Entacapone/levodopa/carbidopa combination tablet: Stalevo

Drugs R D. 2003;4(5):310-1. doi: 10.2165/00126839-200304050-00006.


Entacapone (Comtess/Comtan) is Orion Pharma's original proprietary catechol-O-methyl transferase (COMT) inhibitor. Entacapone is able to slow down degradation of levodopa and improve the availability and efficacy of each levodopa dose, hence its use as a complement to levodopa/carbidopa in patients with Parkinson's disease. In order to simplify the daily dosing of these medications, Orion has developed an entacapone/levodopa/carbidopa combination tablet. Three tablet strengths are being developed so as to cover the most common clinical dosing needs. In September 2000, Orion signed a marketing and distribution agreement with Novartis for the combination tablet. Under the terms of the agreement, Orion has exclusive marketing rights for the product in Germany, the UK, Ireland, the Nordic and Baltic countries, and several Eastern European countries. Novartis has exclusive rights to the US and territories other than those markets for which Orion holds market exclusivity. Orion also has the option to co-promote the product in France, Spain and several other countries. In June 2003, the US FDA approved the entacapone/levodopa/carbidopa combination tablet (Stalevo) for the treatment of patients with idiopathic Parkinson's disease who experience signs and symptoms of end-of-dose 'wearing off'. Market launch of the product is expected toward the end of 2003 in the US. Also in June 2003, the Committee for Proprietary Medicinal Products of the European Agency for the Evaluation of Medicinal Products adopted a positive opinion of the combination tablet. In September 2002, Orion submitted an application for the approval of the combination product in the European Union. It is expected that the product will be marketed in the European Union in early 2004. Orion estimates that about two of three fluctuating Parkinson's disease patients will be able to be treated effectively with the triple combination tablet.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Carbidopa / adverse effects
  • Carbidopa / therapeutic use*
  • Catechols / adverse effects
  • Catechols / therapeutic use*
  • Clinical Trials as Topic
  • Drug Combinations
  • Humans
  • Levodopa / adverse effects
  • Levodopa / therapeutic use*
  • Movement Disorders / drug therapy*
  • Nitriles
  • Parkinson Disease / drug therapy
  • Tablets


  • Antiparkinson Agents
  • Catechols
  • Drug Combinations
  • Nitriles
  • Tablets
  • Levodopa
  • entacapone
  • Carbidopa