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The safety and warnings concerning the use of Stalevo, a medication containing carbidopa and levodopa, are crucial for ensuring safe treatment. Please review the following carefully and consult with your healthcare provider if you have any questions or concerns:

• Drowsiness and Unexpected Sleep Episodes: Stalevo may cause sudden sleep episodes, even during activities requiring concentration, such as driving. Avoid engaging in these activities until you understand how Stalevo affects you, especially if you have a history of drowsiness or sleep-related issues. Inform your healthcare provider if you experience excessive daytime sleepiness or sudden sleep episodes. Avoid combining Stalevo with other sedatives.

• Low Blood Pressure and Fainting: This medication can cause a significant drop in blood pressure, especially when standing up. To minimize the risk of dizziness or fainting, rise slowly from sitting or lying positions. Notify your provider if you experience unusual dizziness or if your blood pressure seems lower than normal.

• Depression and Suicidal Thoughts: There is a risk of developing depression or experiencing suicidal thoughts while on Stalevo. If you or those around you detect signs of depression or any suicidal behavior, seek immediate medical attention.

• Hallucinations and Behavioral Changes: Stalevo may lead to hallucinations or altered behavior and thinking, such as paranoia or confusion. Avoid using Stalevo if you have certain mental health conditions, and report any significant behavioral changes to your provider.

• Impulsive Behavior: The medication may cause impulsive behaviors, such as gambling, excessive spending, or binge eating. If such behaviors occur, consult your healthcare provider. You may not be aware of these actions, so regular discussions with your provider are recommended.

• High Fevers and Confusion: Sudden discontinuation or dose reduction of Stalevo can lead to symptoms resembling neuroleptic malignant syndrome (NMS), a serious condition. Symptoms include high fever, confusion, and muscle stiffness. Do not alter your dosage without consulting your provider.

• Diarrhea and Colitis: Stalevo may cause diarrhea, potentially indicating colitis. This can lead to dehydration or low potassium levels. Maintain adequate hydration and inform your provider if severe diarrhea occurs. Discontinue Stalevo if symptoms persist and seek medical advice.

• Muscle Damage (Rhabdomyolysis): This medication can increase the risk of severe muscle damage. Report muscle pain, dark urine, or cramping to your healthcare provider immediately, as these may indicate serious side effects.

• Drug Interactions: Stalevo interacts with medications metabolized by COMT, such as apomorphine and epinephrine, potentially affecting heart rate and blood pressure. Discuss all medications with your provider to prevent adverse interactions.

• Stomach Bleeding: If you have a history of stomach ulcers, Stalevo may increase the risk of bleeding. Watch for symptoms like stomach pain, vomiting blood, or black stools and contact your provider if they occur.

Contraindications: Do not use Stalevo if taking nonselective monoamine oxidase inhibitors (MAOIs) or if you have narrow-angle glaucoma, as these conditions may pose severe health risks.

Always seek guidance from your healthcare provider regarding these warnings and any concerns you might have.

Common side effects:

• nausea
• diarrhea
• vomiting
• dizziness
• dry mouth
• stomach upset
• loss of appetite
• changes in urine color
• drowsiness
• lightheadedness

Less common but important to monitor:

• involuntary movements
• muscle spasms
• slow muscle movements
• severe stomach pain
• vision changes
• unusual bleeding

Serious side effects:

• neuroleptic malignant syndrome (NMS)
• severe muscle damage (rhabdomyolysis)
• allergic reactions

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Tranylcypromine)
• Bromopride
• Clorgyline
• Furazolidone
• Iproniazid
• Nialamide
• Pargyline
• Sulpiride
• Toloxatone

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Amisulpride
• Apomorphine
• Bitolterol
• Bupropion
• Desipramine
• Dobutamine
• Dopamine
• Epinephrine
• Fluvastatin
• Glimepiride
• Glipizide
• Glyburide
• Haloperidol
• Irbesartan
• Isoetharine
• Isoniazid
• Isoproterenol
• Losartan
• Macimorelin
• Methyldopa
• Metoclopramide
• Nateglinide
• Norepinephrine
• Rosiglitazone
• Sapropterin
• Tolbutamide
• Venlafaxine
• Voriconazole
• Warfarin

Interactions with low risk that usually do not require a change in therapy:

• Droxidopa
• Fosphenytoin
• Indinavir
• Iron
• Kava
• Phenylalanine
• Phenytoin
• Spiramycin
• Tyrosine