Entacapone for Parkinson's disease

About entacapone

Parkinson's disease affects the way your brain co-ordinates the movements of your muscles. A number of cells in a small part of your brain, called the substantia nigra, become damaged and die. These brain cells pass messages down nerves in the spinal cord by producing a substance called dopamine and it is these messages which control the muscles of the body. As the cells in the brain are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain, causes nerve messages to the muscles to become slowed and abnormal. This produces the main symptoms of Parkinson's disease, which are stiffness, shaking (tremor), and slowness of movement.

You will already be taking a medicine called either co-beneldopa or co-careldopa. These contain levodopa which helps relieve the symptoms of Parkinson's disease. Levodopa is converted into dopamine and this increases the level of dopamine in your brain.

Entacapone works by increasing the effectiveness of the levodopa you are taking in co-beneldopa or co-careldopa. It is prescribed for people who have had Parkinson's disease for a while and whose symptoms deteriorate between medicine doses. It will be prescribed for you by a specialist doctor.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking entacapone it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have heart disease.

• If you have a problem with the way your liver works.

• If you have been told you have a tumour on your adrenal gland, or if you have ever had a condition affecting your muscles, called rhabdomyolysis, or a reaction to an antipsychotic medicine, called neuroleptic malignant syndrome. These are all very rare conditions.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack and any additional information your doctor has given to you. These will give you more information about entacapone, and will also provide you with a full list of side-effects which you could experience from taking it.

• Take the tablets exactly as your doctor tells you to. If you are prescribed Comtess®, take one 200 mg tablet at the same time as your co-careldopa or co-beneldopa tablet or capsule. If you are prescribed Stanek®, Stalevo® or Sastravi® tablets, these are available in different strengths. You will be prescribed the strength of tablet that best suits your condition. Your doctor will tell you how to take the tablets, and the directions will also be on the label of the pack to remind you about what the doctor said to you.

• You can take entacapone either before or after meals.

• When you first start taking entacapone, your doctor may need to adjust the doses of your other medicines. This is to help reduce any side-effects caused by these tablets increasing the effectiveness of your usual dose of levodopa.

• It is important that you keep your regular appointments with your doctor and clinic. This is so your doctor can check on your progress.

• Entacapone may cause your urine to turn a reddish-brown colour. This is harmless and is nothing to worry about.

• Stay as active as possible and exercise regularly as much as you are able. You may walk more slowly than before, but a daily walk is good exercise and may help to loosen up stiff muscles.

• If you are a driver you should tell the DVLA and your insurance company if you have Parkinson's disease.

• If you buy any medicines or vitamins 'over the counter', check with a pharmacist that they are suitable to take with entacapone. You should not take any medicines or vitamin preparations which contain iron at the same time as your entacapone tablets. This is because iron can reduce the amount of entacapone your body absorbs. If you need to take an iron preparation, leave at least two hours between taking entacapone and the iron preparation.

• Keep taking the tablets until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor will want you to reduce your dose gradually if you need to stop treatment.

• Sometimes people taking medicines for Parkinson's disease can feel very sleepy during the day. Some people have even fallen asleep suddenly without much warning of being tired. If this happens to you, do not drive and do not use tools or machines, and discuss it with your doctor at your next appointment.

• Some people taking medicines for Parkinson's disease can experience problems with impulsive types of behaviour. If you notice any changes in your behaviour, such as an increased desire to gamble, binge eat, or spend excessively, or an increased sex drive, you must let your doctor know as soon as possible.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains the most common ones associated with entacapone. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any continue or become troublesome.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.