Stalevo (Page 3 of 8)

6 ADVERSE REACTIONS

The following adverse reactions are discussed in more detail in the Warnings and Precautions sections of labeling:

6.1 Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, the incidence of adverse reactions (number of unique patients experiencing an adverse reaction associated with treatment/total number of patients treated) observed in the clinical trials of a drug cannot be directly compared to the incidence of adverse reactions in the clinical trials of another drug and may not reflect the incidence of adverse reactions observed in clinical practice.

Entacapone

The most commonly observed adverse reactions (incidence at least 3% greater than placebo incidence) in the double-blind, carbidopa-levodopa-placebo-controlled trials of entacapone (N=1,003 patients) associated with the use of carbidopa-levodopa-entacapone alone and not seen at an equivalent frequency among the placebo-treated patients were: dyskinesia, diarrhea, nausea, hyperkinesia, abdominal pain, vomiting, dry mouth, and urine discoloration.

The treatment difference incidence for premature study discontinuation for entacapone with levodopa and dopa decarboxylase inhibitor in the double-blind, placebo-controlled trials was 5%. The treatment difference incidence for the most frequent causes of study discontinuation was 2% for diarrhea, and 1% for other specific adverse reactions including psychiatric reasons, dyskinesia/ hyperkinesia, nausea, or abdominal pain.

Adverse Reaction Incidence in Controlled Clinical Studies of Entacapone

Table 2 lists treatment emergent adverse reactions that occurred in at least 1% of patients treated with carbidopa/levodopa and 200 mg of entacapone who participated in the double-blind, placebo-controlled studies, and that were numerically more common in this group than in the carbidopa/levodopa plus placebo group. In these studies, either entacapone or placebo was added to carbidopa/levodopa (or benserazide/levodopa).

Table 2: Summary of Patients With Adverse Reactions After Start of Trial Drug Administration At Least 1% in Entacapone Group and Greater Than Placebo
SYSTEM ORGAN CLASS Carbidopa/levodopa plus Entacapone Carbidopa/levodopa plus Placebo
Adverse Reaction (n=603)% of patients (n=400)% of patients
SKIN AND APPENDAGES DISORDERS
Sweating Increased 2 1
MUSCULOSKELETAL SYSTEM DISORDERS
Back Pain 5 3
CENTRAL AND PERIPHERAL NERVOUS SYSTEM DISORDERS
Dyskinesia 25 15
Hyperkinesia 10 5
Hypokinesia 9 8
Dizziness 8 6
SPECIAL SENSES, OTHER DISORDERS
Taste Perversion 1 0
PSYCHIATRIC DISORDERS
Anxiety 2 1
Somnolence 2 0
Agitation 1 0
GASTROINTESTINAL SYSTEM DISORDERS
Nausea 14 8
Diarrhea 10 4
Abdominal Pain 8 4
Constipation 6 4
Vomiting 4 1
Mouth Dry 3 0
Dyspepsia 2 1
Flatulence 2 0
Gastritis 1 0
Gastrointestinal Disorders NOS 1 0
RESPIRATORY SYSTEM DISORDERS
Dyspnea 3 1
PLATELET, BLEEDING AND CLOTTING DISORDERS
Purpura 2 1
URINARY SYSTEM DISORDERS
Urine Discoloration 10 0
BODY AS A WHOLE-GENERAL DISORDERS
Fatigue 6 4
Asthenia 2 1
RESISTANCE MECHANISM DISORDERS
Infection Bacterial 1 0

6.2 Postmarketing Experience

The following spontaneous reports of adverse events temporally associated with entacapone or Stalevo have been identified since market introduction and are not listed in Table 2. Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate their frequency or establish causal relationship to entacapone or Stalevo exposure.

Hepatitis with mainly cholestatic features has been reported.

Effects of Gender and Age on Adverse Reactions

No differences were noted in the rate of adverse reactions attributable to entacapone alone by age or gender.

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