Medicine & USMLE

Entacapone / Tolcapone

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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. Opioids
  16. Memantine
  17. Halothane / Flurane
  18. Donepezil
  19. Propofol
  20. Ergotamine
  21. Triptans
  22. Selegiline / Rasagiline
  23. Entacapone / Tolcapone
  24. Gabapentin
  25. Lamotrigine
  26. Carbamazepine
  27. 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