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Comtan

Comtan

(entacapone)

Comtan (Entacapone) belongs to a group of medications called catechol-O-methyl transferase (COMT) inhibitors. It is used along with levodopa-carbidopa or levodopa-benserazide to treat Parkinson's Disease.

Available form

Dosage

Tablet

200MG

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Comtan information

Dosage

Side Effects

Available Form

Contraindications

Precautions

Warnings

Comtan (Entacapone) is to be taken together with either levodopa-carbidopa or levodopa-benserazide to treat people with Parkinson's disease who experience end-of-dose "wearing off" of levodopa. End-of-dose "wearing off" refers to a decrease in the amount of time that levodopa is effective, which results in fluctuations in Parkinson's disease symptoms.

The recommended dose of Comtan (Entacapone) is 200 mg taken with each levodopa-carbidopa or levodopa-benserazide dose, up to 8 times daily.

Comtan (Entacapone) can be taken with or without food. Swallow the tablets whole. Do not crush or chew the tablets.

Comtan (Entacapone) has no effect on symptoms of Parkinson's disease when taken alone.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Comtan (Entacapone) exactly as prescribed by your doctor. If you miss taking a dose of Comtan (Entacapone) with your levodopa dose, skip that dose and take your next Comtan (Entacapone) dose with your next levodopa dose. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Comtan (Entacapone) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of Comtan (Entacapone) with your doctor.

The following side effects have been reported by at least 1% of people taking Comtan (Entacapone). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

Constipation
darkened colour of sweat, saliva, or urine
decrease in weight
decreased appetite
Diarrhea
dizziness
Dry Mouth
falling
fatigue
Fever

headache
increased sweating
involuntary movements
muscle pain or cramps
nausea
nightmares
sensation of spinning
tremor
trouble sleeping
vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

chest pain
excessive daytime sleepiness
difficult urination
hallucinations (hearing or seeing things that aren't there)
sexual dysfunction
signs of colitis (inflammation of the digestive tract; persistent diarrhea, abdominal cramping)
signs of Depression (e.g., changes in sleeping or appetite, loss of interest in activities, poor concentration, feelings of guilt)
signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)

signs of Low Blood Pressure (e.g., dizziness, lightheadedness)
signs of muscle breakdown (e.g., muscle weakness, pain, bruising, confusion)
suddenly falling asleep
unusual and uncontrolled muscle movement of the body (including face, tongue, arms, hands, head, upper body)
unusual tiredness or weakness
unusual weight gain or loss
vision changes (e.g., blurred vision, dilated (large) pupils, double-vision)
worsening symptoms of Parkinson's disease

Stop taking the medication and seek immediate medical attention if any of the following occur:

signs of Heart Attack (e.g., sudden chest pain or pain radiating to back, down arm, or jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
signs of neuroleptic malignant syndrome (e.g., agitation; anxiety; confusion; fast, irregular, or pounding heartbeat; increased body temperature; muscle rigidity)
signs of a severe skin reaction (i.e., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, rash, Hives, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Comtan (Entacapone).

There may be an interaction between Comtan (Entacapone) and any of the following:

alcohol
antihistamines (e.g., Chlorpheniramine, Diphenhydramine, Hydroxyzine)
anti-seizure medications (e.g., Carbamazepine, Gabapentin, Lamotrigine, Phenytoin, Phenobarbital)
antipsychotics (e.g., Fluphenazine, Perphenazine, Quetiapine, Risperidone)
Apomorphine
azelastine
Baclofen
barbiturates (e.g., butalbital, phenobarbital)
benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
brimonidine
Buprenorphine
Buspirone
chloral hydrate
dobutamine
dopamine
droperidol
epinephrine
iron supplements
isoproterenol
Linezolid

magnesium sulfate
MAO inhibitors (e.g., moclobemide, phenelzine, Rasagiline, Selegiline, tranylcypromine)
Methotrimeprazine
methyldopa
Mirtazapine
muscle relaxants (e.g., Cyclobenzaprine, methocarbamol, orphenadrine)
narcotic medications (e.g., Codeine, Fentanyl, Morphine)
norepinephrine
paraldehyde
Pimozide
Pramipexole
Procarbazine
Ropinirole
selective serotonin reuptake inhibitors (e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
Tapentadol
Tramadol
tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
Warfarin
Zolpidem
Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Behavioural and mood changes: Comtan (Entacapone) may cause mood and psychiatric changes, including hallucinations, hypersexuality, pathological gambling, and increased libido. Tell your doctor as soon as possible if you notice any unusual changes in your behaviour, have thoughts of harming yourself, or feel depressed.

If you have depression or a history of depression, discuss with your doctor how Comtan (Entacapone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Comtan (Entacapone), and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Comtan (Entacapone) contact your doctor as soon as possible.

Diarrhea: Diarrhea is a common side effect of Comtan (Entacapone). It may appear as early as the first week of starting treatment or many months after starting treatment. For some people, the diarrhea causes weight loss. If you notice any weight loss or have excessive diarrhea, contact your doctor.

Dizziness/reduced alertness: Comtan (Entacapone) may cause low blood pressure or dizziness and lightheadedness when rising from a lying or sitting position. People taking medications that can cause dizziness should rise slowly from sitting or lying down to reduce the possibility of severe dizziness or fainting. Do not drive, operate machinery, or perform other hazardous tasks until you have determined how Comtan (Entacapone) affects you.

Fructose intolerance: Comtan (Entacapone) contains fructose. If you have fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency, you should not take Comtan (Entacapone). Talk to your doctor.

Heart disease: Comtan (Entacapone) may cause an increase in the risk of heart attack or heart disease. If you have a history of heart disease, discuss with your doctor how Comtan (Entacapone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Comtan (Entacapone) to build up in the body, causing side effects. Comtan (Entacapone) is not recommended for people with liver problems.

Melanoma: People with Parkinson's disease may be at increased risk of developing melanoma (a type of Skin Cancer). It is not known if this increased risk is due to Parkinson's disease or to the medications used to treat Parkinson's disease. Your doctor will monitor you for skin cancer while you are taking Comtan (Entacapone). Talk to your doctor if you have any concerns.

Neuroleptic malignant syndrome (NMS): Comtan (Entacapone) may cause a potentially fatal reaction called neuroleptic malignant syndrome (NMS). If you develop symptoms of NMS, such as muscle stiffness, fever, confusion, sweating, or irregular heartbeat, stop taking Comtan (Entacapone) and seek immediate medical attention.

Prostate Cancer: A recent study has shown an increase in the number of cases of prostate cancer among men who have taken levodopa/carbidopa with or without Comtan (Entacapone) for approximately 3 years. Although it is not clear whether this increased risk of prostate cancer is due to the medication or something else, it is important to have regular prostate examinations while taking medications for Parkinson's Disease.

Rhabdomyolysis (muscle breakdown): Occasionally, Comtan (Entacapone) may cause rapid breakdown of muscle tissue. If you notice signs of muscle weakness or pain, high body temperature, unexpected bruising, confusion, or difficulty passing urine, contact your doctor immediately.

Stopping Comtan (Entacapone): Stopping Comtan (Entacapone) too quickly can cause potentially life-threatening side effects. Before stopping this medication, discuss the risks and benefits with your doctor. Do not stop taking Comtan (Entacapone) until you have spoken with your doctor first.

Sudden onset of sleep: There are reports of people who take this combination medication treatment (Comtan (Entacapone) with levodopa - carbidopa) falling asleep without prior warning or drowsiness. If you have a sleep disorder, discuss this with your doctor. If you experience drowsiness while taking this medication, avoid driving or using machinery.

Pregnancy: Comtan (Entacapone) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast feeding: It is not known if Comtan (Entacapone) passes into breast milk. If you are a breast-feeding mother and are using Comtan (Entacapone), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Comtan (Entacapone) have not been established for children less than 18 years of age.

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