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Tolcapone |
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What is Tolcapone and why is it prescribed? Tolcapone helps to relieve the muscle stiffness, tremor, and weakness caused by Parkinson's disease. When taken with Sinemet (levodopa/carbidopa), it sustains the blood levels of dopamine needed for normal muscle function. Because Tolcapone has been known to cause liver failure, it is prescribed only when other Parkinson's drugs fail to control the symptoms. Like all Parkinson's medications, Tolcapone can provide long-term relief of symptoms, but won't cure the underlying disease. If your symptoms do not improve after 3 weeks of Tolcapone therapy, your doctor will discontinue the drug. During the first few weeks of Tolcapone treatment, be prepared for certain side effects that appear most frequently at the start of therapy. Among the possibilities: attacks of dizziness or fainting when you first stand up, hallucinations, nausea, and increased stiffness. These problems tend to diminish with the passage of time or a reduction in your Sinemet dosage. However, they have forced a few people to discontinue Tolcapone therapy. How should you take Tolcapone? Follow your doctors directions for taking Tolcapone. Tolcapone works by boosting the efficacy of Sinemet, and will not work without it. It can be taken with either the immediate-release or controlled-release form of the drug (Sinemet or Sinemet CR). You may take it with or without food. Tolcapone is taken 3 times a day. Always take the first dose of Tolcapone with your first dose of Sinemet. Take your second and third doses of Tolcapone 6 and 12 hours later. (Your doctor will probably decrease your dose of Sinemet when you start taking Tolcapone.) If you miss a dose take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at once. Store Tolcapone at room temperature in a tightly sealed container. Are there any Tolcapone side effects? Tolcapone side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. More common Tolcapone side effects may include abdominal pain, abnormal muscle movements, acid indigestion, breathing difficulty, chest pain, confusion, constipation, decreased muscle movement, diarrhea, dizziness, drowsiness, dry mouth, excessive dreaming, falling, fatigue, fainting, flu, gas, hallucination, headache, increased muscle movement, loss of appetite, loss of balance, muscle cramps, muscle stiffness, nausea, skin tingling, sleep disturbances, sweating, tiredness, upper respiratory tract infection, urinary tract infection, urine discoloration, and vomiting. Less common Tolcapone side effects may include agitation, arthritis, bronchitis, burning, cataract, chest discomfort, depression, excessive emotional reactions, eye inflammation, feeling of well-being, fever, hair loss, hyperactivity, impaired mental function, impotence, increased heart rate, increased muscle tone, infection, irritability, lack of sensibility, low blood pressure, lower back pain, muscle ache, neck pain, panic reaction, rash, ringing in the ears, salivation, sinus congestion, skin bleeding, skin tumor, speech disorder, stiffness, throat inflammation, tooth disorder, tremor, uneasy feeling, urinary frequency or incontinence, urination problems, uterine tumor, and weight loss. Rare Tolcapone side effects may include abnormal thinking, allergic reaction, amnesia, apathy, asthma, bloody nose, chills, cough, decreased heart rate, dehydration, delusions, diabetes, difficulty swallowing, ear infection, ear pain, eczema, eye problems, facial swelling, heart disorders, hiccups, high blood pressure, hostility, increased or decreased sex drive, irregular or rapid heartbeat, itching, joint problems, laryngitis, manic reaction, migraine headache, mouth ulcers, nervousness, nosebleeds, paranoia, prostate problems, salivation, skin disorders, stomach or intestinal bleeding or inflammation, thirst, tongue disorders, twitching, and vaginal inflammation. What are the possible food and drug interactions when taking Tolcapone? If Tolcapone is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Be sure to inform your doctor of all the prescription and over the counter medications you are taking. It is especially important to check with your doctor before combining Tolcapone with Apomorphine, Desipramine (Norpramin), Isoproterenol (Isuprel), MAO inhibitors (such as the antidepressants Marplan, Nardil, and Parnate), Methyldopa (Aldomet), Nervous system depressants (such as alcohol and the sedatives phenobarbital and Seconal), or Warfarin (Coumadin). Are there any special warnings about Tolcapone? Because of Tolcapone's possible effects on the liver, your doctor should do a blood test to check your liver function before you start Tolcapone therapy, then every 2 weeks for the first year, every 4 weeks for the next 6 months, and every 8 weeks thereafter. In addition, be alert for any sign of developing liver damage, such as clay-colored stools, yellowing of your skin and eyes, fatigue, itching, loss of appetite, nausea, dark urine, and pain in the upper right abdomen. Report any such problems to your doctor immediately. Especially at the start of therapy, Tolcapone can cause severe low blood pressure, marked by nausea, sweating, dizziness, or fainting. To avoid these symptoms, get up very slowly from a seated or reclining position. Hallucinations are most likely to occur within the first 2 weeks of therapy. If this problem surfaces, report it to your doctor immediately. Diarrhea, occasionally severe, is also a possibility, typically after 6 to 12 weeks of therapy. If this becomes a problem, let your doctor know. Also be quick to inform your doctor if you develop a high fever, muscle rigidity, or altered consciousness. Because Tolcapone has been known to cause drowsiness and affect mental and motor skills, you should avoid operating machinery or driving until you know how the drug affects you. Tolcapone can cause nausea, especially at the start of therapy, and sometimes increases muscle stiffness. Your Parkinson's symptoms may also increase, along with fever and confusion, when the drug is discontinued. Your doctor will adjust your other medications carefully if Tolcapone needs to be stopped. |
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Information on this website is provided for educational purposes and should not replace discussions with your doctor. |
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