Stalevo vs. Sinemet for Parkinson's Disease: Important Differences and Potential Risks.

Stalevo

Carbidopa / levodopa

(Sinemet)

Summary for Stalevo

Prescription only

Stalevo is a combination medication that treats Parkinson's disease (PD) in adults. It contains carbidopa and levodopa, which help raise dopamine levels in the brain to improve PD symptoms. It also has entacapone, which works as a COMT inhibitor to help the effects last longer. Stalevo helps lessen "off" time (when movement symptoms come back as the medication wears off). Side effects include involuntary movements, nausea, and diarrhea.

Indications for Stalevo

Parkinson's disease (PD)

Pros and Cons for Stalevo

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 for Stalevo

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 for Stalevo

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)
Low vitamin B6 levels and seizures
Interactions with other medications
Risk of stomach bleeding in people who've had a stomach ulcer

Summary for Sinemet

Prescription only

Carbidopa / levodopa (Sinemet) is a first-choice option for Parkinson's disease (PD) in adults. It's also used to treat adults with conditions that cause PD symptoms, like shakiness and slowed movement. This medication helps raise and keep dopamine levels high in the brain to help with movement. But it's usually taken multiple times per day to relieve PD symptoms. Immediate-release tablets are available as brand name Sinemet and generic. Extended-release tablets and orally disintegrating tablets are generic only. Side effects can include movement problems, nausea, and possible hallucinations.

Indications for Sinemet

Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have PD symptoms, like slowness, stiffness, and tremors)

Pros and Cons for Sinemet

Pros

First-choice option for treating PD symptoms
Available in many forms: immediate-release (IR) tablets, extended-release (ER) tablets, and orally disintegrating tablets (ODTs)
Might work within 1 hour

Cons

Usually need to take many times per day to control PD symptoms
Can make you very sleepy and possibly fall asleep suddenly
Can darken the color of your saliva, sweat, and urine

Common Side Effects for Sinemet

Involuntary movements (dyskinesia or dystonia)
Nausea

Warnings for Sinemet

Sleepiness or falling asleep during activities
High fevers and confusion when lowering the dose or stopping too suddenly
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Risk of depression and thoughts of suicide
Low vitamin B6 levels and seizures
Caution use in people with a history of heart attack and arrhythmia
Caution use in people with a history of stomach ulcers
Higher eye pressure in people with glaucoma
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only