Drug interactions
Carbidopa-entacapone-levodopa + Norepinephrine
Severity: Moderate
Carbidopa-entacapone-levodopa and Norepinephrine: 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
Entacapone inhibits COMT, one of the enzymes that inactivate catecholamines such as norepinephrine. Intravenous norepinephrine may therefore have a stronger or longer effect, with greater rises in blood pressure and heart rate or arrhythmias.
What this interaction means in plain words
Carbidopa-entacapone-levodopa and Norepinephrine 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.
Why it happens
Inhibition of COMT-mediated catecholamine metabolism by entacapone.
What to do
Monitor heart rate, rhythm and blood pressure continuously and titrate norepinephrine to effect, using lower doses if needed.
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?
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Other interactions of Carbidopa-entacapone-levodopa
- Carbidopa-entacapone-levodopa + Isocarboxazid Contraindicated
- Carbidopa-entacapone-levodopa + Phenelzine Contraindicated
- Carbidopa-entacapone-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-entacapone-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-entacapone-levodopa Major
- Asenapine transdermal + Carbidopa-entacapone-levodopa Major
Frequently asked questions
Can I take Carbidopa-entacapone-levodopa with Norepinephrine?
MediHelp rates the interaction as moderate. Carbidopa-entacapone-levodopa and Norepinephrine 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. Entacapone inhibits COMT, one of the enzymes that inactivate catecholamines such as norepinephrine. Intravenous norepinephrine may therefore have a stronger or longer effect, with greater rises in blood pressure and heart rate or arrhythmias.
How serious is the interaction between Carbidopa-entacapone-levodopa and Norepinephrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, rhythm and blood pressure continuously and titrate norepinephrine to effect, using lower doses if needed.
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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