Article Menu

Export Article

More by Authors Links

Article Data

  • Views 8723
  • Dowloads 231

Case Report

Open Access

Levodopa-carbidopa-entacapone overdose presenting as altered mental status, xanthoderma, and yellowish sclera

  • SUN HWA LEE1
  • SEONG JONG YUN2
  • SEOKYONG RYU1
  • SEUNG WOON CHOI1
  • HYE JIN KIM1
  • TAE KYUNG KANG1
  • SUNG CHAN OH1
  • SUK JIN CHO1

1Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea

2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea Correspondence:

DOI: 10.22514/SV142.102018.12 Vol.14,Issue 2,November 2018 pp.75-77

Published: 02 November 2018

*Corresponding Author(s): SEONG JONG YUN E-mail: zoomknight@naver.com

PDF (239.73 kB) View Full-text

Abstract

Levodopa-carbidopa-entacapone is a sin-gle combination drug consisting of levo-dopa (aromatic amino acid), carbidopa (dopa-decarboxylase inhibitor), and en-tacapone (catechol-O-methyltransferase inhibitor). The Food and Drug Admin-istration approved levodopa-carbidopa-entacapone in 2003, as treatment for idiopathic Parkinson’s disease in patients experiencing signs and symptoms of wear-ing-off. Although various adverse drug re-actions of levodopa-carbidopa-entacapone have been recorded, there has been no re-ported case of levodopa-carbidopa-entaca-pone overdose. We report the first case of signs and symptoms of an overdose of lev-odopa-carbidopa-entacapone (levodopa: 3000 mg; carbidopa: 750 mg; entacapone: 6000 mg) in a suicide attempt, presenting as altered mentality, xanthoderma, and yellowish sclera without hyperbilirubine-mia.

Keywords

levodopa-carbidopa-entaca-pone, Parkinson’s disease, drug overdose, xanthoderma, yellowish sclera, toxicology

Cite and Share

SUN HWA LEE, SEONG JONG YUN, SEOKYONG RYU, SEUNG WOON CHOI, HYE JIN KIM, TAE KYUNG KANG, SUNG CHAN OH, SUK JIN CHO. Levodopa-carbidopa-entacapone overdose presenting as altered mental status, xanthoderma, and yellowish sclera. Signa Vitae. 2018; 14(2): 75-77. doi: 10.22514/SV142.102018.12

URL:

https://www.signavitae.com/articles/10.22514/SV142.102018.12

References

1. Solla P, Cannas A, Marrosu F, Marrosu MG. Therapeutic interventions and adjustments in the management of Parkinson’s disease: role of combined carbidopa/levodopa/entacapone (Stalevo). Neuropsychiatr Dis Treat 2010;6:483-90.

2. Food and Drug Administration. STALEVO. http://www.accessdata.fda.gov/ drugsatfda_

3. docs/label/2003/21485_stalevo_lbl.pdf. Accessed January 3, 2017.

4. Hoehn MM, Rutledge CO. Acute overdose with levodopa. Clinical and biochemical consequences. Neurology 1975;25:792-4.

5. Sporer KA. Carbidopa-levodopa overdose. Am J Emerg Med 1991;9:47-8.

6. Stuerenburg HJ, Schoser BG. Acute overdosage and intoxication with carbidopa/levodopa can be detected in the subacute stage by measurement of 3-o-methyldopa. J Neurol Neurosurg Psychiatry 1999;67:122-3.

7. Delmas G, Rothmann C, Flesch F. Acute overdose with controlled-release levodopa-carbidopa. Clin Toxicol (Phila) 2008;46:274-7.

8. Najib J. Entacapone: a catechol-O-methyltransferase inhibitor for the adjunctive treatment of Parkinson’s disease. Clin Ther 2001;23:802-32.

9. Huang P, Yang XD, Chen SD, Xiao Q. The association between Parkinson’s disease and melanoma: a systematic review and meta-analysis. Transl Neurodegener 2015;4:21.

10. Stanley RJ, Stoecker WV, Moss RH. A relative color approach to color discrimination for malignant melanoma detection in der-moscopy images. Skin Res Technol 2007;13:62-72.

Submission Turnaround Time

Top