Do not take Stalevo if you
- are allergic (hypersensitive) to levodopa, carbidopa or entacapone, or any of the other ingredients of Stalevo
- have narrow-angle glaucoma (an eye disorder)
- have a tumour of the adrenal gland
- are taking certain medicines for treating depression (combinations of selective MAO-A and MAO-B inhibitors, or non-selective MAO-inhibitors)
- have ever had neuroleptic malignant syndrome (NMS ? this is a rare reaction to medicines used to treat severe mental disorders)
- have ever had non-traumatic rhabdomyolysis (a rare muscle disorder)
- have a severe liver disease.
Take special care with Stalevo
Consult your doctor if you have or have ever had:
- a heart attack or any other diseases of the heart including cardiac arrythmias, or of the blood vessels
- asthma or any other disease of the lungs
- a liver problem, because your dose may need to be adjusted
- kidney or hormone-related diseases
- stomach ulcers or convulsions
- if you experience prolonged diarrhoea consult your doctor as it may be a sign of inflammation of the colon
- any form of severe mental disorder like psychosis
- chronic wide-angle glaucoma, because your dose may need to be adjusted and the pressure in your eyes may need to be monitored.
Consult your doctor if you are currently taking:
- antipsychotics (medicines used to treat psychosis)
- a medicine which may cause low blood pressure when rising from a chair or bed. You should be aware that Stalevo may make these reactions worse.
Consult your doctor if during the treatment with Stalevo you:
- notice that your muscles get very rigid or jerk violently, or if you get tremors, agitation, confusion, fever, rapid pulse, or wide fluctuations in your blood pressure. If any of this happens, contact your doctor immediately
- feel depressed, have suicidal thoughts, or notice unusual changes in your behaviour
- find yourself suddenly falling asleep, or if you feel very drowsy. If this happens, you should not drive or use any tools or machines (see also section 'Driving and using machines')
- notice that uncontrolled movements begin or get worse after you started to take Stalevo. If this happens, your doctor may need to change the dose of your antiparkinson medicine
- experience diarrhoea: monitoring of your weight is recommended in order to avoid potentially excessive weight loss
- experience progressive anorexia, asthenia (weakness, exhaustion) and weight decrease within a relatively short period of time. If this happens, a general medical evaluation including liver function should be considered
- experience excessive gambling or excessive sexual activity
- feel the need to stop using Stalevo, see section 'If you stop taking Stalevo'.
Your doctor may take some regular laboratory tests during a long term treatment with Stalevo.
If you must undergo surgery, please tell your doctor that you are using Stalevo.
Stalevo is not recommended to be used for treatment of extrapyramidal symptoms (e.g. involuntary movements, shaking, muscle rigidity and muscle contractions) caused by other medicines.
Experience with Stalevo in patients under 18 years is limited. Therefore, the use of Stalevo in children is not recommended.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription and herbal medicines.
Do not take Stalevo if you are taking certain medicines for treating depression (combinations of selective MAO-A and MAO-B inhibitors, or non-selective MAO inhibitors).
Stalevo may increase the effects and side effects of certain medicines. These include:
- medicines used to treat depression such moclobemide, amitryptiline, desipramine, maprotiline, venlafaxine and paroxetine,
- rimiterole and isoprenaline, used to treat respiratory diseases
- adrenaline, used for severe allergic reactions
- noradrenaline, dopamine and dobutamine, used to treat heart diseases and low blood pressure
- alpha-methyldopa, used to treat high blood pressure
- apomorphine, which is used to treat Parkinson?s disease.
The effects of Stalevo may be weakened by certain medicines. These include:
- dopamine antagonists used to treat mental disorders, nausea and vomiting
- phenytoin used to prevent convulsions
- papaverine used to relax the muscles.
Stalevo may make it harder for you to digest iron. Therefore, do not take Stalevo and iron supplements at the same time. After taking one of them, wait at least 2 to 3 hours before taking the other.
Taking Stalevo with food and drink
Stalevo may be taken with or without food. For some patients, Stalevo may not be well absorbed if it is taken with, or shortly after eating protein-rich food (such as meats, fish, dairy products, seeds and nuts). Consult your doctor if you think this applies to you.
Pregnancy and breast-feeding
If you are pregnant or think you may be pregnant, consult your doctor before taking Stalevo.
You should not breast-feed during treatment with Stalevo.
Driving and using machines
Stalevo may lower your blood pressure, which may make you feel light-headed or dizzy. Therefore, be particularly careful when you drive or when you use any tools or machines.
If you feel very drowsy, or if you sometimes find yourself suddenly falling asleep, wait until you feel fully awake again before driving or doing anything else that requires you to be alert. Otherwise, you may put yourself and others at risk of serious injury or death.
Important information about some of the ingredients of Stalevo
Stalevo contains sucrose (1.6 mg/tablet). If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicinal product.