Nourianz vs. Stalevo

Nourianz (istradefylline) and Stalevo (carbidopa, levodopa, and entacapone) are used to treat different aspects of Parkinson's disease.

Nourianz is indicated as adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson's disease experiencing "off" episodes.

Stalevo is used to treat Parkinson symptoms.

Nourianz and Stalevo belong to different drug classes. Nourianz is an adenosine receptor antagonist and Stalevo is a combination of an inhibitor of aromatic amino acid decarboxylation, an aromatic amino acid, and a COMT inhibitor.

Side effects of Nourianz and Stalevo that are similar include dizziness, constipation, nausea, and sleep problems (insomnia).

Side effects of Nourianz that are different from Stalevo include involuntary muscle movements and hallucinations.

Side effects of Stalevo that are different from Nourianz include diarrhea, vomiting, headache, drowsiness, blurred vision, stomach pain or upset, loss of appetite, dry mouth, changes in your sense of taste, skin rash or itching, unusual skin changes, muscle cramps, back pain, agitation, anxiety, and strange dreams.

Both Nourianz and Stalevo may interact with seizure medications.

Nourianz may also interact with itraconazole, ketoconazole, clarithromycin, rifampin, St. John's wort, midazolam, atorvastatin, and digoxin.

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

Common side effects of Nourianz include:

• involuntary muscle movements,
• dizziness,
• constipation,
• nausea,
• hallucinations, and
• insomnia

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).

Nourianz (istradefylline) is an adenosine receptor antagonist indicated as adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson's disease (PD) experiencing "off" episodes.

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.

Nourianz may interact with itraconazole, ketoconazole, clarithromycin, carbamazepine, rifampin, phenytoin, St. John's wort, midazolam, atorvastatin, and digoxin. Nourianz is not recommended for use during pregnancy; it may harm a fetus. Women of childbearing potential are advised to use contraception during treatment with Nourianz. It is unknown if Nourianz passes into breast milk or how it would affect a nursing infant. Consult your doctor before breastfeeding.

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 dosage of Nourianz is 20 mg orally once daily. The dosage may be increased to a maximum of 40 mg once daily.

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