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What is the most important information I should know about carbidopa, entacapone, and levodopa?

Do not stop taking carbidopa, entacapone, and levodopa suddenly. It may take several weeks before you feel the full effects of this medicine. Stopping the medication suddenly may lead to side effects. If the medication needs to be stopped, your doctor may need to lower the dosage gradually. Do not crush, chew, or break the tablets. Swallow them whole. Use caution when driving, operating machinery, or performing other hazardous activities. Carbidopa, entacapone, and levodopa may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Call your doctor immediately if you have uncontrollable movements of the mouth, tongue, cheeks, jaw, arms, or legs; fever; or increased body heat.

What is carbidopa, entacapone, and levodopa?

Carbidopa, entacapone, and levodopa are medications used to treat Parkinson's disease. Parkinson's disease is believed to be related to low levels of a chemical called dopamine (DOE pa meen) in the brain. Levodopa is turned into dopamine in the body. Carbidopa and entacapone are used with levodopa to prevent the breakdown (metabolism) of levodopa in the body.

Carbidopa, entacapone, and levodopa are used together to treat the stiffness, tremors, spasms, and poor muscle control associated with Parkinson's disease.

Carbidopa, entacapone, and levodopa may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking carbidopa, entacapone, and levodopa?

Do not take carbidopa, entacapone, and levodopa without first talking to your doctor if you have

• narrow-angle glaucoma (angle closure glaucoma);

• current or past history of malignant melanoma (a type of skin cancer); or

• taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.

Before taking carbidopa, entacapone, and levodopa, tell your doctor if you have:

• heart disease, including high blood pressure, hardening of the arteries, a previous heart attack, or an irregular heartbeat;

• respiratory disease, including asthma and chronic obstructive pulmonary disease (COPD) (e.g., emphysema, chronic bronchitis);

• liver disease;
• kidney disease;

• a history of bile duct obstruction;

• an endocrine (hormonal) disease;

• a stomach or intestinal ulcer;

• wide-angle glaucoma; or

• depression or mental health problems.

You may not be able to take carbidopa, entacapone, and levodopa, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Carbidopa, entacapone, and levodopa is in the FDA pregnancy category C. This means that it is not known whether carbidopa, entacapone, and levodopa will be harmful to an unborn baby. Do not take carbidopa, entacapone, and levodopa without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether carbidopa, entacapone, and levodopa will be harmful to a nursing infant. Do not take carbidopa, entacapone, and levodopa without first talking to your doctor if you are breast-feeding a baby.