I currently take Stalevo 125 5 times per day trying to avoid protein-rich meals as much as possible. I just worry about the other stuff alongside the levodopa - the 25mg cardopa and 200mg entacapone in every single tablet. I've experimented with Stalevo 100, 150 and 200 but when I tried 4 x 150 recently

I was freezing between doses. Anyone any experience of the different times these strengths of

tablet last in the body?

12 Replies

  • John, if you've found something that works why are you worrying?

  • Hi John,

    I am coming up to my 62nd birthday and have had PD or 13 years. I take stalvo 125 5 times starting at 6 am.

    I also take azlect & mirapexin slow release once a day. Stalevo has been great for the stiff joints. I also have as a booster dissolvable madipar,1 maybe 2 a day, depending on what i am doing. it does work but h go on my exercise bike to kick start them, when all is going well there is no stopping me. My worst time of the day is 9am for an hour . So at the moment I am trying exercise at different times to gets the old legs moving. I still drive, took up knitting again, joined a choir. I am of course interested in research, but very rarely , apart from this site do i worry about or look up anything on pd, i keep myself busy and it keeps me going . yes i do have a downer now and again, have a good feel sorry for myself cry, and get on with life.

    Worrying is not good for you.

  • Hi Goof

    Great to hear from someone taking very similar dosage to myself. I could have added that I am fit and active get on treadmill several times a week, walk every day (my 10000 steps have become more like 6000 in winter!).

    Could I ask if you find meals a hindrance to drug-absorption and also would you be kind enough to give me the times you take your drugs? Mine are 0730, 1000, 1245, 1545 and 1845.

    Many thanks for your help


  • I take stalvo & the 2 slow release at 6am but generally don't get up till 7. when i have my breakfast, 6am 9am 1300 , 1700, 2100. Stalvo is supposed to work better on an empty stomach.

  • Why are you worried about the entacapone and carbidopa?

  • the carbidopa is to help the absorption of levodopa without nausea. I worried about the entacapone too as it made no sense to me that the levodopa not be absorbed in the intestine . It helps it get to the brain. But as my IBS interferes with absorption in general it sort of makes sense. I tried it before and asked (because it wore off suddenly after 2 hours, made me pee incontinently, and all body fluids are stained bright orange) to be put back on sinimet boosted with sinimet CR. This gave me dyskinesia at inconvenient times. Not always in a position to exercise when it kicks in, e.g., trapped in accessaride on way to meeting or in an auditorium not on aisle seat! Now I'm on sinimet 8 a.m. , sinimet 11 a.m., stalevo plus sinimet ER 2 p.m. sinimet 5 p.m., sinimet plus sinimet ER toward bedtime.

  • I can check, but this doesn't sound like a med my Mom is taking.

  • Perhaps it was just a typo, but I believe it is Stalevo 100, not Stalevo 125, that contains 25mg carbidopa and 200mg entacapone. The ratio of Levodopa/Carbidopa in any Stalevo pill is 4/1; thus, Stalevo 125 contains125mg of Levodopa and 31.25mg carbidopa. Also, all Stalevo pills, regardless of strength, contain 200mg of entacapone.

  • I was on the Stalevo 150 4 times a day and mirapex .75 4 times a day, azilect 1mg/day. I also found in the afternoon the Stalevo was causing freezing. Right now I would say I take at 7 am , starts working at 7:45 am and about done working for me at 10:00am, take next dose at 11am etc. Proteins always interfer with medication (especially milk, chicken, fish, eggs, cheese). Need to eat in small portions 1-1.5 hours after taking medicine.

  • It is not necessary to avoid protein-rich meals. What you should avoid is taking a dose of Stalevo / Levodopa at the same time as a protein-rich meal. So try and time dose to be at least half an hour before a meal and when the meal will have moved on out of the stomach, say about an hour after a meal. You would probably need to try different timings to see what you find works best.

    I take 125mg Madopar (100mg Levodopa 25mg Benseraside) 4 times per day. The third and fourth doses have an additional 62.5mg of Madopar, i.e. total dose is 150mg of Levodopa and 37.5mg benserazide. I also take 200mg Entacopone. Stalevo is Sinemet and Entacopone altogether in one tablet, remembering that Sinemet is levodopa and carbidopa. Benseraside is functionally the same thing as Carbidopa both do the same job without leaving the blood stream and are then eliminated via the urine.

    What I wanted to say was that having 4 doses per day of Levodopa leaves me with up to 2 hours between doses getting gradually worse where I am very likely to freeze and possibly fall. My specialist PD nurse is reluctant to give me a 5th dose as that will take me over their preferred limit of 500mg per day limit. This limit is set to try and avoid dyskinesia and hallucination problems that are liable to occur after taking Levodopa for a number of years.

    But, I would rather take extra now while I have things to do and risk dyskinesia etc problems later. At my next appointment I will try and persuade my PD specialist to give me a 5th dose.

    I have found the Entacopone does help maintain availablity of Levodopa / Dopamine but only to a small degree, i.e. no where near the 2 hour off-period that I experience between each of my 4 dailydoses.

    I feel that post might be a bit confusing, I can clarify things if you would like me to.

  • I'm on Stalevo 100x4. I was taking 5 but I suspected it was giving me sleep disturbance and possibly dizziness. I'm not really sure. PD is such a sensitive condition I find it difficult to work out for sure what's causing what. I know a lot of stress certainly cranks up the symptoms. The freezing doesn't sound very nice. I hope they'll find a way of alleviating that for you.

    As to your question about duration this is a thing that has changed over time with me, DX 4/5 years ago. At first on 50 mg there was alot of overlap. In August this year, on 100x4/5, it took 40 minutes for the Stalevo to kick in. At 90 mins it was at its best. The tremor was returning 25 mins before the next dose.

    But yesterday I was experiencing increased symptoms an hour before my next dose and it also took an hour after swallowing the stuff for the symptoms to subside significantly. I have to say that this was after a really bad night with little sleep. I was very tense and my tremour was quite bad. Anyway 100x4 isn't particularly brilliant for me right now but I'm hanging on to it for as long as I can. My next apt with the neurologist is mid Jan, maybe he'll just put me on 100x5.

    I'll try and monitor my condition over a period of a day or two soon and get back to you. Unfortunately I'm pretty hopeless at taking my dose on time.

    Good luck

  • I have found the need to reduce and increase dosage at various times over the years in response to my daily feeling of well being and have tablet strengths 50, 75, 100 and 125 to afford the flex ability.

    During Summer time I am usually on half the dosage levels of Winter months; with 3 taking times a day at 9.00 16.00 and 23.00

    That said, I do wonder about the levels of Carbidopa and Entacapone

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