Tolcapone has a risk of hepatic toxicity and therefore entacapone is the preferable preparation.
Parkinson's disease - to be used with levodopa preparations.
Catechol-o-methyl transferase inhibitors block the enzyme breakdown of dopamine and the drug levodopa and thereby reduces 'off' times. Because these medications affect levodopa levels directly the dose commonly needs to be reduced.
Oral.
Entacapone interacts with warfarin causing an increase in INR. Interactions with anti-depressants are also recognised.
Patients should be warned to avoid abrupt withdrawal and should be aware of potential side effects, particularly signs of liver disease.
Entacapone shows large inter and intra-patient variability.
