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COMT inhibitors - Parkinson's drugs

COMT inhibitors are used to treat the symptoms of Parkinson's.COMT inhibitor

COMT inhibitors do not help Parkinson's on their own – they have to be used with levodopa.

COMT inhibitors reduce Parkinson's symptoms by blocking an enzyme that breaks down levodopa, prolonging its effect.

There are branded and unbranded COMT inhibitors available. These include:

  • entacapone (Comtess)
  • tolcapone (Tasmar)

Entacapone (Comtess)

Entacapone (Comtess) can be taken with levodopa or tolcapone.

It is effective from the first dose and you 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Tolcapone was withdrawn from the UK in 1998 due to its effect on liver function. However, 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.

Advantages of COMT inhibitors

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.

When used with levodopa, COMT inhibitors can reduce the daily 'off' time and increase the 'on' time. In many cases, the dose and frequency that levodopa is taken can also be reduced.

The terms 'on/off' or 'motor fluctuations' refer to the period when people can no longer rely on the smooth and even symptom control that their drugs once gave them.

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 treatments for Parkinson's booklet.

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