Entacapone Brand Name– Comtan
What is Entacapone
Entacapone is a reversible inhibitor of peripheral catechol-O-methyltransferase (COMT) and is used as an adjunct to levodopa/carbidopa therapy in the treatment of Parkinson’s disease.
Clinically, COMT inhibitors improve levodopa availability in the CNS, thereby prolonging the motor response to levodopa treatment. Entacapone allows the patient’s dosage of levodopa to be lowered, and results in a decrease in the incidence or severity of levodopa dose-related side effects (e.g., dyskinesia, nausea, etc.).
With initial entacapone therapy, an increase in levodopa-induced side effects may be seen until the dosage of levodopa is adjusted downward.
Entacapone treatment of Parkinson’s disease patients has been associated with significant increases in daily “on” time and decreases in “off” time. In addition, entacapone has been shown to improve total activities of daily living and motor function scores, but it has no effect on cognitive function.
Entacapone may be given with regular or controlled-release formulations of levodopa/carbidopa with or without the concurrent use of selegiline.
As compared to another available COMT inhibitor, tolcapone, entacapone has a shorter duration of COMT inhibition but appears to have an improved side effect profile and does not require additional laboratory monitoring.
The FDA approved entacapone in October 1999.
Indications
- Parkinson’s disease
For use as an adjunct to levodopa and carbidopa to treat end-of-dose ‘wearing-off’ in patients with Parkinson’s disease
Side Effects
- abdominal pain
- agitation
- anxiety
- asthenia
- back pain
- colitis
- confusion
- constipation
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyskinesia
- dyspepsia
- dyspnea
- fatigue
- flatulence
- gastritis
- hallucinations
- hyperhidrosis
- hyperkinesis
- hypotension
- impulse control symptoms
- infection
- myalgia
- nausea
- neuroleptic malignant syndrome-like symptoms
- orthostatic hypotension
- psychosis
- pulmonary fibrosis
- purpura
- rhabdomyolysis
- skin discoloration
- sudden sleep onset
- syncope
- tongue discoloration
- urine discoloration
- ventricular tachycardia
- vomiting
- withdrawal
- xerostomia
Monitoring Parameters
- LFTs
- neurologic function
Contraindications
- abrupt discontinuation
- behavioral changes
- biliary obstruction
- breast-feeding
- children
- coadministration with other CNS depressants
- colitis
- diarrhea
- driving or operating machinery
- dyskinesia
- ethanol ingestion
- geriatric
- hepatic disease
- hyperthermia
- hypotension
- impulse control symptoms
- infants
- jaundice
- MAOI therapy
- melanoma
- orthostatic hypotension
- pregnancy
- psychosis
- pulmonary fibrosis
- retroperitoneal fibrosis
- rhabdomyolysis
- surgery
- syncope
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Alfentanil
- Alprazolam
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Ampicillin
- Ampicillin; Sulbactam
- Articaine; Epinephrine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- atypical antipsychotic
- Azelastine
- Azelastine; Fluticasone
- Barbiturates
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Cannabidiol
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chloral Hydrate
- Chloramphenicol
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Cholestyramine
- Clobazam
- Clonazepam
- Clonidine
- Clorazepate
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine; Probenecid
- Deutetrabenazine
- Dexmedetomidine
- Dexmethylphenidate
- Dextromethorphan; Promethazine
- Diazepam
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dobutamine
- Dopamine
- Dronabinol
- Droperidol
- Enflurane
- Ephedrine
- Epinephrine
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esketamine
- Estazolam
- Eszopiclone
- Ethanol
- Etomidate
- Fenfluramine
- Fentanyl
- Flibanserin
- Fluphenazine
- Flurazepam
- Fospropofol
- Gabapentin
- General anesthetics
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Haloperidol
- Halothane
- Heterocyclic antidepressants
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Ibuprofen; Oxycodone
- Isocarboxazid
- Isoflurane
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Ketamine
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levorphanol
- Linezolid
- Lofexidine
- Lorazepam
- Loxapine
- Maprotiline
- Melatonin
- Meperidine
- Meperidine; Promethazine
- Meprobamate
- Mesoridazine
- Methadone
- Methyldopa
- Methylphenidate
- Metoclopramide
- Midazolam
- Mirtazapine
- Molindone
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nefazodone
- Norepinephrine
- Opiate Agonists-Antagonists
- Oxazepam
- Oxycodone
- Oxymorphone
- Perampanel
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenothiazines
- Phenylephrine; Promethazine
- Pimozide
- Pramipexole
- Pregabalin
- Prilocaine; Epinephrine
- Probenecid
- Procarbazine
- Prochlorperazine
- Promethazine
- Propofol
- Quazepam
- Racepinephrine
- Ramelteon
- Remifentanil
- Rifampin
- Scopolamine
- Sedating H1-blockers
- Sevoflurane
- Skeletal Muscle Relaxants
- Sodium Oxybate
- Solriamfetol
- Sufentanil
- Suvorexant
- Tapentadol
- Tasimelteon
- Temazepam
- Tetrabenazine
- Thalidomide
- Thiethylperazine
- Thioridazine
- Thiothixene
- Tizanidine
- Tramadol
- Tranylcypromine
- Trazodone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Warfarin
- Zaleplon
- Zolpidem
