Tasmar

Generic name: Tolcapone

Drug class: Catechol-O-methyltransferase (COMT) inhibitors

Dosage form: Film-coated tablets (100 mg and 200 mg)

Root of administration: Oral

Dose: 100 mg three times daily; may be increased to 200 mg three times daily if necessary and tolerated

Mechanism of action: Tolcapone is a selective and reversible inhibitor of catechol-O-methyltransferase (COMT), an enzyme responsible for metabolizing levodopa. By inhibiting COMT, tolcapone increases the bioavailability of levodopa, leading to more stable plasma levels and enhanced therapeutic effects in Parkinson’s disease patients.

Drug usage cases:

• Adjunctive treatment for Parkinson’s disease in combination with levodopa and carbidopa when patients experience motor fluctuations.

Drug contraindications:

• Active liver disease or a history of liver problems caused by tolcapone.
• Use of monoamine oxidase (MAO) inhibitors within the past 14 days.

Side effects:

• Severe liver injury, including acute liver failure (rare but serious).
• Uncontrolled, involuntary movements (dyskinesia).
• Nausea, vomiting, diarrhea.
• Loss of appetite (anorexia).
• Sleep disturbances, including increased dreaming.
• Urine discoloration (dark or red-brown urine).
• Somnolence (drowsiness).
• Hallucinations.
• Abnormal muscle tone (dystonia).
• Excessive sweating (hyperhidrosis).

Warnings:

• Regular monitoring of liver function is essential due to the risk of severe liver injury.
• Discontinue treatment if liver enzyme levels exceed twice the upper limit of normal.
• Monitor for signs of dyskinesia and adjust levodopa dosage accordingly.
• Be cautious of potential drowsiness and advise patients against engaging in activities requiring full alertness until they know how the medication affects them.
• Patients should be aware of the possibility of hallucinations and report any such occurrences to their healthcare provider.

Use during pregnancy or breastfeeding: The safety of tolcapone during pregnancy and breastfeeding has not been established. It is recommended to consult a healthcare provider to weigh potential risks and benefits before using this medication during these periods.