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Compare Zelapar vs. Stalevo

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Selegiline (Zelapar) and Stalevo (carbidopa/levodopa/entacapone) are both used to treat Parkinson's disease (PD), but they work differently and have different uses. Selegiline is a monoamine oxidase type B (MAO-B) inhibitor that helps prevent the breakdown of dopamine in your brain, extending the effects of levodopa. It's used as an add-on treatment for people already taking carbidopa and levodopa. Stalevo, on the other hand, combines three medications: carbidopa, levodopa, and entacapone. This combination helps levodopa reach higher levels in your brain and stay effective longer, reducing "off" periods when symptoms return. Selegiline is available in tablets, capsules, and orally disintegrating tablets (ODTs), while Stalevo is available in multiple strengths but only as a tablet. Selegiline can cause high blood pressure if you eat foods high in tyramine, while Stalevo can cause diarrhea and dark-colored bodily fluids. Both medications can cause sleepiness and hallucinations, but Stalevo also has a rare risk of severe muscle damage. Selegiline is available in a lower-cost generic form, while the ODT version is only available as a brand name.

  • Selegiline
    Stalevo
  • Selegiline
    Stalevo

  • Summary of Zelapar vs. Stalevo

    Summary for MAO-B inhibitor
    Prescription only

    Selegiline helps relieve symptoms of Parkinson's disease in people who have "off" episodes as their carbidopa/levodopa medication starts to wear off. Selegiline is a type of monoamine oxidase inhibitor (MAOI), which is a drug class that has many drug interactions. Generic selegiline tablets and capsules are taken twice per day; the brand name for the pills, Eldepryl, is no longer available. Selegiline also comes as orally disintegrating tablets (ODTs) under the brand name Zelapar that are dissolved on the tongue once per day. Side effects include changes in blood pressure, nausea, and dizziness.

    Summary for Dopa decarboxylase inhibitor / Dopamine replacement / COMT inhibitor
    Prescription only

    Stalevo is a combination medication that treats Parkinson's disease (PD) in adults. It has carbidopa (a dopa decarboxylase inhibitor), levodopa (a dopamine replacement), and entacapone (a COMT inhibitor). The addition of entacapone helps the effects of the medication last longer. This helps lessen "off" time (when movement symptoms come back as the medication wears off). Side effects include involuntary movements, nausea, and diarrhea. Stalevo is available as a brand name and generic.

  • Indications of Zelapar vs. Stalevo

    Indications for
    •Relief of "off" episodes in people with Parkinson's disease (PD) who are taking a carbidopa/levodopa medication
    Indications for
    •Parkinson's disease (PD)

  • Pros and Cons of Zelapar vs. Stalevo

    Pros and Const for MAO-B inhibitor
    Pros
    •Extends the actions of carbidopa/levodopa to relieve PD symptoms
    •Comes as tablets, capsules, and ODTs
    •Taken once or twice a day, depending on the form of the medication
    Cons
    •Doesn't work well when you take it by itself; must take in addition to a carbidopa/levodopa medication
    •Commonly causes nausea and dizziness
    Pros and Const for Dopa decarboxylase inhibitor / Dopamine replacement / COMT inhibitor
    Pros
    •Combines three medications into a single pill, so you don't have to take as many tablets to control your PD symptoms
    •Helps relieve PD symptoms for a longer period of time than carbidopa/levodopa alone
    •Available in six different strengths, so your prescriber can adjust your dose if needed
    •Okay to take if you have kidney problems
    Cons
    •Usually need to take multiple times per day to help relieve PD symptoms
    •Might need to first take immediate-release carbidopa/levodopa and entacapone separately until you find the right dose before switching to Stalevo
    •Can make you very sleepy and cause you to fall asleep all of a sudden
    •Can make the color of your saliva, sweat, and urine darker

  • Common Side Effects of Zelapar vs. Stalevo

    Common Side Effects for

    Selegiline tablets and capsules:

    •Nausea (20%)
    •Dizziness (14%)
    •Stomach pain (8%)
    •Confusion (6%)
    •Hallucinations (6%)
    •Dry mouth (6%)

    Zelapar (selegiline) ODTs:

    •Nausea (11%)
    •Dizziness (11%)
    •General body pain (8%)
    •Headache (7%)
    •Trouble sleeping (7%)
    •Runny nose (7%)
    •Involuntary movements (dyskinesia; 6%)
    •Skin irritation (6%)
    •Back pain (5%)
    •Indigestion (5%)
    •Inflamed or sore mouth (5%)
    •Other irritation in the mouth (e.g., pain when swallowing, pain in mouth, mouth sores)
    Common Side Effects for
    •Involuntary movements (dyskinesia, 25%)
    •Nausea (14%)
    •Rapid involuntary movements (10%)
    •Diarrhea (10%)
    •Changes in the color of your urine (10%)
    •Slow involuntary movements (9%)
    •Stomach pain (8%)
    •Dizziness (8%)
    •Constipation (6%)
    •Tiredness (6%)
    •Back pain (5%)

  • Warnings of Zelapar vs. Stalevo

    Common Side Effects for
    •High blood pressure
    •Serotonin syndrome
    •Extreme sleepiness and falling asleep during activities
    •Low blood pressure and risk of falls
    •Difficulty controlling body movements
    •Hallucinations and behavior changes
    •Intense urges
    •Caution in people with phenylketonuria (PKU) - Zelapar ODTs only
    Common Side Effects for
    •Sleepiness or falling asleep during activities
    •Low blood pressure and fainting
    •Risk of depression and suicidal behavior
    •Hallucinations and changes in behavior and thoughts
    •Difficulty controlling impulsive behavior
    •High fevers and confusion with treatment changes
    •Diarrhea and inflamed colon (colitis)
    •Severe muscle damage (rhabdomyolysis)
    •Interactions with other medications
    •Risk of stomach bleeding in people who've had a stomach ulcer

  • Prices with our coupons for Zelapar vs. Stalevo

    Learn more about Selegiline
    Learn more about Stalevo

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