Comtan 200 mg200mg
Type:30 Tablets
Generic Name:Entacapone
Manufacturer:Novartis (Bangladesh) Ltd.
Price:৳82.46
Indication
Parkinson's disease
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
Contraindication
History of neuroleptic malignant syndrome and nontraumatic rhabdomyolysis. Phaeochromocytoma. Hepatic impairment.
Mode of Action
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.
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
Side Effect
>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
Pregnancy Category Note
Pregnancy Category: C Lactation: excretion in milk unknown; use with caution
Interaction
Drugs metabolised by COMT e.g. adrenaline, apomorphine, dobutamine, dopamine, isoprenaline, methyldopa, noradrenaline and remiterol. Iron preparations and levodopa. Avoid ethanol.