entacapone (Rx)

Brand and Other Names:Comtan
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 200mg
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Parkinson Disease

200 mg PO with each dose of levodopa/carbidopa

Not to exceed 1600 mg/day

See also combo with levodopa/carbidopa

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Safety and efficacy not established

Not recommended

Parkinson disease

200 mg PO with each dose of levodopa/carbidopa

Not to exceed 1600 mg/day

See also combo with levodopa/carbidopa

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Interactions

Interaction Checker

and entacapone

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Dyskinesia (25%)

            Nausea (14%)

            Diarrhea (10%)

            Hyperkinesia (10%)

            Urine discoloration (10%)

            1-10%

            Hypokinesia (9%)

            Dizziness (8%)

            Abdominal pain (8%)

            Fatigue (6%)

            Constipation (6%)

            Back pain (4%)

            Vomiting (4%)

            Dry mouth (3%)

            Dyspnea (3%)

            Increased sweating (2%)

            Back pain (2%)

            Anxiety (2%)

            Somnolence (2%)

            Dyspepsia (2%)

            Flatulence (2%)

            Purpura (2%)

            Asthenia (2%)

            Hallucinations (1-4%)

            Taste perversion (1%)

            Agitation (1%)

            Gastritis (1%)

            Bacterial infection (1%)

            Frequency Not Defined

            Insomnia

            Postural hypotension

            Confusion

            Dopaminergic side affects due to increased dopamine levels

            Rare: rhabdomyolysis, retroperitoneal fibrosis

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            Use only in combo with levodopa/carbidopa

            Increases plasma levodopa levels, which may result in suddenly falling asleep without prior warning of sleepiness while engaged in activities of daily living; adjust levodopa dose

            Less hepatotoxic than tolcapone

            May be linked to higher melanoma risk in patients with Parkinson Disease

            Diarrhea may occur and be associated with weight loss, dehydration, and hypokalemia; if severe, may be a sign of drug-induced microscopic colitis

            Dyskinesia incidence 25% compared with 15% for placebo

            Dopaminergic therapy in patients with Parkinson disease has been associated with hypotension, orthostatic hypotension, syncope, increased heart rates, possible arrhythmias, and excessive changes in blood pressure

            Hallucinations and psychotic-like behavior reported with dopaminergic therapy

            Rhabdomyolysis, hyperpyrexia, and confusion reported

            Impulse control/compulsive behaviors: Risk of uncontrollable sexual, gambling or other urges

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Reversible catechol-O-methyltransferase (COMT) inhibitor that prolongs half life of levodopa in Parkinsonian patients, reducing motor fluctuations

            Pharmacokinetics

            Peak Plasma Time: 1 hr

            Concentration: 1.2 mcg/mL

            Excretion: Feces (90); urine (10%)

            Bioavailability: 35%

            Protein Bound: 98%

            Vd: 20 L

            Half-life elimination: 0.4-0.7 hr (B-phase); 2.4 hr (Y-phase)

            Metabolism: Hepatic glucuronidation

            Total body clearance: 850 mL/min

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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