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levodopa + carbidopa + entacapone is a fixed-dose combination therapy developed by Novartis and Orion Corporation for the treatment of Parkinson's disease. It is specifically indicated for patients who experience end-of-dose motor fluctuations, known as wearing-off. The combination works through three distinct mechanisms: levodopa serves as a metabolic precursor to dopamine, crossing the blood-brain barrier to replenish depleted dopamine levels; carbidopa is a peripheral DOPA decarboxylase inhibitor that prevents the premature conversion of levodopa to dopamine outside the central nervous system, thereby reducing side effects and increasing levodopa bioavailability; and entacapone is a selective, reversible inhibitor of catechol-O-methyltransferase (COMT), which further prevents the breakdown of levodopa, extending its therapeutic half-life and providing more stable plasma levels.
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