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

Key takeaways

Tolcapone (Tasmar) and Stalevo (carbidopa/levodopa/entacapone) are both used to treat Parkinson's disease (PD), but they have some key differences. Tolcapone is a catechol-O-methyltransferase (COMT) inhibitor that must be used with carbidopa/levodopa to be effective, while Stalevo combines carbidopa, levodopa, and entacapone into a single pill for convenience. Tolcapone is known for its risk of serious liver damage, requiring regular liver monitoring, whereas Stalevo does not have this specific risk but can cause changes in urine color. Stalevo and Tolcapone are available in a generic form, making them potentially more affordable. Both medications can cause sleepiness, low blood pressure, and hallucinations, but tolcapone can cause liver issues, and Stalevo can lead to stomach bleeding if you have certain kinds of stomach ulcers. Overall, Stalevo offers the convenience of fewer pills but comes with its own set of side effects and risks.

Tolcapone

(Tasmar)

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Stalevo

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Summary for Tasmar

Prescription only

Tolcapone (Tasmar) is an oral add-on medication for Parkinson's disease (PD). It's usually used when carbidopa/levodopa isn't controlling PD symptoms well enough.

Indications for Tasmar

Parkinson's disease (PD); as add-on treatment to carbidopa/levodopa

Pros and Cons for Tasmar

Pros

Can help relieve PD symptoms that occur between levodopa doses; sometimes called the "wearing-off" effect
For the brand medication (Tasmar), the manufacturer offers a copay savings card for those with private insurance.

Cons

Can cause liver failure; not a good option for people with liver problems
Has a lot of side effects
Cannot be taken alone; only used as an add-on medication
Can be expensive

Common Side Effects for Tasmar

Involuntary movements (dyskinesia, 42%)
Nausea (30%)
Sleep problems (24%)
Excessive dreaming (21%)
Muscle contractions and cramps (17—19%)
Loss of appetite (19%)
Sleepiness (18%)
Low blood pressure (17%)
Diarrhea (16%)
Dizziness (13%)
Confusion (11%)
Headache (10%)

Warnings for Tasmar

Serious liver damage
Sleepiness or falling asleep during activities
Low blood pressure and fainting
Hallucinations and changes in behavior and thoughts
Impulsive behavior
Muscle damage (rhabdomyolysis)

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