Stalevo 100 Tablets
It is used to treat Parkinson's disease.
Drug Class
Antiparkinsonian agents
Pharmacologic Class
Dopaminergic agents; Catechol-O-methyltransferase (COMT) inhibitors
Pregnancy Category
Category C
FDA Approved
Jun 2003
DEA Schedule
Not Controlled
Overview
What is this medicine?
Stalevo is a combination medicine used to treat Parkinson's disease. It helps reduce symptoms like stiffness, tremors, muscle spasms, and poor muscle control. It works by increasing a natural substance called dopamine in the brain. One part of the medicine (entacapone) helps the main ingredient (levodopa) work longer and more effectively.
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 with your prescription and follow the instructions closely. You can take this medication with or without food. Swallow the tablet whole - do not chew, break, or crush it.
If you take an iron supplement or a multivitamin that contains iron, consult your doctor or pharmacist about how to take it with this medication. Iron may reduce the absorption of this medication in your body.
Your diet can also affect how well your body absorbs this medication. Diets high in protein, fat, or calories, as well as acidic foods, may reduce absorption. Discuss your diet with your doctor, especially if you plan to make any changes.
Do not stop taking this medication suddenly without consulting your doctor, as this may increase your risk of side effects. If you need to stop taking this medication, your doctor will instruct you on how to taper off gradually.
Continue taking this medication even when you are not experiencing symptoms. Keep a record of your symptoms to track your progress. Take this medication at the same time every day, as directed by your doctor or healthcare provider, even if you feel well.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom. Keep all medications 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 is 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 with your prescription and follow the instructions closely. You can take this medication with or without food. Swallow the tablet whole - do not chew, break, or crush it.
If you take an iron supplement or a multivitamin that contains iron, consult your doctor or pharmacist about how to take it with this medication. Iron may reduce the absorption of this medication in your body.
Your diet can also affect how well your body absorbs this medication. Diets high in protein, fat, or calories, as well as acidic foods, may reduce absorption. Discuss your diet with your doctor, especially if you plan to make any changes.
Do not stop taking this medication suddenly without consulting your doctor, as this may increase your risk of side effects. If you need to stop taking this medication, your doctor will instruct you on how to taper off gradually.
Continue taking this medication even when you are not experiencing symptoms. Keep a record of your symptoms to track your progress. Take this medication at the same time every day, as directed by your doctor or healthcare provider, even if you feel well.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom. Keep all medications 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 is 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 Stalevo exactly as prescribed by your doctor. Do not stop taking it suddenly, as this can lead to serious side effects.
- You can take Stalevo with or without food, but try to be consistent. High-protein meals may reduce the absorption of levodopa, so discuss dietary protein intake with your doctor.
- Stay hydrated to help prevent orthostatic hypotension (dizziness when standing up).
- Be aware of potential side effects like dizziness, drowsiness, or sudden sleep onset, and avoid driving or operating machinery until you know how the medication affects you.
- Report any new or worsening symptoms, especially unusual urges or behaviors (e.g., gambling, increased sexual urges, compulsive shopping), hallucinations, or confusion, to your doctor immediately.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Individualized, based on patient's current levodopa/carbidopa regimen. Stalevo 100 contains 100 mg levodopa, 25 mg carbidopa, and 200 mg entacapone. Max daily dose of entacapone is 1600 mg (equivalent to 8 tablets of Stalevo 100). Doses should be taken with or without food, but consistently.
Dose Range:
1 - 8 mg
Condition-Specific Dosing:
conversionFromLevodopaCarbidopa:
Start with a Stalevo tablet containing a levodopa dose similar to or slightly higher than the current levodopa dose. Adjust dosing interval and number of doses per day based on clinical response.
conversionFromEntacaponeAndLevodopaCarbidopa:
Direct switch to Stalevo with equivalent doses of levodopa, carbidopa, and entacapone.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment required.
Moderate:
No specific dose adjustment required.
Severe:
Use with caution. Entacapone excretion is primarily renal; consider dose reduction if adverse effects occur.
Dialysis:
Not well studied. Use with caution.
Hepatic Impairment:
Mild:
Use with caution. Consider dose reduction.
Moderate:
Use with caution. Consider dose reduction, especially for entacapone.
Severe:
Not recommended due to increased exposure to entacapone.
Pharmacology
Mechanism of Action
Stalevo combines three active ingredients: Levodopa, Carbidopa, and Entacapone. Levodopa is a metabolic precursor of dopamine that crosses the blood-brain barrier and is converted to dopamine in the brain, alleviating Parkinson's symptoms. Carbidopa is a peripheral dopa decarboxylase inhibitor that prevents the peripheral conversion of levodopa to dopamine, allowing more levodopa to reach the brain and reducing peripheral side effects. Entacapone is a reversible, selective COMT (Catechol-O-methyltransferase) inhibitor that reduces the peripheral metabolism of levodopa, thereby increasing the bioavailability and prolonging the half-life of levodopa in the plasma, leading to more sustained dopaminergic stimulation in the brain.
Pharmacokinetics
Absorption:
Bioavailability:
Levodopa: 15-30% (variable); Carbidopa: 40-70%; Entacapone: 35% (oral)
Tmax:
Levodopa: 0.5-2 hours; Carbidopa: 1-2 hours; Entacapone: 0.5-1.5 hours
FoodEffect:
High-protein meals can significantly decrease the absorption of levodopa. Entacapone absorption is not significantly affected by food, but taking Stalevo with food may delay levodopa absorption.
Distribution:
Vd:
Levodopa: 0.3-1.6 L/kg; Carbidopa: 1.1 L/kg; Entacapone: 0.27 L/kg (at steady state)
ProteinBinding:
Levodopa: Not extensively bound; Carbidopa: ~36%; Entacapone: >98% (primarily to albumin)
CnssPenetration:
Levodopa: Yes (active transport); Carbidopa: Limited; Entacapone: Limited
Elimination:
HalfLife:
Levodopa: ~1.5 hours (prolonged to ~2.4 hours with entacapone); Carbidopa: ~2 hours; Entacapone: ~0.4-0.7 hours (terminal half-life ~2.9 hours)
Clearance:
Levodopa: ~0.5 L/kg/hr; Carbidopa: Not available; Entacapone: ~0.7 L/kg/hr
ExcretionRoute:
Levodopa: Urine (metabolites); Carbidopa: Urine (unchanged and metabolites); Entacapone: Feces (90-95%, mainly metabolites), Urine (10-15%, mainly metabolites)
Unchanged:
Levodopa: <1% (urine); Carbidopa: ~30% (urine); Entacapone: <0.2% (urine)
Pharmacodynamics
OnsetOfAction:
Within 30-60 minutes (for levodopa effect)
PeakEffect:
1-2 hours (for levodopa effect, prolonged with entacapone)
DurationOfAction:
Variable, typically 3-6 hours, depending on individual response and disease progression. Entacapone extends the duration of levodopa's effect.
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:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
New or worsening behavior or mood changes, including:
+ Depression
+ Thoughts of suicide
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
A new skin lump or growth
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, or sore throat
Unexplained bruising or bleeding
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.
Neuroleptic Malignant Syndrome (NMS)
NMS is a rare but potentially life-threatening condition that can occur when this medication is stopped suddenly 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
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 symptoms, contact your doctor if they bother you or do not go away:
Dizziness
Drowsiness
Fatigue
Weakness
Constipation
Diarrhea
Stomach pain
Upset stomach
Vomiting
Dry mouth
Headache
Trouble sleeping
* Back pain
This is not an exhaustive list of possible side effects. If you have questions or concerns, 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:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
New or worsening behavior or mood changes, including:
+ Depression
+ Thoughts of suicide
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
A new skin lump or growth
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, or sore throat
Unexplained bruising or bleeding
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.
Neuroleptic Malignant Syndrome (NMS)
NMS is a rare but potentially life-threatening condition that can occur when this medication is stopped suddenly 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
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 symptoms, contact your doctor if they bother you or do not go away:
Dizziness
Drowsiness
Fatigue
Weakness
Constipation
Diarrhea
Stomach pain
Upset stomach
Vomiting
Dry mouth
Headache
Trouble sleeping
* Back pain
This is not an exhaustive list of possible side effects. If you have questions or concerns, 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:
- Sudden onset of sleep or extreme drowsiness during daily activities
- New or worsening uncontrolled movements (dyskinesia)
- Hallucinations (seeing or hearing things that are not there)
- Delusions or confusion
- Unusual urges or behaviors (e.g., compulsive gambling, hypersexuality, binge eating, compulsive shopping)
- Severe or persistent diarrhea
- Muscle rigidity, fever, confusion, or rapid heart rate (signs of Neuroleptic Malignant Syndrome-like reaction, especially if stopped abruptly)
- Darkening of urine, sweat, or saliva (harmless, due to entacapone metabolites)
- Signs of liver problems (e.g., yellowing of skin/eyes, dark urine, persistent nausea/vomiting, severe stomach pain)
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 adjust the dosage of any medication without consulting your doctor first.
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 adjust the dosage of any medication without consulting your doctor first.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This will help ensure they have a complete understanding of your treatment plan.
To minimize the risk of accidents, avoid driving and other activities that require alertness until you understand how this medication affects you. When getting up from a sitting or lying down position, rise slowly to reduce the likelihood of feeling dizzy or lightheaded. Be cautious when navigating stairs to prevent falls.
Regular blood tests and other laboratory evaluations are crucial while taking this medication. Follow your doctor's instructions for scheduling these tests. It is also important to 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 effectiveness as the time approaches for your next dose. If this occurs and causes concern, discuss it with your doctor. Please note that it may take several months to realize the full benefits of this medication.
Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may cause drowsiness, consult with your doctor. These substances may interact with your medication and increase the risk of adverse effects.
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, contact your doctor promptly. It is crucial to prevent dehydration and electrolyte imbalances, which can be serious complications.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. They will help you weigh the benefits and risks of this medication to both you and your baby.
To minimize the risk of accidents, avoid driving and other activities that require alertness until you understand how this medication affects you. When getting up from a sitting or lying down position, rise slowly to reduce the likelihood of feeling dizzy or lightheaded. Be cautious when navigating stairs to prevent falls.
Regular blood tests and other laboratory evaluations are crucial while taking this medication. Follow your doctor's instructions for scheduling these tests. It is also important to 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 effectiveness as the time approaches for your next dose. If this occurs and causes concern, discuss it with your doctor. Please note that it may take several months to realize the full benefits of this medication.
Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may cause drowsiness, consult with your doctor. These substances may interact with your medication and increase the risk of adverse effects.
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, contact your doctor promptly. It is crucial to prevent dehydration and electrolyte imbalances, which can be serious complications.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. They will help you weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe dyskinesia
- Agitation
- Confusion
- Insomnia
- Orthostatic hypotension
- Tachycardia
- Arrhythmias
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.
Drug Interactions
Contraindicated Interactions
- Non-selective monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine) - risk of hypertensive crisis. Must discontinue MAOIs at least 2 weeks prior to Stalevo.
- Narrow-angle glaucoma (due to potential for increased intraocular pressure, though rare with levodopa/carbidopa)
Major Interactions
- Antipsychotics (e.g., haloperidol, chlorpromazine, risperidone, olanzapine) - may antagonize the effects of levodopa.
- Iron salts (ferrous sulfate, gluconate) - can chelate levodopa and carbidopa, reducing absorption. Separate administration by at least 2-3 hours.
- Metoclopramide - may antagonize the effects of levodopa and increase risk of extrapyramidal symptoms.
- Other COMT inhibitors (e.g., tolcapone) - concomitant use is not recommended.
- Dopamine D2 receptor antagonists (e.g., droperidol, phenothiazines, butyrophenones, reserpine, tetrabenazine) - may reduce therapeutic effects of levodopa.
Moderate Interactions
- Antihypertensives - increased risk of orthostatic hypotension.
- Tricyclic antidepressants (TCAs) - may increase risk of orthostatic hypotension and hypertension (though less common with carbidopa).
- Sympathomimetics (e.g., epinephrine, norepinephrine, dopamine, dobutamine, isoproterenol) - increased risk of arrhythmias and hypertension due to entacapone inhibiting their metabolism.
- Benzodiazepines - may worsen dyskinesia in some patients.
- Phenytoin - may reduce levodopa efficacy.
Minor Interactions
- High-protein diet - may reduce levodopa absorption and efficacy.
Monitoring
Baseline Monitoring
Neurological examination
Rationale: To assess baseline motor function, dyskinesia, and cognitive status.
Timing: Prior to initiation
Blood pressure (supine and standing)
Rationale: To assess for baseline orthostatic hypotension risk.
Timing: Prior to initiation
Liver function tests (ALT, AST, bilirubin)
Rationale: Entacapone can cause liver enzyme elevations, though rare.
Timing: Prior to initiation
Complete Blood Count (CBC)
Rationale: To assess for baseline hematologic abnormalities.
Timing: Prior to initiation
Routine Monitoring
Motor fluctuations (wearing-off, on-off periods)
Frequency: At each visit, or as needed
Target: Optimal 'on' time with minimal dyskinesia
Action Threshold: Increased 'off' time, unpredictable 'on' periods, or severe dyskinesia warrant dose adjustment.
Dyskinesia
Frequency: At each visit, or as needed
Target: Minimal to no troublesome dyskinesia
Action Threshold: Increasing severity or bothersome dyskinesia may require dose reduction or adjustment of other medications.
Blood pressure (supine and standing)
Frequency: Regularly, especially during dose titration
Target: Stable, normotensive
Action Threshold: Significant orthostatic drop (>20 mmHg systolic or >10 mmHg diastolic) or symptomatic hypotension requires intervention.
Psychiatric symptoms (hallucinations, delusions, impulse control disorders)
Frequency: At each visit
Target: Absence of new or worsening psychiatric symptoms
Action Threshold: Emergence or worsening of symptoms requires evaluation and potential dose adjustment or addition of appropriate therapy.
Liver function tests (ALT, AST)
Frequency: Periodically (e.g., every 6-12 months or as clinically indicated), especially if symptoms of liver dysfunction occur.
Target: Within normal limits
Action Threshold: Significant elevation (e.g., >3x ULN) warrants discontinuation or dose reduction.
Symptom Monitoring
- Worsening or new onset dyskinesia
- Increased 'off' time or motor fluctuations
- Orthostatic hypotension (dizziness, lightheadedness upon standing)
- Hallucinations, delusions, confusion
- Impulse control disorders (e.g., pathological gambling, hypersexuality, compulsive shopping, binge eating)
- Sudden onset of sleep or excessive daytime sleepiness
- Diarrhea (can be severe with entacapone)
- Dark urine (harmless, due to entacapone metabolites)
- Signs of liver dysfunction (e.g., persistent nausea, vomiting, abdominal pain, jaundice, dark urine, fatigue)
Special Patient Groups
Pregnancy
Category C. Stalevo should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown adverse effects.
Trimester-Specific Risks:
First Trimester:
Potential for developmental toxicity observed in animal studies.
Second Trimester:
Potential for developmental toxicity observed in animal studies.
Third Trimester:
Potential for developmental toxicity observed in animal studies. May interfere with lactation.
Lactation
It is not known if levodopa, carbidopa, or entacapone are excreted in human milk. Due to the potential for serious adverse reactions in nursing 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. Breastfeeding is generally not recommended.
Infant Risk:
Moderate risk (L3). Potential for central nervous system effects in infant, and theoretical risk of affecting infant's dopamine regulation. Entacapone may inhibit lactation.
Pediatric Use
Safety and effectiveness in pediatric patients have not been established. Stalevo is not recommended for use in patients younger than 18 years of age.
Geriatric Use
No specific dose adjustment is generally required based on age alone. However, elderly patients may be more sensitive to the central nervous system and cardiovascular side effects (e.g., hallucinations, orthostatic hypotension) of levodopa and may require careful dose titration and monitoring.
Clinical Information
Clinical Pearls
- Stalevo is designed to reduce 'wearing-off' periods in Parkinson's disease patients already on levodopa/carbidopa who experience end-of-dose motor fluctuations.
- Patients should be advised that urine, sweat, and saliva may turn dark (reddish-brown to black) due to entacapone metabolites, which is a harmless effect.
- Monitor for impulse control disorders (ICDs) such as pathological gambling, hypersexuality, compulsive shopping, and binge eating. These can emerge or worsen with dopaminergic therapy and may require dose reduction or discontinuation.
- Sudden sleep attacks can occur without warning in some patients taking dopaminergic medications, including Stalevo. Advise patients to exercise caution when driving or operating machinery.
- Severe diarrhea can occur with entacapone, sometimes with colitis. If persistent or severe, consider discontinuation.
- Do not crush or chew Stalevo tablets; they should be swallowed whole.
- Patients should avoid abrupt discontinuation of Stalevo due to the risk of a neuroleptic malignant syndrome-like reaction (fever, rigidity, altered mental status, autonomic instability).
Alternative Therapies
- Dopamine agonists (e.g., pramipexole, ropinirole, rotigotine)
- MAO-B inhibitors (e.g., selegiline, rasagiline, safinamide)
- Amantadine
- Anticholinergics (e.g., benztropine, trihexyphenidyl) for tremor
- Istradefylline (adenosine A2A receptor antagonist)
Cost & Coverage
Average Cost:
$300 - $600 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Tier 2 or Tier 3 (preferred or non-preferred brand/generic)
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 emergency medical attention. When seeking help, be prepared to provide details about the medication taken, including the amount and time of ingestion.