Encarlev 150 - Tablet Carbidopa + Entacapone + Levodopa - 150mg+37.5mg+200mg 10 Tablet(s) / Strip Opsonin Pharma Limited Introduction: Encarlev 150 is a prescription medicine used in the treatment of Parkinson's disease. This medicine helps to reduce excessive shaking by slowing down the body movements. It works by increasing the amount of chemical messenger that is needed to control abnormal movements. Encarlev 150 is taken with or without food, but better to avoid high protein meal and dairy products. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration advised by your doctor and if... Uses of Encarlev 150: Parkinson's disease Side effects of Encarlev 150: NauseaVomitingConstipationUrine discolorationHeadacheDryness in mouthInsomnia (difficulty in sleeping)Orthostatic hypotension (sudden lowering of blood pressure on standing)AnxietyDizzinessAbnormality of voluntary movementsAbnormal dreams How to use Encarlev 150: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Encarlev 150 may be taken with or without food, but it is better to take it at a fixed time. Avoid Encarlev 150 with high protein meals such as cottage cheese, Swiss cheese, protein powder, eggs and milk. How Encarlev 150 works: Encarlev 150 is a combination of three medicines: Levodopa, Carbidopa and Entacapone which treat Parkinsonism. Levodopa is a Carbidopa precursor which gets converted to dopamine, a chemical messenger that controls movement in the brain. Carbidopa is a peripheral decarboxylase inhibitor which prevents the breakdown of Levodopa allowing it to enter the brain and increase dopamine levels. Entacapone is COMT inhibitor which causes higher and more sustained levels of levodopa in blood, leading to greater relief from the symptoms of Parkinson’s disease. Indication: Parkinson's disease and 'end of dose' motor fluctuations Administration: May be taken with or without food. Keep a consistent diet. A change in diet to foods high in protein may delay levodopa absorption & reduce amount taken up in circulation. Excessive acidity also delays stomach emptying & thus delays levodopa absorption. Fe salts (eg in multivit prep) may also reduce amount of levodopa available to the body. Swallow whole. Adult Dose: Parkinson's disease Adult: PO: Each tab contains levodopa and carbidopa in a ratio of 4:1 and entacapone 200 mg: Initial: 1 tab/day. Titrate dose according to patient's response. Recommended to take only 1 tab per dose administration. Max: 8 tabs/day. Hepatic impairment: Severe: Contraindicated. Child Dose: Safety & efficacy not established Contraindication: Hypersensitivity. Narrow angle glaucoma. Should not be used in patients with suspicious, undiagnosed skin lesions or a history ot melanoma. Mode of Action: Levodopa is the metabolic precurosor of dopamine, it crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa increases the amount of levodopa that is transported into the CNS by inhibiting the decarboxylation of peripheral levodopa. Entacapone is a selective inhibitor of catechol-o-methyltransferase. Given concurrently, entacapone results in greater and more substained plasma levels of levodopa, leading to greater control of parkinsonism symptoms. Precaution: Periodic monitoring of hepatic, renal, haematopoietic and CV functions in patients on prolonged therapy. Monitor for changes in IOP in patients with chronic wide-angle glaucoma. Caution when used in patients with biliary obstruction. Caution when interpreting plasma and urine levels of catecholamines and their metabolites. Withdrawal should be gradual. Lactation: not known if excreted in breast milk; use caution Side Effect: >10% Entacapone Dyskinesia (25%),Nausea (14%),Diarrhea (10%),Hyperkinesia (10%),Urine discoloration (10%) 1-10% Entacapone Hypokinesia (9%), dizziness (8%), Fatigue (6%), hallucinations (1-4%), anxiety (2%), somnolence (2%), asthenia (2%), agitation (1%),Increased sweating (2%),Purpura (2%),Abdominal pain (8%), constipation (6%), vomiting (4%), dry mouth (3%), dyspepsia (2%), flatulence (2%), taste perversion (1%), gastritis (1%),Back pain (4%),Dyspnea (3%),Bacterial infection (1%) Frequency Not Defined Levodopa/Carbodopa Edema,Agitation, anxiety, ataxia, bruxism, confusion, daytime somnolence decreased attention span, dyskinesia, dystonia, euphoria, insomnia, fainting, fatigue, increased trembling of hands, insouciance, malaise, memory loss, nightmares, nervousness, restlessness, trismus, vivid dreams,Alopecia, hot flushes, increased &/or dark perspiration, skin eruptions,Abdominal pain & discomfort, burning feeling... Pregnancy Category Note: Pregnancy Category: C Lactation: not known if excreted in breast milk; use caution Interaction: Increased risk of postural hypotension when used concurrently with hypotensive drugs. Severe orthostatic hypotension may result from concurrent usage with MAOIs. Dopamine D2 receptor antagonists, phenytoin or papaverine may reduce the efficacy of levodopa. Iron salts may reduce the bioavailability. Concurrent usage with drugs that interfere with biliary excretion may lead to increased plasma levels of entacapone. May depress prolactin secretion and increase growth hormone levels.