Medicine & USMLE

Entacapone / Tolcapone

73 views
Neuro Drugs
  1. Levodopa, Carbidopa
  2. Levetiracetam
  3. Valproic Acid
  4. Anticholinergic Syndrome
  5. Cholinergic Crisis
  6. Benztropine / Trihexyphenidyl
  7. Lidocaine
  8. Pyridostigmine, Neostigmine, Edrophonium
  9. Naltrexone
  10. Pregabalin
  11. Scopolamine
  12. Phenytoin
  13. Ethosuximide
  14. Succinylcholine
  15. Memantine
  16. Donepezil
  17. Halothane / Flurane
  18. Propofol
  19. Ergotamine
  20. Triptans
  21. Selegiline / Rasagiline
  22. Entacapone / Tolcapone
  23. Gabapentin
  24. Lamotrigine
  25. Carbamazepine
  26. Ramelteon

Summary

Drugs ending in -capone, like entacapone and tolcapone, are used to treat Parkinson disease. These drugs can cause orthostatic hypotension as a side effect, so it’s important that patients taking these drugs get up slowly to avoid dizziness and falls. These drugs can also cause orange urine discoloration, but this is an expected and harmless side effect that is NOT a reason to stop taking the drug.

Key Points

  • Entacapone (Comtam), Tolcapone (Tasmar)
    • Mechanism
      • Catechol-O-Methyltransferase (COMT) inhibitor
        • Inhibits an enzyme that inactivates dopamine, thus increasing the amount of dopamine in the brain
    • Clinical Uses
      • Parkinson’s Disease
        • Used alongside levodopa/carbidopa, so that a smaller dose of levodopa can be used
    • Side Effects and Adverse Reactions
      • Orthostatic hypotension
        • Rise slowly to avoid sudden dizziness
      • Orange urine discoloration
        • An expected, harmless side effect
      • Hepatotoxicity (tolcapone only)
        • Monitor liver enzymes