Tolcapone

Generic name: Tolcapone
Brand names: Tasmar
Dosage form: oral tablet (100 mg)
Drug class: Dopaminergic antiparkinsonism agents

Usage of Tolcapone

Tolcapone is used together with other medicines (Carbidopa and levodopa) to treat symptoms of Parkinson's disease, such as stiffness, tremors, muscle spasms, and poor muscle control. Tolcapone increases levels of levodopa in the body.

Tolcapone is usually given to people who are already taking Carbidopa and levodopa but have not had successful treatment of symptoms.

Tolcapone may also be used for purposes not listed in this medication guide.

Tolcapone side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, tolcapone can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark colored urine.

Also call your doctor at once if you have:

a light-headed feeling, like you might pass out;

severe or ongoing diarrhea;

confusion, hallucinations (hearing or seeing something that is not there), unusual thoughts or behavior;

worsening tremors, stiffness, or muscle spasms; or

liver problems--nausea, loss of appetite, right-sided upper stomach pain, tiredness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Certain side effects may be more likely in older adults.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking tolcapone. Talk with your doctor if this occurs.

Common side effects of tolcapone may include:

dizziness, drowsiness;

nausea, diarrhea, loss of appetite;

sleep problems, increased dreaming; or

muscle cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Tolcapone

You should not use tolcapone if you are allergic to it, or if you have:

liver disease;

a history of liver problems caused by tolcapone; or

a history of muscle damage or fever and confusion caused by using any medication.

Do not use tolcapone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tolcapone can cause liver failure. You may be required to read and sign a Patient Consent form before you get a prescription for tolcapone.

To make sure tolcapone is safe for you, tell your doctor if you have ever had:

liver disease;

kidney disease; or

low blood pressure.

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether tolcapone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether tolcapone passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Relate drugs

How to use Tolcapone

Usual Adult Dose for Parkinson's Disease:

Initial dose: 100 mg orally 3 times a day-Dose should be increased to 200 mg orally 3 times a day only if the anticipated incremental clinical benefit is justifiedMaximum dose: 600 mg/day Comments:-Because of the risk of potentially fatal acute fulminant liver failure, this drug should only be used in patients who are experiencing symptom fluctuations and are not responding satisfactorily to, or are not appropriate candidates for, other adjunctive therapies.-For patients who do not demonstrate observable symptomatic benefit within 3 weeks of starting therapy, therapy should be discontinued. -In clinical trials, the first dose of the day was always taken with the first dose of the day of levodopa/carbidopa, and subsequent doses were given 6 and 12 hours later.-In clinical trials, a majority of patients who had levodopa doses greater than 600 mg/day or had moderate or severe dyskinesias prior to starting therapy, required a dose reduction of levodopa; the average dose reduction of levodopa was about 30%. Use: As an adjunct to levodopa and carbidopa for the treatment of the signs and symptoms of idiopathic Parkinson's disease.

Warnings

You should not use this medicine if you have liver disease, if you have ever had liver problems caused by tolcapone, or if you have ever had muscle damage or fever and confusion caused by using any medication.

Do not use tolcapone if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Tolcapone can cause liver failure. Call your doctor at once if you have unusual tiredness, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). Your liver function will need to be checked often.

What other drugs will affect Tolcapone

Taking tolcapone with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, opioid pain medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with tolcapone, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

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