Tolcapone

Brand names: Tasmar®

Chemical formula:

Español:
• Tolcapona, Tableta oral

Tolcapone Oral tablet

What is this medicine?

TOLCAPONE (TOLE ka pone) is used in combination with levodopa-carbidopa therapy to treat Parkinson's disease.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•kidney disease
•liver disease
•severe movement disorder
•an unusual or allergic reaction to tolcapone, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take this medicine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your the advice of your doctor or health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
•isoniazid
•medicines called MAO Inhibitors like Nardil, Parnate, Marplan, Eldepryl
•procarbazine

This medicine may also interact with the following medications:
•apomorphine
•dobutamine
•isoproterenol
•methyldopa
•phenelzine
•warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor for regular check ups. You will need to have important blood work done while you are taking this medicine. Tell your doctor if your symptoms do not get better or if they get worse.
 
You may get dizzy or have difficulty controlling your movements. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can increase possible dizziness. Avoid alcoholic drinks.
 
Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.
 
There have been reports of increased sexual urges or other strong urges such as gambling while taking some medicines for Parkinson's disease. If you experience any of these urges while taking this medicine, you should report it to your health care provider as soon as possible.
 
You should check your skin often for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•confusion
•dark urine
•feeling faint or lightheaded
•fever
•general ill feeling or flu-like symptoms
•hallucinations
•involuntary muscle movements
•light-colored stools
•loss of appetite, nausea
•right upper belly pain
•severe diarrhea
•unusually weak or tired
•yellowing of eyes, skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•constipation
•headache
•increased sweating
•muscle cramping
•stomach upset
•trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Tolcapone
Systematic (IUPAC) name
(3,4-dihydroxy-5-nitrophenyl)(4-methylphenyl)methanone
Identifiers
CAS number	134308-13-7
ATC code	N04BX01
PubChem	4659569
DrugBank	APRD00445
Chemical data
Formula	C14H11NO5
Mol. mass	273.241 g/mol
Pharmacokinetic data
Bioavailability	65%
Protein binding	>99.9%
Metabolism	?
Half life	2-3.5 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	C(US)
Legal status	℞-only(US)
Routes	Oral

Tolcapone is a drug that inhibits the enzyme catechol-O-methyl transferase (COMT). ^[1]

Contents 1 Uses 2 Chemistry 3 Pharmacology 4 References

Uses

It is used in the treatment of Parkinson's disease as an adjunct to levodopa/carbidopa medication.

Chemistry

It is a yellow, odorless, non-hygroscopic, crystalline compound with a relative molecular mass of 273.25. The chemical name of tolcapone is 3,4-dihydroxy-4’-methyl-5-nitrobenzophenone. Its empirical formula is C₁₄H₁₁NO₅.

Pharmacology

Tolcapone has the ability to cross the blood-brain barrier and thus exerts its COMT inhibitory effects in the CNS as well as in the periphery.

Tolcapone has demonstrated significant hepatotoxicity^[2] that limits the drug's therapeutic utility to a drug of last resort. Entacapone, another COMT inhibitor, is a more popular selection for L-DOPA adjunct therapy in the treatment of Parkinson's Disease because it has a better side effect and toxicity profile.

Normally, administration of levodopa is compromised when COMT converts it to methyldopa. By preventing this effect, more of the levodopa that is administered reaches the CNS. Additionally, levodopa that is in the CNS, after being converted to dopamine, will not be degraded by COMT when tolcapone inhibits COMT activity.

Response to Tolcapone is influenced by the single nucleotide polymorphism rs4818. [PMID 19699472]

References

1. ^ Antonini A, Abbruzzese G, Barone P, et al. (February 2008). "COMT inhibition with tolcapone in the treatment algorithm of patients with Parkinson's disease (PD): relevance for motor and non-motor features". Neuropsychiatric disease and treatment 4 (1): 1–9. PMID 18728767. 
2. ^ Olanow CW, Watkins PB (2007). "Tolcapone: an efficacy and safety review (2007)". Clinical neuropharmacology 30 (5): 287–94. doi:10.1097/wnf.0b013e318038d2b6. PMID 17909307. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00002826-200709000-00006. 

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MAO-B Selective: Lazabemide • Pargyline • Rasagiline • Selegiline COMT Inhibitors Entacapone • Tolcapone DBH Inhibitors Disulfiram • Nepicastat • Tropolone Others Precursors L-Phenylalanine → L-Tyrosine → L-DOPA (Levodopa) Cofactors Ferrous Iron (Fe2+) • Tetrahydrobiopterin • Vitamin B3 (Niacin, Nicotinamide → NADPH) • Vitamin B6 (Pyridoxine, Pyridoxamine, Pyridoxal → Pyridoxal Phosphate) • Vitamin B9 (Folic Acid → Tetrahydrofolic Acid) • Vitamin C (Ascorbic Acid) • Zinc (Zn2+) Others Activity Enhancers: Benzofuranylpropylaminopentane (BPAP) • Phenylpropylaminopentane (PPAP)

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