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Drug interactions

Carbidopa-entacapone-levodopa + Ferrous fumarate

Severity: Moderate

Carbidopa-entacapone-levodopa and Ferrous fumarate: moderate interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Oral iron salts bind levodopa and entacapone in the gut, reducing their absorption. Plasma levodopa may fall and Parkinson's symptoms may worsen or motor fluctuations may appear.

What this interaction means in plain words

Carbidopa-entacapone-levodopa and Ferrous fumarate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Carbidopa-entacapone-levodopa belongs to Central Nervous System; Ferrous fumarate belongs to Miscellaneous.

Evidence level: Moderate

Why it happens

Chelation of levodopa and entacapone by iron in the gastrointestinal tract reduces absorption.

What to do

Separate oral iron from carbidopa-entacapone-levodopa by at least 2 hours. Monitor motor response, and review iron dosing if symptoms worsen.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Carbidopa-entacapone-levodopa with Ferrous fumarate?

MediHelp rates the interaction as moderate. Carbidopa-entacapone-levodopa and Ferrous fumarate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Oral iron salts bind levodopa and entacapone in the gut, reducing their absorption. Plasma levodopa may fall and Parkinson's symptoms may worsen or motor fluctuations may appear.

How serious is the interaction between Carbidopa-entacapone-levodopa and Ferrous fumarate?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Separate oral iron from carbidopa-entacapone-levodopa by at least 2 hours. Monitor motor response, and review iron dosing if symptoms worsen.

What other medicines interact with Carbidopa-entacapone-levodopa?

MediHelp also lists interactions of Carbidopa-entacapone-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-entacapone-levodopa page.

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