Entacapone

Sounds like 'en-ta-ka-pone'

Key points about entacapone

  • Entacapone is used to treat the symptoms of Parkinson's disease.
  • Entacapone is also called Comtan.
  • Find out how to take it safely and the possible side effects.
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Entacapone is used together with levodopa + carbidopa or levodopa + benserazide to treat the symptoms of Parkinson's disease, or Parkinson-like symptoms such as tremor, shakiness, stiffness, and difficulty moving.

Many people taking levodopa for Parkinson's disease have problems with the effects of the levodopa wearing off between doses. This causes the Parkinson's symptoms to return or worsen. Entacapone blocks a certain natural substance (COMT enzyme) that breaks down the levodopa in the body. This allows the levodopa to last longer so that it doesn't wear off before the next dose.

  • In Aotearoa New Zealand entacapone is available as 200 mg tablets.
  • The usual dose of entacapone is one tablet (200 mg) with each dose of levodopa + carbidopa  or levodopa + benserazide.
  • Always take your entacapone exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much entacapone to take, how often to take it, and any special instructions.

  • Timing: Take your entacapone dose with each prescribed dose of levodopa + carbidopa or levodopa + benserazide. This may be up to 10 times a day.
  • Taking: You can take entacapone with or without food. 
  • Missed dose: If you do miss a dose then take your next dose when you take your next dose of levodopa + carbidopa  or levodopa + benserazide. Do not take double the dose.  
  • Keep taking entacapone regularly. Stopping treatment suddenly can cause serious problems.
  • Swallowing difficulties: If you are struggling to swallow your tablets, you can dissolve the tablet in water. It can take 7 minutes to dissolve. Stir or shake well before drinking and rinse the cup or oral dispenser well. The suspension (dissolved tablet) is orange and may stain your mouth, lips, tongue, saliva and dentures. 

Like all medicines, entacapone can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Changes in the colour of your urine, sweat or saliva — it may turn red, brown or black
  • This is harmless and is nothing to worry about.
  • Feeling or being sick (nausea)
  • This is common when you first start taking entacapone
  • Try taking your dose with food.
  • Falling asleep suddenly during daily activities (such as talking on the phone, or driving)
  • This sleep effect can occur without any feelings of drowsiness beforehand, and can happen anytime during treatment with this medication
  • Tell your doctor
  • Do not drive or use tools until you know how this medicine affects you and until these have stopped happening
  • Avoid drinking alcohol.
  • Feeling dizzy or faint when you stand up (due to a sudden drop in blood pressure)
  • Be careful when getting up from either lying down or sitting, to avoid falls
  • Tell your doctor.
  • Uncontrollable jerky movements, where you switch suddenly from being able to move to being immobile
  • Tell your doctor immediately or ring Healthline 0800 611 116
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

Entacapone can interact with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting entacapone and before starting any new products.

Do not take iron tablets at the same time as entacapone because iron can reduce the amount of entacapone your body can absorb and your medicine won't be as effective. If you need to take iron tablets, take it 2 hours before, or 2 hours after entacapone.

The following links provide further information on entacapone. 

Parkinson's treatment(external link) Parkinson's New Zealand
Comtan(external link) Medsafe Consumer Information Sheet, NZ
Entacapone(external link) Patient Information NZ Formulary

References

  1. Entacapone(external link) New Zealand Formulary
  2. Comtan(external link) Medsafe, NZ
  3. Entapone(external link) Medsafe, NZ
  4. The management of Parkinson’s disease – which treatments to start and when?(external link) BPAC, NZ, 2014

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Maya Patel, MPharm PGDipClinPharm, Auckland

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