias (uncontrolled muscle movements).
Stalevo contains three drugs from different drug classes:
- carbidopa, a decarboxylation inhibitor
- levodopa, a dopamine precursor
- entacapone, a catechol-O-methyltransferase inhibitor
Stalevo is available in a generic version.
Keep reading for specific information about the dosage of Stalevo, including its strengths and how to take the medication. For a comprehensive look at Stalevo, see this article.
Note: This article describes typical dosages for Stalevo provided by the drug’s manufacturer. When taking Stalevo, always follow the dosage prescribed by your doctor.
Read below for recommended dosages of Stalevo and other details about the drug.
Stalevo form
Stalevo comes as an oral tablet.
Stalevo strengths
Stalevo comes in the following six strengths:
- Stalevo 50: 12.5 mg of carbidopa/50 mg of levodopa/200 mg of entacapone
- Stalevo 75: 18.75 mg of carbidopa/75 mg of levodopa/200 mg of entacapone
- Stalevo 100: 25 mg of carbidopa/100 mg of levodopa/200 mg of entacapone
- Stalevo 125: 31.25 mg of carbidopa/125 mg of levodopa/200 mg of entacapone
- Stalevo 150: 37.5 mg of carbidopa/150 mg of levodopa/200 mg of entacapone
- Stalevo 200: 50 mg of carbidopa/200 mg of levodopa/200 mg of entacapone
Typical dosages
The following information describes dosages that are commonly prescribed or recommended in adults. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for Parkinson’s disease
Doctors may prescribe Stalevo to treat PD. It’s typically prescribed if you’ve already been taking carbidopa/levodopa alone or carbidopa/levodopa plus entacapone.
If your doctor prescribes Stalevo for PD, your starting dosage will likely be based on the dosage of carbidopa/levodopa alone or carbidopa/levodopa plus entacapone that you’ve already been taking. For example, if you were taking one tablet of carbidopa/levodopa 25 mg/100 mg and one tablet of entacapone 200 mg, your doctor would likely prescribe you one Stalevo 100 tablet.
Typically, you’ll take Stalevo several times per day to control your symptoms.
Your doctor will closely monitor you and may adjust your Stalevo dosage as needed to control symptoms of PD.
The table below shows the typical maximum dosage of Stalevo based on tablet strength.
| Stalevo tablet strength | Maximum number of tablets taken each day |
|---|---|
| Stalevo 50, Stalevo 75, Stalevo 100, Stalevo 125, Stalevo 150 | 8 |
| Stalevo 200 | 6 |
For more information about your specific dosage, talk with your doctor.
Long-term treatment
Stalevo is meant to be taken as a long-term treatment. If you and your doctor determine that Stalevo is safe and effective for you, you’ll likely take it long term.
Before you start taking Stalevo, your doctor will discuss your treatment plan with you.
The Stalevo dosage your doctor prescribes will depend on several factors. These include:
- how your body responds to Stalevo
- the type and severity of the PD symptoms you’re taking Stalevo to treat
- other medications you take
- side effects you may have with Stalevo
- your liver function
Other medical conditions you have can also affect your Stalevo dosage.
Dosage adjustments
Your doctor may need to adjust your dosage if you take certain medications, such as CYP2C9* inhibitors or inducers. These drugs can affect the level of Stalevo in your body.
Your doctor may also need to adjust your dosage if you have liver damage.
Be sure to tell your doctor about all medications you take and any health conditions you may have.
* CYP2C9 is a type of protein in your liver that breaks down medications.
Stalevo comes as an oral tablet that you swallow whole. Do not divide, crush, chew, or place the tablet in water. You may take your dose with or without food.
Let your doctor know if you’re considering changing your diet. Taking Stalevo with foods that are high in protein may make it harder for your body to absorb levodopa (one of the drugs in Stalevo). This might make the drug less effective. If you have questions about what types of food to eat with Stalevo, talk with your doctor.
Be sure to take Stalevo at the times recommended by your doctor. This helps maintain a steady level of the drug in your body so Stalevo can work effectively.
If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.
If you have questions about how to take Stalevo, talk with your doctor or pharmacist.
ACCESSIBLE DRUG LABELS AND CONTAINERSSome pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Stalevo in an easy-open container. They also may recommend tools that can make it easier to open bottles.
If you miss a dose of Stalevo, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next scheduled dose. Do not take two doses to make up for the missed one. If you’re not sure whether you should take a missed dose or skip it, talk with your doctor or pharmacist.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.
It’s important that you don’t take more Stalevo than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.
Effects of an overdose
Overdose effects of Stalevo can include:
- low blood pressure
- racing heart rate
- hallucinations (seeing or hearing things that aren’t really there)
- kidney problems
- muscle breakdown
- belly pain
- diarrhea
If you take more than the recommended amount of Stalevo
Call your doctor right away if you believe you’ve taken too much Stalevo. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
It’s not known whether Stalevo can cause drug dependence. However, stopping treatment abruptly can cause worsening of PD symptoms. It can also cause serious side effects similar to neuroleptic malignant syndrome. These include:
- confusion
- fever
- stiff muscles
- high or low blood pressure
- nervous system problems
You and your doctor will periodically reevaluate your need for Stalevo throughout your treatment. If a decision is made to stop your Stalevo treatment, your doctor will slowly lower your dose over time. This is known as a dose taper. A dose taper helps reduce your risk of experiencing worsening symptoms or serious side effects when you stop treatment with Stalevo.
Tapering your Stalevo dose could last several weeks or even months. The exact time needed to taper your dose depends on your Stalevo dose and how long you’ve taken it.
Do not stop taking Stalevo unless your doctor specifically tells you to do so. If you have questions about your treatment, talk with your doctor.
Below are some frequently asked questions about Stalevo.
What is the recommended maximum dosage of Stalevo?
The maximum dosage of Stalevo that’s recommended is based on the amount of entacapone in Stalevo tablets. The daily maximum recommended dosage of entacapone is 1,600 mg. For more details about the recommended maximum number of tablets to take per day, see the table in the “Dosage for Parkinson’s disease” section above.
If you have questions or concerns about your dosage of Stalevo, talk with your doctor or pharmacist. If it seems like you need a higher dosage, ask your doctor whether a dosage increase is right for you. Do not increase your dosage unless your doctor recommends doing so.
How long does it take for Stalevo to start working?
Stalevo starts to work about 30 minutes after your first dose. Each dose works quickly but also wears off. That’s why it’s important to follow your dosing schedule to control your PD symptoms. Your doctor will also monitor you during treatment to check whether the drug is working for you.
Talk with your doctor if you have questions about what to expect with Stalevo treatment.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Stalevo for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.
As with any drug, never change your dosage of Stalevo without your doctor’s recommendation. If you have questions about the dosage of Stalevo that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Stalevo. These additional articles might be helpful:
- More about Stalevo: For information about other aspects of Stalevo, refer to this article.
- Side effects: To learn about side effects of Stalevo, see the Stalevo prescribing information.
- Details about your condition: For details about Parkinson’s disease, see our Parkinson’s disease hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.