Syncapone 50
12.5mg+200mg+50mgRx৳ 15/unit
Pack: ৳ 150
৳ 15/unit
Pack: ৳ 150
At a glance
Carbidopa + Entacapone + Levodopa is a combination medication used in the treatment of Parkinson's disease. Levodopa is converted to dopamine in the brain, Carbidopa prevents peripheral breakdown of levodopa, and Entacapone prolongs levodopa levels to better control Parkinson's symptoms.
Indications
- Parkinson's disease (with end-of-dose motor fluctuations)
Pharmacology
Levodopa is the metabolic precursor of dopamine; it crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa is a peripheral decarboxylase inhibitor that prevents the breakdown of levodopa, allowing more levodopa to enter the CNS. Entacapone is a selective COMT inhibitor that results in greater and more sustained plasma levels of levodopa.
Dosage
Adults: Each tablet contains levodopa and carbidopa in a 4:1 ratio and entacapone 200 mg (Stalevo 50/75/100/125/150/200).
Initial dose: 1 tablet/day. Titrate dose according to patient's response.
Per dose: Only 1 tablet per dose administration is recommended.
Maximum dose: 8 tablets/day (maximum 2000 mg entacapone/day).
Hepatic impairment: Severe: Contraindicated; Mild-moderate: Caution, dose reduction may be needed.
Renal impairment: Severe (including dialysis): Caution required.
Elderly: No dose adjustment required.
Children: Safety and efficacy not established.
Transfer instructions: Patients on entacapone and levodopa/carbidopa can be transferred to equivalent tablets. Direct switch for patients not on entacapone is not recommended; initiate entacapone separately first.
Side effects
Common side effects: Dyskinesia (abnormal movements), nausea, hyperkinesia, urine discoloration (red/brown/black), diarrhea, abdominal pain, constipation, headache, dry mouth, insomnia, orthostatic hypotension, anxiety, dizziness, abnormal dreams.
Serious (rare): Diarrhea (sometimes severe, colitis), hallucinations, other mental disturbances, rhabdomyolysis, neuroleptic malignant syndrome (fever, muscle stiffness, confusion), fibrosis, skin cancer.
Urine may become red, brown, or black (harmless).
Use in pregnancy
May be unsafe during pregnancy (Category C). Animal studies have shown harmful effects on the developing baby. Use only if potential benefit justifies potential risk to the fetus.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- May cause dizziness and sleepiness; caution when driving or operating machinery.
- Avoid high-protein meals (meat, poultry, dairy products) as they reduce levodopa absorption.
- Do not stop suddenly (may cause serious syndrome: fever, muscle stiffness, abnormal movements, sweating, confusion).
- Inform your doctor if you develop hallucinations or behavioral changes.
- Periodic evaluation of hepatic, hematopoietic, cardiovascular, and renal function is recommended during extended therapy.
- Caution during pregnancy and lactation; do not breastfeed during treatment.
Overdose effects
Overdose symptoms: Agitation, confusional state, coma, bradycardia, ventricular tachycardia, Cheyne-Stokes respiration, discoloration of skin/tongue/conjunctiva, chromaturia. Treatment: Hospitalization, gastric lavage, repeated charcoal doses. Pyridoxine is not effective.
Storage conditions
Store below 30°C, away from light and moisture. Keep out of reach of children.