Uses of Adcapone: - Parkinson's disease Parkinson's disease History of neuroleptic malignant syndrome and nontraumatic rhabdomyolysis. Phaeochromocytoma. Hepatic impairment.

How to use Entacapone: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Entacapone may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Adjunct to levodopa treatment in Parkinson's disease Adult: 200 mg w/ each levodopa/dopa decarboxylase inhibitor dose. Max: 200 mg 10 times daily (2,000 mg daily). Hepatic Impairment Safety and efficacy not established Renal Dose: Renal Impairment Dose adjustment not necessary

Drugs metabolised by COMT e.g. adrenaline, apomorphine, dobutamine, dopamine, isoprenaline, methyldopa, noradrenaline and remiterol. Iron preparations and levodopa. Avoid ethanol.

History of neuroleptic malignant syndrome and nontraumatic rhabdomyolysis. Phaeochromocytoma. Hepatic impairment.

Common - Nausea - Vomiting - Fatigue - Confusion - Constipation - Insomnia (difficulty in sleeping) - Nightmare - Hallucination - Increased sweating - Fall - Urine discoloration - Dizziness - Diarrhea - Muscle coordination impaired - Ischemic heart disease - Heart attack - Abdominal pain - Dryness in mouth >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

Precaution: Levodopa-induced orthostatic hypotension may be aggravated. Abrupt withdrawal. Concomitant use with a selective MAO-A and MAO-B inhibitor, or concomitant use with a selective MAO-A plus a selective MAO-B inhibitor. Biliary obstruction. Impairs ability to drive and operate machinery. Pregnancy and lactation. Children and elderly. Lactation: excretion in milk unknown; use with caution

Symptoms: Decreased activity, confusion, somnolence, hypotonia, urticaria, skin discolouration. Management: Symptomatic treatment.

Store at 25°C.

Antiparkinson drugs

Entacapone is a selective, reversible, peripheral inhibitor of COMT, an enzyme involved in the metabolism of dopamine and levodopa. It is used in patients with Parkinson's disease and "end-of-dose" motor fluctuations that cannot be stabilised on levodopa combinations alone.

Pregnancy Category: C Lactation: excretion in milk unknown; use with caution