Formulary
Opicapone: Indications, Dosing, Side Effects and Interactions
Opicapone prevents the peripheral breakdown of levodopa, by inhibiting catechol- O -methyltransferase, allowing more levodopa to reach the brain.
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Opicapone: Indications, Dosing, Side Effects and Interactions
Opicapone prevents the peripheral breakdown of levodopa, by inhibiting catechol- O -methyltransferase, allowing more levodopa to reach the brain.
Drug action
Opicapone 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): 50 mg once daily, dose to be taken at bedtime, at least one hour before or after levodopa combinations.
Cautions
Concurrent levodopa dose may need to be reduced; elderly over 85 years (limited information available)
Contraindications
Catecholamine-secreting neoplasms; history of neuroleptic malignant syndrome; history of non-traumatic rhabdomyolysis; paraganglioma; phaeochromocytoma
Side effects
Common or very common Constipation; dizziness; drowsiness; dry mouth; hallucinations; headache; hypotension; movement disorders; muscle complaints; sleep disorders; vomiting Uncommon Anxiety; appetite decreased; depression; dry eye; dyspnoea; ear congestion; gastrointestinal discomfort; hypertension; hypertriglyceridaemia; musculoskeletal stiffness; nocturia; pain in extremity; palpitations; syncope; taste altered; urine discolouration; weight decreased Side-effects, further information Manufacturer advises consider liver function tests in patients who experience progressive anorexia, asthenia and weight decrease within a relatively short period of time.
Interactions
**Other interactions (10):**
- Monoamino oxidase (MAO) inhibitors Combination of opicapone and MAO inhibitors could result in inhibition of the majority of the pathways responsible for the metabolism of catecholamines.
- Concomitant use of opicapone and MAO inhibitors for the treatment of Parkinson's disease, e.g.
- There is no experience with opicapone when used concomitantly with the MAO-B inhibitor safinamide.
- Medicinal products metabolised by COMT Opicapone may interfere with the metabolism of medicinal products containing a catechol group that are metabolised by COMT, e.g.
- Careful monitoring of patients being treated with these medicinal products is advised when opicapone is used.
- Tricyclic antidepressants and noradrenaline re-uptake inhibitors There is limited experience with opicapone when used concomitantly with tricyclic antidepressants and noradrenaline re-uptake...
Pregnancy
Manufacturer advises avoid-limited information available.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises caution in moderate impairment (risk of increased exposure); avoid in severe impairment (no information available). Dose adjustments Manufacturer advises consider dose reduction in moderate impairment.
Medicinal forms
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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