Comtan (Entacapone)

Description

Comtan (Entacapone) is a medicine taken by mouth that helps people with Parkinson's disease. It works by blocking a specific enzyme in the body that breaks down dopamine, a chemical that plays an important role in movement. By stopping this enzyme, Comtan helps to make the effects of another medication called Levodopa last longer. This is especially helpful for people who experience a return of symptoms before their next dose of medicine, often referred to as "wearing-off." Doctors usually prescribe Comtan along with other treatments to help better control movement problems.

Directions

Comtan is usually taken with each dose of Carbidopa and Levodopa. Typically, the standard Comtan dosage is one 200 mg tablet administered orally with each Levodopa/Carbidopa dose, up to a maximum of eight times a day. Using Comtan can help make Levodopa work better, but it might also lead to more side effects for some people. Because of this, doctors may need to adjust the dosage of these medications for safety.

Ingredients

The active ingredient in Comtan is Entacapone.

Contraindications

Avoid taking or using Comtan if you've previously experienced allergic reactions to Entacapone or any of the other ingredients in Comtan.

Cautions

• Before taking Comtan, discuss with your healthcare provider the following:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding

• Do not use Comtan with non-selective MAO inhibitors as it may lead to excessive catecholamine activity, potentially causing severe side effects. Selective MAO-B inhibitors, such as selegiline, are safe to use with Comtan.
• Use caution when combining Comtan with drugs metabolized by COMT, like epinephrine, dopamine, and norepinephrine, as this may cause increased heart rate, arrhythmias, or blood pressure changes.
• Some people may experience drowsiness or suddenly fall asleep during daily activities, including driving. Avoid engaging in potentially hazardous activities if this occurs, and discuss with your doctor if symptoms persist.
• Comtan may cause dizziness or fainting, especially when standing up quickly. Monitor for symptoms, particularly in combination with other medications that lower blood pressure.
• Report any hallucinations, confusion, or aggressive behavior while taking Comtan. These symptoms may require a dose adjustment or discontinuation.
• Some people may experience uncontrollable urges, such as gambling, overeating, or increased sexual desire. Discuss any unusual behaviors with a doctor immediately.
• Comtan may cause diarrhea, which can range from mild to severe. Prolonged diarrhea could indicate microscopic colitis. Contact your doctor if diarrhea persists or worsens.
• Comtan may increase the involuntary movements caused by Levodopa. Adjusting the Levodopa dose may help.
• Severe muscle breakdown (rhabdomyolysis) may occur, leading to symptoms like muscle pain or weakness. Seek medical attention if these occur.
• Abruptly stopping or reducing Comtan may trigger symptoms like fever, rigidity, or confusion. Taper use gradually under medical supervision.
• People with Parkinson’s disease are at higher risk for melanoma. Regular skin checks are recommended.
• People with liver or kidney impairment should use Comtan cautiously, as it may increase drug levels in the body.
• People with liver disease may experience higher drug exposure. Discuss liver function monitoring with a doctor if you have hepatic impairment.

Side Effects

The most common side effects of Comtan include dyskinesia (uncontrolled movements), nausea, diarrhea, and dry mouth. Other frequent reactions are abdominal pain, fatigue, vomiting, and urine discoloration. These effects are typically mild and manageable, but if they persist or worsen, consult a healthcare provider.

Comtan may lead to severe diarrhea, psychiatric symptoms like anxiety or agitation, and rare cases of hepatitis with cholestatic features. If you experience jaundice, severe stomach pain, or persistent diarrhea, contact a healthcare provider immediately. Always take Comtan as directed and report any unusual symptoms.

References

1. Comtan (Entacapone) Product Monograph. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2016.
2. Comtan (Entacapone) Drug Label Information. Morristown, NJ: Almatica Pharma LLC; 2020.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....