Rytary vs. Stalevo

Rytary (carbidopa and levodopa) and Stalevo (carbidopa, levodopa and entacapone) are used to treat Parkinson's disease.

Rytary is also used to treat post-encephalitic Parkinsonism and Parkinsonism that may follow carbon monoxide intoxication or manganese intoxication.

Both Rytary and Stalevo contain a combination an inhibitor of aromatic amino acid decarboxylation and an aromatic amino acid. Stalevo also contains a COMT inhibitor.

Side effects of Rytary and Stalevo that are similar include nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, anxiety, constipation, and vomiting.

Side effects of Rytary that are different from Stalevo include involuntary movements and low blood pressure and dizziness upon standing (orthostatic hypotension).

Side effects of Stalevo that are different from Rytary include diarrhea, drowsiness, blurred vision, stomach pain or upset, loss of appetite, changes in your sense of taste, skin rash or itching, unusual skin changes, muscle cramps, back pain, and agitation.

Both Rytary and Stalevo may interact with metoclopramide and isoniazid.

Rytary may also interact with monoamine oxidase inhibitors (MAOIs), phenothiazines, butyrophenones, risperidone, iron salts, or multi-vitamins containing iron salts.

Stalevo may also interact with apomorphine, cholestyramine, dobutamine, epinephrine, isoproterenol, methyldopa, papaverine, phenytoin, probenecid, antibiotics, blood pressure medication, antidepressants, medicines to treat psychiatric disorders, cold or allergy medicine, narcotics, sleeping pills, muscle relaxers, medicine for seizures, and anti-anxiety medications.

Withdrawal symptoms may occur if you suddenly stop taking Rytary or Stalevo.

Common side effects of Rytary include:

• nausea,
• dizziness,
• headache,
• insomnia,
• abnormal dreams,
• dry mouth,
• involuntary movements,
• anxiety,
• constipation,
• vomiting, and
• low blood pressure and dizziness upon standing (orthostatic hypotension)

Common side effects of Stalevo include:

• diarrhea,
• nausea,
• vomiting,
• headache,
• dizziness,
• drowsiness,
• blurred vision,
• stomach pain or upset,
• loss of appetite,
• constipation,
• dry mouth,
• changes in your sense of taste,
• skin rash or itching,
• unusual skin changes,
• muscle cramps,
• back pain,
• agitation,
• anxiety,
• difficulty sleeping (insomnia), or
• strange dreams.

Tell your doctor if you have serious side effects of Stalevo including:

• involuntary movements (especially twitching of the eyelid),
• fainting or falling,
• difficulty swallowing,
• stomach/abdominal pain,
• persistent diarrhea,
• vision changes (including blurred vision),
• black/tarry stools,
• muscle pain,
• changes in the amount of urine,
• mental/mood changes (such as confusion, hallucinations, thoughts of suicide),
• signs of infection (e.g., persistent sore throat), or
• unusual strong urges (such as increased gambling, increased sexual urges).

Rytary (carbidopa and levodopa) is a combination an inhibitor of aromatic amino acid decarboxylation and an aromatic amino acid, used for the treatment of Parkinson's disease, post-encephalitic Parkinsonism, and Parkinsonism that may follow carbon monoxide intoxication or manganese intoxication.

Stalevo (carbidopa, levodopa and entacapone) is a combination of several medications used to treat Parkinson symptoms such as muscle stiffness, tremors, spasms, and poor muscle control. Levodopa is converted to a chemical called dopamine in the brain. Symptoms of Parkinson's disease may be caused by low levels dopamine in the brain. Carbidopa helps prevent the breakdown of levodopa before it can reach the brain and take effect. When used with carbidopa and levodopa, entacapone increases levels of levodopa in the body.

Rytary may interact with MAO inhibitors, phenothiazines, butyrophenones, risperidone, metoclopramide, isoniazid, iron salts, or multi-vitamins containing iron salts. Tell your doctor all medications and supplements you use.

Stalevo may interact with other Parkinson's medications, metoclopramide, isoniazid, phenytoin, papaverine, blood pressure medications, antidepressants, or medicines to treat psychiatric disorders.

Stalevo may also interact with cholestyramine, dobutamine, epinephrine, isoproterenol, methyldopa, papaverine, antibiotics, cold or allergy medicine, narcotics, sleeping pills, muscle relaxers, medicine for seizures, or anti-anxiety medications.

The recommended starting dosage of Rytary is 23.75 mg/95 mg taken orally three times a day for the first 3 days. On the fourth day of treatment, the dosage of Rytary may be increased to 36.25 mg/145 mg taken three times a day.

The optimum daily dosage of Stalevo must be determined for each patient. Therapy should be individualized and adjusted according to the desired therapeutic response.