Carb/lev/entac 37.5-150-200mg Tabs
It is used to treat Parkinson's disease.
Drug Class
Antiparkinsonian agent
Pharmacologic Class
Dopamine precursor; DOPA decarboxylase inhibitor; Catechol-O-methyltransferase (COMT) inhibitor
Pregnancy Category
Category C
FDA Approved
Jun 2003
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication combines three drugs to help manage Parkinson's disease symptoms, especially when your current medication starts to wear off before your next dose. Levodopa turns into dopamine in your brain to help control movement. Carbidopa helps more levodopa get to your brain and reduces side effects. Entacapone helps levodopa last longer in your body, which can reduce 'off' times.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided to you and follow the instructions precisely. You can take this medication with or without food. Swallow the tablet whole - do not chew, break, or crush it.
If you are taking an iron supplement or a multivitamin that contains iron, consult your doctor or pharmacist about how to take it in conjunction with this medication. Iron may reduce the absorption of this medication in your body.
It's also important to note that a diet high in protein, fat, or calories may decrease the absorption of this medication. Consuming acidic foods may have a similar effect. Discuss your diet with your doctor, especially if you plan to make any changes.
Do not stop taking this medication abruptly without consulting your doctor, as this may increase your risk of side effects. If you need to stop taking this medication, your doctor will advise you on how to gradually discontinue it.
Continue taking this medication even when you are not experiencing symptoms. Keeping a diary of your symptoms can be helpful in tracking your progress. Take this medication at the same time every day, as directed by your doctor or healthcare provider, even if you are feeling well.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided to you and follow the instructions precisely. You can take this medication with or without food. Swallow the tablet whole - do not chew, break, or crush it.
If you are taking an iron supplement or a multivitamin that contains iron, consult your doctor or pharmacist about how to take it in conjunction with this medication. Iron may reduce the absorption of this medication in your body.
It's also important to note that a diet high in protein, fat, or calories may decrease the absorption of this medication. Consuming acidic foods may have a similar effect. Discuss your diet with your doctor, especially if you plan to make any changes.
Do not stop taking this medication abruptly without consulting your doctor, as this may increase your risk of side effects. If you need to stop taking this medication, your doctor will advise you on how to gradually discontinue it.
Continue taking this medication even when you are not experiencing symptoms. Keeping a diary of your symptoms can be helpful in tracking your progress. Take this medication at the same time every day, as directed by your doctor or healthcare provider, even if you are feeling well.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses.
Lifestyle & Tips
- Take exactly as prescribed; do not stop suddenly without consulting your doctor.
- Do not crush or chew tablets; swallow whole.
- Take with or without food, but be aware that high-protein meals may reduce the effectiveness of the medication. Discuss dietary considerations with your doctor.
- Stand up slowly to avoid dizziness or fainting due to low blood pressure.
- Report any new or worsening involuntary movements (dyskinesia), hallucinations, unusual urges (e.g., gambling, shopping, eating), or changes in mood/behavior to your doctor immediately.
- Urine, sweat, or saliva may turn reddish-brown or black; this is a harmless effect of entacapone.
- Avoid driving or operating machinery if you experience sudden sleep onset or excessive drowsiness.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Individualized, typically 1 tablet of the prescribed strength taken orally with or without food. Dosing frequency is based on levodopa requirements, usually 3 to 8 times daily.
Dose Range:
37.5 - 200 mg
Condition-Specific Dosing:
Parkinson's Disease (wearing-off):
Initial dose should provide approximately 10% more levodopa than the previous carbidopa/levodopa regimen, or a direct switch to a strength providing equivalent levodopa. Entacapone component is fixed at 200mg per dose. Maximum recommended daily dose of entacapone is 1600 mg (8 tablets of 200mg).
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended.
Moderate:
No specific adjustment recommended.
Severe:
Use with caution. Entacapone excretion is primarily biliary, but renal impairment may affect levodopa/carbidopa pharmacokinetics.
Dialysis:
Not specifically studied; use with caution. Entacapone is highly protein bound and unlikely to be significantly removed by dialysis.
Hepatic Impairment:
Mild:
No specific adjustment recommended.
Moderate:
Use with caution. Consider dose reduction for entacapone component as its metabolism is primarily hepatic. Monitor for adverse effects.
Severe:
Use with caution. Consider significant dose reduction for entacapone component. Monitor for adverse effects.
Pharmacology
Mechanism of Action
Carbidopa/levodopa/entacapone is a combination product used to treat Parkinson's disease. Levodopa is a metabolic precursor of dopamine that crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa, an aromatic L-amino acid decarboxylase inhibitor, prevents the peripheral conversion of levodopa to dopamine, thereby increasing the amount of levodopa available to the brain and reducing peripheral side effects. Entacapone is a reversible and selective catechol-O-methyltransferase (COMT) inhibitor that prevents the peripheral degradation of levodopa, prolonging its half-life and increasing its bioavailability to the brain, particularly useful for managing 'wearing-off' symptoms.
Pharmacokinetics
Absorption:
Bioavailability:
Levodopa: ~30% (when given with carbidopa); Entacapone: ~35%
Tmax:
Levodopa: 0.6-2 hours; Entacapone: 1 hour
FoodEffect:
Food delays and decreases the absorption of levodopa. High-protein meals can reduce levodopa absorption and efficacy. Entacapone absorption is not significantly affected by food.
Distribution:
Vd:
Levodopa: 0.9-1.6 L/kg; Entacapone: 20 L
ProteinBinding:
Levodopa: ~10-30%; Carbidopa: ~36%; Entacapone: >98% (primarily to albumin)
CnssPenetration:
Levodopa: Yes (after conversion to dopamine); Carbidopa: Limited; Entacapone: Limited
Elimination:
HalfLife:
Levodopa: 1.5-2 hours (with carbidopa); Entacapone: 0.4-0.7 hours (initial), 2.4 hours (terminal)
Clearance:
Not available
ExcretionRoute:
Levodopa: Primarily renal (metabolites); Carbidopa: Renal (unchanged and metabolites); Entacapone: Primarily fecal (90-95%), small amount renal (10-20%)
Unchanged:
Levodopa: <1% (renal); Carbidopa: ~30% (renal); Entacapone: <0.2% (renal)
Pharmacodynamics
OnsetOfAction:
Variable, typically within 30-60 minutes for levodopa effect
PeakEffect:
Variable, typically 1-2 hours after dose
DurationOfAction:
Variable, typically 2-4 hours, but prolonged by entacapone, reducing 'wearing-off' periods.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
New or worsening behavioral or mood changes, including depression or suicidal thoughts
Hallucinations (seeing or hearing things that are not there)
Severe dizziness or fainting
Confusion
Vomiting blood or coffee ground-like material
Black, tarry, or bloody stools
Muscle pain or weakness, dark urine, or difficulty urinating
Skin lumps or growths, or changes in the color or size of a mole
Strong, uncontrollable urges (such as eating, gambling, sex, or spending money)
New or worsening trouble controlling body movements
Chest pain or pressure
Shortness of breath
Fever, chills, sore throat, unexplained bruising or bleeding, or feeling extremely tired or weak
Sudden, unexplained sleepiness, especially during activities like driving, eating, or talking
If you experience sudden sleepiness, do not drive or engage in activities that require alertness. Contact your doctor immediately if you experience this or any other concerning side effects.
Neuroleptic Malignant Syndrome (NMS): A Rare but Serious Condition
NMS is a potentially life-threatening condition that can occur when this medication is stopped abruptly or when the dose is lowered. If you experience any of the following symptoms, contact your doctor immediately:
Fever
Muscle cramps or stiffness
Dizziness
Severe headache
Confusion or changes in thinking
Fast or irregular heartbeat
Excessive sweating
Other Possible Side Effects
Most people do not experience significant side effects, but some may occur. If you notice any of the following side effects, contact your doctor if they bother you or do not go away:
Dizziness, drowsiness, tiredness, or weakness
Constipation, diarrhea, stomach pain, upset stomach, or vomiting
Dry mouth
Headache
Trouble sleeping
Back pain
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
New or worsening behavioral or mood changes, including depression or suicidal thoughts
Hallucinations (seeing or hearing things that are not there)
Severe dizziness or fainting
Confusion
Vomiting blood or coffee ground-like material
Black, tarry, or bloody stools
Muscle pain or weakness, dark urine, or difficulty urinating
Skin lumps or growths, or changes in the color or size of a mole
Strong, uncontrollable urges (such as eating, gambling, sex, or spending money)
New or worsening trouble controlling body movements
Chest pain or pressure
Shortness of breath
Fever, chills, sore throat, unexplained bruising or bleeding, or feeling extremely tired or weak
Sudden, unexplained sleepiness, especially during activities like driving, eating, or talking
If you experience sudden sleepiness, do not drive or engage in activities that require alertness. Contact your doctor immediately if you experience this or any other concerning side effects.
Neuroleptic Malignant Syndrome (NMS): A Rare but Serious Condition
NMS is a potentially life-threatening condition that can occur when this medication is stopped abruptly or when the dose is lowered. If you experience any of the following symptoms, contact your doctor immediately:
Fever
Muscle cramps or stiffness
Dizziness
Severe headache
Confusion or changes in thinking
Fast or irregular heartbeat
Excessive sweating
Other Possible Side Effects
Most people do not experience significant side effects, but some may occur. If you notice any of the following side effects, contact your doctor if they bother you or do not go away:
Dizziness, drowsiness, tiredness, or weakness
Constipation, diarrhea, stomach pain, upset stomach, or vomiting
Dry mouth
Headache
Trouble sleeping
Back pain
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe dizziness or fainting (orthostatic hypotension)
- New or worsening involuntary movements (dyskinesia)
- Hallucinations (seeing or hearing things that aren't there)
- Delusions or confusion
- Unusual urges or behaviors (e.g., compulsive gambling, hypersexuality, binge eating)
- Severe or persistent diarrhea
- Signs of liver problems (e.g., persistent nausea/vomiting, dark urine, yellowing of skin/eyes, severe abdominal pain)
- Sudden onset of sleep during daily activities
- Worsening Parkinson's symptoms or 'off' periods
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Glaucoma
+ Skin lumps or growths
+ A history of skin cancer
* If you have taken specific antidepressant medications, such as isocarboxazid, phenelzine, or tranylcypromine, within the last 14 days. Using this medication within 14 days of these drugs can lead to severe high blood pressure.
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Glaucoma
+ Skin lumps or growths
+ A history of skin cancer
* If you have taken specific antidepressant medications, such as isocarboxazid, phenelzine, or tranylcypromine, within the last 14 days. Using this medication within 14 days of these drugs can lead to severe high blood pressure.
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
When starting this medication, avoid driving and other activities that require alertness until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and exercise caution when climbing stairs.
Regular blood tests and other laboratory assessments are crucial while taking this medication. Follow your doctor's instructions for scheduling these tests. Additionally, notify all healthcare providers and laboratory personnel that you are taking this medication, as it may interfere with certain lab tests.
You may experience a decrease in the medication's effect as the time for your next dose approaches. If this occurs and causes concern, discuss it with your doctor. It may take several months to achieve the full therapeutic effect of this medication.
Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that can cause drowsiness, consult with your doctor.
You may notice a dark discoloration (red, brown, or black) in your saliva, urine, or sweat while taking this medication. Although this is harmless, it may stain your clothing.
If you experience diarrhea or vomiting, consult your doctor promptly to prevent dehydration and electrolyte imbalances.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby.
When starting this medication, avoid driving and other activities that require alertness until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and exercise caution when climbing stairs.
Regular blood tests and other laboratory assessments are crucial while taking this medication. Follow your doctor's instructions for scheduling these tests. Additionally, notify all healthcare providers and laboratory personnel that you are taking this medication, as it may interfere with certain lab tests.
You may experience a decrease in the medication's effect as the time for your next dose approaches. If this occurs and causes concern, discuss it with your doctor. It may take several months to achieve the full therapeutic effect of this medication.
Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that can cause drowsiness, consult with your doctor.
You may notice a dark discoloration (red, brown, or black) in your saliva, urine, or sweat while taking this medication. Although this is harmless, it may stain your clothing.
If you experience diarrhea or vomiting, consult your doctor promptly to prevent dehydration and electrolyte imbalances.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe dyskinesia
- Agitation
- Confusion
- Insomnia
- Orthostatic hypotension
- Cardiac arrhythmias
- Nausea/vomiting
What to Do:
Seek immediate medical attention. Call 911 or Poison Control at 1-800-222-1222. Management is supportive, including gastric lavage, IV fluids, and careful monitoring of vital signs and cardiac rhythm. Consider antiarrhythmic agents if needed. Pyridoxine is not effective in reversing levodopa effects when carbidopa is present.
Drug Interactions
Contraindicated Interactions
- Non-selective monoamine oxidase inhibitors (MAOIs) (e.g., phenelzine, tranylcypromine) - risk of hypertensive crisis. Must be discontinued at least 2 weeks prior to starting carbidopa/levodopa/entacapone.
Major Interactions
- Selective MAO-A inhibitors (e.g., moclobemide) - risk of hypertensive crisis.
- Iron salts (ferrous sulfate, gluconate) - form chelates with levodopa and entacapone, reducing absorption. Separate administration by at least 2-3 hours.
- Dopamine D2 receptor antagonists (e.g., antipsychotics like haloperidol, chlorpromazine, metoclopramide) - may antagonize the effects of levodopa, worsening Parkinson's symptoms.
- Antihypertensive agents - increased risk of orthostatic hypotension.
- Other drugs metabolized by COMT (e.g., isoproterenol, epinephrine, norepinephrine, dopamine, dobutamine, alpha-methyldopa, apomorphine) - entacapone may potentiate their effects.
Moderate Interactions
- Tricyclic antidepressants (TCAs) - may increase risk of orthostatic hypotension and hypertension.
- Phenytoin - may reduce levodopa efficacy.
- Papaverine - may reduce levodopa efficacy.
- Benzodiazepines - may reduce levodopa efficacy.
- High-protein diet - may reduce levodopa absorption and efficacy.
- Pyridoxine (Vitamin B6) - large doses may reverse levodopa effects if carbidopa is not present in sufficient amounts (less relevant with combination product).
Minor Interactions
- Not available
Monitoring
Baseline Monitoring
Complete medical history and physical exam
Rationale: To identify contraindications, pre-existing conditions (e.g., cardiovascular disease, psychiatric disorders, glaucoma, liver disease), and establish baseline neurological status.
Timing: Prior to initiation
Liver function tests (ALT, AST, bilirubin)
Rationale: Although rare, entacapone has been associated with liver enzyme elevations and, in very rare cases, liver failure.
Timing: Prior to initiation
Renal function (BUN, creatinine)
Rationale: To assess baseline kidney function, especially in patients with pre-existing renal impairment.
Timing: Prior to initiation
Blood pressure (supine and standing)
Rationale: To assess for baseline orthostatic hypotension, a common side effect of dopaminergic therapy.
Timing: Prior to initiation
Routine Monitoring
Motor symptoms (e.g., tremor, rigidity, bradykinesia, dyskinesia, 'wearing-off' periods)
Frequency: At each visit (e.g., every 1-3 months initially, then every 3-6 months)
Target: Optimal symptom control with minimal dyskinesia
Action Threshold: Worsening symptoms, new or increased dyskinesia, or significant 'wearing-off' require dose adjustment or re-evaluation.
Psychiatric status (e.g., hallucinations, delusions, confusion, impulse control disorders)
Frequency: At each visit
Target: Absence of significant psychiatric symptoms
Action Threshold: New or worsening psychiatric symptoms require dose adjustment or consideration of alternative therapy.
Blood pressure (supine and standing)
Frequency: Regularly, especially during dose titration and if symptoms of orthostatic hypotension occur.
Target: Stable blood pressure without symptomatic orthostasis
Action Threshold: Symptomatic orthostatic hypotension (e.g., dizziness, syncope) requires intervention (e.g., dose reduction, non-pharmacological measures).
Liver function tests (ALT, AST)
Frequency: Periodically, especially if symptoms of liver dysfunction develop or if patient has pre-existing liver disease.
Target: Within normal limits
Action Threshold: Significant or persistent elevations may warrant discontinuation of entacapone.
Symptom Monitoring
- Dyskinesia (involuntary movements)
- Nausea/vomiting
- Orthostatic hypotension (dizziness upon standing)
- Hallucinations/delusions
- Confusion/disorientation
- Sleep disturbances (insomnia, somnolence, sudden sleep onset)
- Impulse control disorders (e.g., pathological gambling, hypersexuality, compulsive shopping, binge eating)
- Diarrhea
- Urine discoloration (orange/brown)
- Abdominal pain
- Fatigue
Special Patient Groups
Pregnancy
Category C. There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Levodopa has been shown to cause visceral and skeletal malformations in rabbits at doses similar to human therapeutic doses.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity based on animal studies.
Second Trimester:
Risk of adverse effects on fetal development not fully established.
Third Trimester:
Risk of adverse effects on fetal development not fully established.
Lactation
Levodopa is excreted in human milk. It is unknown if carbidopa or entacapone are excreted in human milk. Dopaminergic agents can inhibit lactation. Due to the potential for serious adverse reactions in breastfed infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Infant Risk:
L3 (Moderate risk). Potential for inhibition of lactation, and unknown effects of entacapone on infant. Monitor infant for drowsiness, poor feeding, or unusual movements.
Pediatric Use
Safety and effectiveness have not been established in pediatric patients. Use is not recommended.
Geriatric Use
No overall differences in safety or effectiveness were observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Dose titration should be done carefully due to increased susceptibility to side effects like orthostatic hypotension and hallucinations.
Clinical Information
Clinical Pearls
- This combination product is specifically designed for Parkinson's patients experiencing 'wearing-off' phenomena, where the effects of levodopa/carbidopa diminish before the next dose.
- Patients should be advised about the potential for urine, sweat, or saliva to turn reddish-brown or black due to entacapone, which is a harmless effect.
- Counsel patients on the risk of impulse control disorders (e.g., pathological gambling, hypersexuality, compulsive shopping, binge eating) and to report these to their physician.
- Sudden sleep onset can occur without warning, even in patients who do not report prior somnolence. Advise caution with driving or operating machinery.
- Iron supplements should be taken at least 2-3 hours apart from this medication to avoid reduced absorption.
- Diarrhea can be a significant side effect of entacapone; if severe or persistent, it may warrant discontinuation.
- Dose adjustments should be made gradually and individualized based on patient response and tolerability.
Alternative Therapies
- Dopamine agonists (e.g., pramipexole, ropinirole, rotigotine, apomorphine)
- MAO-B inhibitors (e.g., selegiline, rasagiline, safinamide)
- COMT inhibitors (e.g., entacapone, tolcapone - as monotherapy adjunct to carbidopa/levodopa)
- Amantadine
- Istradefylline
- Pimavanserin (for Parkinson's disease psychosis)
- Deep Brain Stimulation (DBS) for advanced cases
Cost & Coverage
Average Cost:
Varies widely by strength and pharmacy, typically $300-$1000+ per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Tier 2 or 3 (for generic), Tier 3 or 4 (for brand)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.