Formulary
Entacapone: Indications, Dosing, Side Effects and Interactions
Entacapone prevents the peripheral breakdown of levodopa, by inhibiting catechol- O -methyltransferase, allowing more levodopa to reach the brain.
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Entacapone: Indications, Dosing, Side Effects and Interactions
Entacapone prevents the peripheral breakdown of levodopa, by inhibiting catechol- O -methyltransferase, allowing more levodopa to reach the brain.
Drug action
Entacapone prevents the peripheral breakdown of levodopa, by inhibiting catechol- O -methyltransferase, allowing more levodopa to reach the brain.
Indications and dose
**Adjunct to co-beneldopa or co-careldopa in Parkinson's disease with 'end-of-dose' motor fluctuations (under expert supervision)**
- **Adult** (By Mouth): 200 mg, dose to be given with each dose of levodopa with dopa-decarboxylase inhibitor; maximum 2 g per day.
Cautions
Concurrent levodopa dose may need to be reduced by about 10-30%; ischaemic heart disease
Contraindications
History of neuroleptic malignant syndrome; history of non-traumatic rhabdomyolysis; phaeochromocytoma
Side effects
Common or very common Abdominal pain; confusion; constipation; diarrhoea; dizziness; dry mouth; fall; fatigue; hallucination; hyperhidrosis; ischaemic heart disease; movement disorders; nausea; sleep disorders; urine discolouration; vomiting Uncommon Myocardial infarction Rare or very rare Agitation; appetite decreased; skin reactions; weight decreased Frequency not known Colitis; drowsiness; hair colour changes; hepatic disorders; impulse-control disorder; nail discolouration; neuroleptic malignant syndrome; rhabdomyolysis; sudden onset of sleep
Interactions
**Other interactions (13):**
- No interaction of entacapone with carbidopa has been observed with the recommended treatment schedule.
- In single-dose studies in healthy volunteers, no interactions were observed between entacapone and imipramine or between entacapone and moclobemide.
- Similarly, no interactions between entacapone and selegiline were observed in repeated-dose studies in Parkinsonian patients.
- However, the experience of the clinical use of entacapone with several medicinal products, including MAO-A inhibitors, tricyclic antidepressants, noradrenaline reuptake inhibitors such as...
- Caution should be exercised when these medicinal products are used concomitantly with entacapone (see also sections 4.3 and 4.4).
- Entacapone may be used with selegiline (a selective MAO-B inhibitor), but the daily dose of selegiline should not exceed 10 mg.
Pregnancy
Avoid-no information available.
Breast feeding
Avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises avoid.
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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