The P-I-E-N-O Parkinsn's List Drug Database

entacapone / ANTIPARKINSON: Dopamine agonist: TRIAL PHASE

Entacapone is another new catechol-o-methyltransferase inhibitor. Like tolcapone, this compound improves the effectiveness of levodopa by decreasing fluctuations in medication response through inhibition of COMT.

Studies to determine long-term safety and benefits of entacapone as a supplement to levodopa treatment in Parkinson's disease patients with reduced benefits or complications from levodopa have been completed in the United States and Europe. Entacapone enhances the effects of levodopa and is safe. Occasional mild side effects include headache, dizziness. nausea, loose stools, increased dyskinesia and changes in the color of urine.

Entacapone is taken with each dose of levodopa. Peak effect is within one hour and its duration of action closely matches that of carbidopa/levodopa. These properties suggest that a combination tablet containing levodopa, carbidopa and entacapone may be feasible and desirable. Current plans include further studies to determine the benefit of entacapone in patients taking levodopa, but not experiencing motor fluctuations. Patients already taking levodopa, either in the form of Sinemet^TM or Madopar^TM , would want to consider addition of a catechol-o- methyltransferase inhibitor, either tolcapone or entacapone. Significant improvements in symptom control and reduced wearing-off can be expected immediately. Both medications, work well with either regular carbidopa/levodopa and the slow-release formulation of Sinemet CR^TM . Patients with a stable response to levodopa should experience improvement without needing significant adjustments in levodopa dosages. Some adjustments might be warranted in patients with significant levodopa induced dyskinesia or other dopaminergic side effects.

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