COMT inhibitors - Parkinson's drugs
COMT inhibitors are used to
treat the symptoms of Parkinson's
COMT inhibitors do not help Parkinson’s on their own – they have
to be used with levodopa
COMT inhibitors reduce the symptoms by slowing the destruction
of levodopa and prolonging its effect.
The generic drug names and brand names are:
- Entacapone (Comtess®)
- Tolcapone (Tasmar®)
- Levodopa/carbidopa/entacapone (Stalevo®)
Entacapone (Comtess®)
Entacapone (Comtess®) is taken with levodopa or
tolcapone.
It is effective from the first dose and the individual should
feel the benefit within a day or two.
See the
Comtess Medicine Guide for independent, up to date information
about this medicine.
Tolcapone (Tasmar®)
Tolcapone was withdrawn from the UK in 1998 due to its effect on
liver function. In 2005 prescribing procedures were heavily
modified and tolcapone was reintroduced.
To avoid any potential risks, only physicians experienced in the
management of advanced Parkinson's will be able to prescribe
tolcapone. Patients must also undergo regular medical checks.
See the
Tolcapone Medicine Guide for independent, up to date
information about this medicine.
Stalevo
Stalevo is a combination drug to treat Parkinson's, which
contains levodopa, carbidopa and entacapone in one tablet.
See the
Stalevo Medicine Guide for independent, up to date information
about this medicine.
Advantages of COMT inhibitors
When used with levodopa, COMT
inhibitors can reduce the daily 'off' time and increase the 'on'
time. In many cases, the levodopa dose and dosing frequency can
also be reduced.
The terms 'on/off' or 'motor fluctuations' refers to the period
of time, often years, when people may find that the smooth and even
control of symptoms that their drugs once gave them is no longer
dependable.
Read more in our motor fluctuations in
Parkinson's information sheet
Some disadvantages of COMT inhibitors
These drugs can increase the side effects caused by levodopa,
notably dyskinesias (unwanted involuntary movements), nausea and
vomiting.
If these side effects increase after starting the drug, people
should raise the issue with their healthcare professional as
reducing the levodopa dose can often help.
Be aware that other drugs (for Parkinson's or other conditions)
can affect the action of COMT inhibitors. The combination of
apomorphine and entacapone needs
careful supervision.
Other reported side effects of COMT inhibitors include abdominal
pain, diarrhoea and discoloured urine.
Read more in our drug treament of
Parkinson's booklet
More drug treatments of Parkinson's
Return to the drug treatment of
Parkinson's main page
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