Stalevo is a combination of levodopa and carbidopa, and also includes the COMT inhibitor entacapone. We want to share the e-mail exchange with you for it's educational value.
The e-mail:
My neurologists changed my medication two weeks ago, as I have have reactions to all that has been tried. I am now taking Stalevo three times a day. I have been having dizzy spells in the last few day and I always seem to be very tired lately. Could this medication be causing these problems? I also find that it is not working well on my restless leg syndrome. I was on Requip, which was helping the RLS, but I started having severe memory problems, so my doctor changed me to the Stalevo. Is it also for RLS symptoms?
My Parkinson's Info Response:
You have a large challenge on your hands. You and your neurologist are going to have to wrestle with the costs and benefits together. He or she is much better equipped to help you. I will give you what I can, hoping it helps you and your neurologist have a good discussion the next time you talk. You may want to give him or her a call on the phone, and report the same details you shared with me.
Requip is a dopamine agonist. It is quite helpful in the early stages of PD, and even beyond. Dopamine agonists have also proven helpful with restless leg syndrome (RLS).
Stalevo is not an RLS medication, although it is possible that it may help RLS in some patients. Stalevo is levodopa, which converts to dopamine. It also contains the COMT inhibitor entacapone, which helps levodopa stay in your body longer.
Stalevo is hard to get used to for many patients. The tiredness and dizziness is somewhat common. It may be part of the adjustment. Ask your neurologist if he or she wants you to tough it out. People who tough it out often adjust.
It sounds to me like there is a tradeoff between memory problems and RLS. Perhaps you and your neurologist are going to have to choose which symptom to favor.
When you call your neurologist, I would explain exactly what you just told me. I would ask:
1 – Are my dizziness and fatigue a normal part of adjusting to Stalevo?
2 – Should these symptoms improve?
3 – Should I tough it out with the Stalevo?
4 – Is there a tradeoff between my RLS symptoms and memory symptoms?
5 – Is there anything you can do to improve the RLS symptoms, dizziness, or fatigue?
Before you call your doctor, you may need to decide what symptom you want relief from the most. Together you can come up with a plan. You may end up taking both Requip and Stalevo.
I am wondering if the Neupro patch might be a good complement to Stalevo. Just a thought.
Will you please let me know what happens?
Warmest regards,
Matt Nilsen
