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Carbidopa / Levodopa / Entacapone Coupon - Carbidopa / Levodopa / Entacapone 50mg/200mg/200mg tablet

carbidopa / levodopa / entacapone

Generic Stalevo
Used for Parkinson's Disease
Used for Parkinson's Disease

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.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Cydnee Ng, PharmD
Last reviewed on March 17, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Stalevo?

What is Stalevo used for?

How Stalevo works

Stalevo is a combination of three ingredients: carbidopa, levodopa, and entacapone. These ingredients work together to bring up the dopamine dopamine levels in the brain. This helps relieve symptoms of Parkinson's disease (PD).

  • Levodopa is a dopamine replacement. Once you take levodopa, it travels into the brain where it turns into dopamine. When there's more dopamine in the brain, PD symptoms lessen.

  • Carbidopa is a dopa decarboxylase inhibitor, and entacapone is a catechol-O-methyltransferase (COMT) inhibitor. Dopa decarboxylase and COMT are proteins in the body that break down levodopa before it reaches the brain. By blocking these proteins, more levodopa can get to the brain and turn into dopamine. It helps both levodopa and dopamine reach and stay at higher levels in the brain. This enhances levodopa's ability to relieve PD symptoms.

Are you looking for information on Sinemet (carbidopa / levodopa) or Rytary (carbidopa / levodopa) instead?
When does Stalevo start working?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsStalevo
Drug ClassDopa decarboxylase inhibitor / Dopamine replacement / COMT inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Avg retail price
$433.13(save 44.42%)
GoodRx discount
$240.73
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What are the side effects of Stalevo?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • 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%)

Other Side Effects

  • Vomiting
  • Indigestion
  • Dry mouth
  • Shortness of breath
  • More sweating
  • Anxiety
  • Weakness

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Withdrawal symptoms after treatment changes (e.g., stopping suddenly): very high fevers, sweating, confusion, irregular pulse, muscle stiffness, changes in breathing, changes in blood pressure
  • Severe muscle damage (rhabdomyolysis): muscle aches, soreness, cramping, dark-colored urine
  • Depression
  • Suicidal thoughts or behavior
When do Stalevo possible side effects begin and end?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Risk of diarrhea
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common-Entacapone

Twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

Incidence not known-Carbidopa and Levodopa and/or Levodopa alone

Bleeding gums

bloody or black, tarry stools

bloody or cloudy urine

change in size, shape, or color of an existing mole

changes in skin color

chest pain, discomfort, or tightness

constipation

constricted pupil

convulsions

cough

difficult or labored breathing

difficulty with speaking

drooling

drooping eyelid (ptosis)

facial dryness

fast, irregular, or pounding heartbeat

fever with or without chills

general feeling of illness

hallucinations (seeing, hearing, or feeling things that are not there)

hoarseness

large, flat, blue, or purplish patches in the skin

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

loss of appetite

loss of bladder control

lower abdominal or stomach pain

lower back or side pain

mole that leaks fluid or bleeds

muscle cramps or spasms

muscle pain or stiffness

muscle trembling, jerking, or stiffness

nausea

pain

painful or difficult urination

pinpoint red spots on the skin

raised red swellings on the skin, the buttocks, legs, or ankles

restlessness

severe mental changes

shakiness and unsteady walk

shuffling walk

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sweating

swollen glands

trembling, or other problems with muscle control or coordination

unusual bleeding or bruising

unusual tiredness or weakness

vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common-Entacapone

Absence of or decrease in body movement

diarrhea

dizziness

urine discoloration

Less common-Entacapone

Acid or sour stomach

anxiety

belching

bitter, sour, or unusual taste in the mouth

bloated

burning feeling in the chest or stomach

dry mouth

excess air or gas in the stomach or intestines

fear

full feeling

heartburn

hyperventilation

increased sweating

indigestion

irritability

lack or loss of strength

passing gas

restlessness

sleepiness or unusual drowsiness

stomach discomfort or upset

swollen mouth and tongue

tenderness in the stomach area

trouble sleeping

urge to have bowel movement

Incidence not known-Carbidopa and Levodopa and/or Levodopa alone

Being forgetful

bladder pain

blurred vision

body aches or pain

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

burning and upper abdominal or stomach pain

burning sensation of the tongue

clenching, gnashing, or grinding teeth

confusion about identity, place, and time

dark saliva

dark sweat

decreased mental acuity

difficulty swallowing

discouragement

double vision

ear congestion

enlarged pupils

excessive watering of the mouth

fainting

false or unusual sense of well-being

feeling like you will pass out

feeling of warmth

feeling sad or empty

flushing

hair loss

headache

hiccups

hives or welts

increased blinking

increased interest in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

lack of appetite

large, hard skin blisters

leg pain

loss of voice

muscle spasm, especially of the neck and back

nasal congestion

nightmares

numbness

pain in the chest below the breastbone

painful or prolonged erection of the penis

pharyngeal pain

pounding in the ears

problems with memory or speech

redness of the face, neck, arms, and occasionally upper chest

runny nose

sense of stimulation

skin rash

sleeplessness

slow movement

slow or fast heartbeat

slow reflexes

sneezing

swelling

tremor, increased

trouble concentrating

trouble recognizing objects

trouble thinking and planning

urinary frequency

urinary retention

weight gain

weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Stalevo

thumbs-up

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

thumbs-down

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

pharmacist-tips

Pharmacist tips for Stalevo

pharmacist

  • Take Stalevo with or without food. Avoid taking the medication with a high-fat, high-calorie, or high-protein meal. Examples include avocados, cheese, and peanut butter. These foods can slow the medication from getting absorbed into the body by about 2 hours.

    • Only take 1 Stalevo tablet when it's time for you to take the medication. All tablet strengths of Stalevo contain 200 mg of entacapone. Taking more than 1 Stalevo tablet at once can raise your risk of side effects.

      • Swallow the Stalevo tablet whole. Don't cut, crush, or chew them. If you have trouble swallowing pills whole, tell your prescriber so they can find other options for you.

        • Stalevo can make you very sleepy and even cause you to fall asleep suddenly, even if you don't feel tired. Don't drive or do anything that needs your focus until you know how the medication affects you.

          • Stalevo can cause or worsen uncontrolled movements of your body. These involuntary movements are called dyskinesia. It happen sooner and at lower dosages than with carbidopa/levodopa-only medications (like Sinemet). Let your prescriber know if you have uncontrolled movements that bother you a lot.

            • Stalevo can cause nausea, vomiting, or diarrhea in some people. Make sure to drink plenty of fluids to prevent dehydration if you have these side effects during treatment. Talk to a healthcare professional if they don't get better. They can check whether there's something else going on.

              • Stalevo can make the color of your saliva, sweat, and urine darker (e.g., red, brown, black). Though it's harmless, these colored bodily fluids can stain your clothing.

                • Ask your prescriber or pharmacist before taking iron supplements or multivitamins that contain iron. Iron can cause less Stalevo to get absorbed into your body. This can affect how well Stalevo works to relieve your PD symptoms.

                  faqs

                  Frequently asked questions about Stalevo

                  Can you crush Stalevo?
                  No, don't crush the Stalevo tablets. You should swallow the table whole. Ask your prescriber about your options if you're having trouble swallowing pills whole.
                  Can Stalevo be cut in half?
                  No, you shouldn't cut Stalevo tablets in half. The tablets don't have a score line (or an indented line down the middle) to help guide you to cut them evenly. It can be hard to cut an unscored tablet. You can also hurt yourself and also take the wrong dose. Swallow Stalevo tablets whole. If you have trouble swallowing pills whole, tell your prescriber. They can discuss other options with you.
                  How long does Stalevo take to work?
                  It can be different for each person. But it typically takes Stalevo about 30 minutes to 1 hour to start working. It's important that you take Stalevo as prescribed so you can get the most relief from the medication. Talk to your prescriber if you have concerns about how fast Stalevo is working to help with your Parkinson's symptoms.
                  When is the best time to take Stalevo?
                  You'll usually need to take Stalevo a few times each day to help control your Parkinson's symptoms. Your prescriber will work with you to come up with a dosing schedule that works best for you. Follow their instructions carefully. And don't take your doses too close together or too far apart. Taking your doses at the same times each day can help keep the levels of medication stable in your body. This will help Stalevo work the best it can to relieve your Parkinson's symptoms.
                  What's the difference between Stalevo and Sinemet?
                  Stalevo and Sinemet both help treat symptoms of Parkinson's disease. Stalevo contains carbidopa, levodopa, and entacapone. But Sinemet has carbidopa and levodopa only. The addition of entacapone in Stalevo helps levodopa reach and stay at higher levels in the brain. This can help lessen how often you're in the "off" time, or when your symptoms come back as levodopa wears off in your body. Talk to your prescriber about other differences between the two medications.
                  What's the difference between Stalevo and Rytary?
                  Stalevo and Rytary both have carbidopa and levodopa to help with Parkinson's symptoms. But Stalevo also contains entacapone. Stalevo and Rytary work in different ways to help lessen "off" time. This is the time when your symptoms come back as the effects of levodopa wears off. Rytary is an extended-release capsule. It slowly releases medication into the body so it lasts longer. On the other hand, the entacapone in Stalevo helps the levodopa get into the brain better and stay at high levels longer. Talk to your prescriber to learn more about the differences between these medications.
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                  What are the risks and warnings for Stalevo?

                  Stalevo can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Sleepiness or falling asleep during activities

                  • Risk factors: History of drowsiness | History of sleep problems | Taking sedatives or medications that make you drowsy

                    Some people taking Stalevo have fallen asleep out of nowhere. This has happened even when they didn't feel tired beforehand. It can happen during activities like talking or eating. In some cases, people have fallen asleep while driving. It's sometimes led to accidents.

                    Because of this risk, avoid driving or doing things that need your full attention until you know how Stalevo affects you. This is especially important if you often feel sleepy or have suddenly fallen asleep before. Also avoid taking medications that make you sleepy while taking Stalevo. They can make you even sleepier.

                    Tell your prescriber know if you feel very sleepy during the daytime while taking Stalevo. Also let them know if you fall asleep during activities that you need to be alert for.

                    risk-warning

                    Low blood pressure and fainting

                    • Risk factors: History of low blood pressure

                      Some people who take Stalevo can have low blood pressure. It can cause a drop in blood pressure when you stand from a sitting or lying down position. Low blood pressure can lead to dizziness, lightheadedness, and sometimes fainting.

                      To lower your risk of falling, get up slowly when you stand. Tell your prescriber if your blood pressure is lower than usual or if you feel dizzy while taking Stalevo.

                      risk-warning

                      Risk of depression and suicidal behavior

                      • Risk factors: History of mental health conditions

                        Stalevo can cause depression with or without suicidal behavior. Get medical help right away if you or the people around you notice that you have signs of depression or thoughts of hurting yourself while taking this medication.

                        risk-warning

                        Hallucinations and changes in behavior and thoughts

                        Some people taking medications like Stalevo have had hallucinations. Others can also have feelings of uneasiness or distress. Tell your prescriber if you or your loved ones notice you're having hallucinations while you're taking Stalevo. Also let them know about any unusual behaviors or unusual thoughts.

                        risk-warning

                        Difficulty controlling impulsive behavior

                        Parkinson's medications that raise dopamine levels, like Stalevo, can cause impulsive behavior. These behaviors can include strong sexual urges and gambling urges. They can also be urges to spend a lot of money and binge eating. Urges can be hard to control.

                        Tell your prescriber if these behaviors negatively affect your life while taking Stalevo. You might not notice these urges. So, your prescriber might ask about them at your next visit.

                        risk-warning

                        High fevers and confusion with treatment changes

                        Although rare, starting Stalevo, suddenly lowering the dose suddenly, or stopping it too fast can cause high fever and confusion. It can be life-threatening if these symptoms happen along with muscle stiffness, irregular pulse, rapid breathing, or changes in blood pressure.

                        Don't stop taking Stalevo or lower your dose without talking to your prescriber first. They can instruct you on how to do this safely.

                        risk-warning

                        Diarrhea and inflamed colon (colitis)

                        The entacapone in Stalevo can cause people to have diarrhea. In studies, some had mild-to-moderate diarrhea. Rarely, people had severe diarrhea. People started to have diarrhea in the first few months of treatment. But it can sometimes start as early as the first week.

                        Keep in mind that diarrhea can be a sign of inflammation in the colon (colitis). Diarrhea in this case can be moderate to severe with watery, non-bloody stool. You might also have stomach pain.

                        Sometimes, diarrhea and colitis can lead to weight loss, dehydration, and low potassium levels. Be sure to drink lots of fluids to stay hydrated.

                        Tell your care team if you have any diarrhea or other related symptoms while taking Stalevo. Most of the time, diarrhea and colitis get better or go away after stopping the medication.

                        risk-warning

                        Severe muscle damage (rhabdomyolysis)

                        Some people who took Stalevo had severe muscle damage called rhabdomyolysis, which can be serious. Tell your prescriber right away if you have muscle aches, soreness, cramping, or a fever while you're taking Stalevo. These can be signs of serious muscle damage.

                        risk-warning

                        Interactions with other medications

                        Stalevo can interact with a few medications and cause side effects. Examples include apomorphine (Apokyn), methyldopa, and epinephrine (EpiPen). Taking Stalevo with these medications can raise your heart rate and blood pressure. It can cause changes to your heart rhythm.

                        It's also harmful to take Stalevo with nonselective monoamine oxidase inhibitors (MAOIs). Don't take Stalevo with nonselective MAOIs, like phenelzine (Nardil) and tranylcypromine (Parnate). Note that some Parkinson's medications like rasagiline (Azilect) and selegiline are selective MAO-B inhibitors. You can take these Parkinson's medications with Stalevo.

                        Share a list of all your medications with your care team. They can check for interactions and make sure you're safe.

                        risk-warning

                        Risk of stomach bleeding in people who've had a stomach ulcer

                        Let your prescriber know if you've had a stomach ulcer before. This is because Stalevo might raise your risk of stomach bleeding. Get medical help right away if you have severe stomach pain, vomit or cough up blood, or notice black stools that look like tar. These can be signs of stomach bleeding.

                        dosage

                        Stalevo dosage forms

                        The average cost for 120 tablets of 50mg/200mg/200mg of Stalevo is $273.45 with a free GoodRx coupon. This is 36.87% off the average retail price of $433.13.
                        tablet
                        Tablet
                        DosageQuantityPrice as low asPrice per unit
                        12.5mg/50mg/200mg180 tablets$1381.53$7.68
                        25mg/100mg/200mg30 tablets$240.73$8.02
                        31.25mg/125mg/200mg30 tablets$240.73$8.02
                        37.5mg/150mg/200mg90 tablets$702.18$7.80
                        50mg/200mg/200mg30 tablets$273.45$9.11

                        Typical dosing for Stalevo

                        Stalevo is available in many strengths. All tablets have different amounts of carbidopa and levodopa. But they all contain 200 mg of entacapone.

                        Your dose will depend on how well your previous medications have been helping with your Parkinson's symptoms.

                        • For people previously taking Sinemet (carbidopa / levodopa) plus entacapone (Comtan): The dose will usually stay the same. You can switch straight to the Stalevo tablet with the same amount of carbidopa, levodopa, and entacapone as your previous regimen.

                        • For people previously taking Sinemet (carbidopa / levodopa) alone: You'll usually start by taking entacapone (Comtan) along with your Sinemet (carbidopa / levodopa). Your prescriber will slowly adjust your doses until your symptoms are under control. Once they find the right dose for you, you'll switch to a Stalevo tablet that's the same dose.

                        interactions

                        Interactions between Stalevo and other drugs

                        Stalevo may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Stalevo. Please note that only the generic name of each medication is listed below.

                        Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                        Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                        Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                        contraindications-icon

                        Stalevo contraindications

                        Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Stalevo will not be safe for you to take.
                        alternatives

                        What are alternatives to Stalevo?

                        There are a number of medications that your doctor can prescribe in place of Stalevo. Compare a few possible alternatives below.
                        Stalevo
                        Used for:
                        $240.73 Lowest GoodRx priceView Prices
                        Sinemet (carbidopa / levodopa)
                        Used for:

                        • Parkinson's disease (PD)

                        • Parkinsonism (conditions that cause people to have signs and symptoms of PD, including slowness, stiffness, shakiness, and imbalance)

                        $9.00 Lowest GoodRx priceView Prices
                        Rytary (carbidopa / levodopa)
                        Used for:
                        $377.20 Lowest GoodRx priceView Prices
                        images

                        Stalevo images

                        Red-Brown Oval Sto 200 - Carbidopa / Levodopa / Entacapone 50mg-200mg-200mg Tablet
                        This medicine is Red-Brown, Oval Tablet Imprinted With "Sto 200".Red-Brown Oval Sto 200 - Carbidopa / Levodopa / Entacapone 50mg-200mg-200mg Tablet
                        Red-Brown Oval Lce 200 - Carbidopa / Levodopa / Entacapone 50mg-200mg-200mg Tablet
                        This medicine is Red-Brown, Oval Tablet Imprinted With "Lce 200".Red-Brown Oval Lce 200 - Carbidopa / Levodopa / Entacapone 50mg-200mg-200mg Tablet
                        Red-Brown Oval T1 200 - Carbidopa / Levodopa / Entacapone 50mg-200mg-200mg Tablet
                        This medicine is Red-Brown, Oval Tablet Imprinted With "T1 200".Red-Brown Oval T1 200 - Carbidopa / Levodopa / Entacapone 50mg-200mg-200mg Tablet

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                        References

                        Best studies we found

                        American Parkinson Disease Association. (2024). Carbidopa/levodopa: Answers to frequently asked questions.

                        Fiedorowicz, J. G., et al. (2004). The role of monoamine oxidase inhibitors in current psychiatric practice. Journal of Psychiatric Practice.

                        Gandhi, K. R., et al. (2023). Levodopa (L-dopa). StatPearls.

                        View All References (4)

                        Jenner, P. (2023). Stalevo®: A pioneering treatment for OFF periods in Parkinsons disease. European Journal of Neurology.

                        Parkinson’s Foundation. (n.d.). Dyskinesia.

                        Parkinson’s Foundation. (n.d.). Managing “off” time in Parkinson’s.

                        Rising Pharma Holdings, Inc. (2022). Carbidopa, levodopa, and entacapone tablet, film coated [package insert]. DailyMed.

                        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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