Article Data

  • Views 7428
  • Dowloads 224

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

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.

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