Entacapone vs. Carbidopa for Parkinson's Disease: Important Differences and Potential Risks.

Key takeaways

Entacapone (Comtan) and Carbidopa (Lodosyn) are both used to treat symptoms of Parkinson's disease (PD), but they work in different ways. Entacapone is a COMT inhibitor that helps levodopa stay in your body longer by blocking the COMT protein, which breaks down levodopa. This means you need to take it with each dose of carbidopa/levodopa for it to work. On the other hand, Carbidopa is a decarboxylase inhibitor that helps more levodopa reach your brain by preventing its breakdown before it gets there. This allows you to take a lower dose of levodopa, reducing some of its side effects. Entacapone and Carbidopa are both available in both brand-name and generic forms. Both medications can cause side effects like involuntary movements and nausea, but Entacapone can also cause diarrhea and stomach pain, while Carbidopa can lead to psychotic behavior and depression. Additionally, both medications can make you very sleepy or cause you to fall asleep suddenly, so you should be cautious when driving or doing activities that require concentration.

Entacapone

(Comtan)

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Carbidopa

(Lodosyn)

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Summary for Entacapone

Prescription only

Entacapone (Comtan) is used for Parkinson's disease (PD) and helps relieve symptoms like shakiness and slowed movement. It's used along with the combination medication carbidopa/levodopa. Entacapone (Comtan) is a good option for people whose levodopa wears off before their next dose ("wearing-off" periods). But, this medication has to be taken every time you take carbidopa/levodopa for it to work properly. Some side effects include involuntary movements (dyskinesia) and nausea. Entacapone (Comtan) is available as a brand-name and generic medication.

Indications for Entacapone

Relief of "wearing-off" symptoms in people with Parkinson's disease who are taking carbidopa/levodopa medications (e.g., Sinemet, Rytary)

Pros and Cons for Entacapone

Pros

Helps carbidopa/levodopa relieve your PD symptoms better
Can be useful for people with advanced PD or people who experience "wearing-off" periods with their carbidopa/levodopa
Can take with or without food

Cons

Must take with every dose of carbidopa/levodopa to see an effect on PD symptoms; it has no effect when it's taken alone
Can cause involuntary movements or other movement problems
Can cause nausea, especially when you first start taking the medication

Common Side Effects for Entacapone

Involuntary movements (dyskinesia, 25%)
Nausea (14%)
Muscle spasms (hyperkinesia, 10%)
Changes in the color of your urine (10%)
Diarrhea (10%)
Slowed muscle movements (hypokinesia, 9%)
Stomach pain (8%)
Dizziness (8%)

Warnings for Entacapone

Sleepiness or falling asleep while doing daily activities
Low blood pressure and fainting
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Diarrhea and inflamed colon (colitis)
Muscle damage (rhabdomyolysis)
High fevers and confusion
Interactions with other medications

Summary for Carbidopa

Prescription only

Carbidopa (Lodosyn) is taken with Sinemet (carbidopa / levodopa) or levodopa alone to treat adults with symptoms of Parkinson's disease (PD), like shakiness and slowed movement. The medication belongs to the decarboxylase inhibitor class and it works by helping levodopa better travel into your brain so it can relieve your symptoms. This might allow some people to take a lower dose of levodopa, which can lower some of its side effects. Side effects include fatigue, a drop in blood pressure, changes in urination, and weight changes.

Indications for Carbidopa

When taken together with levodopa or Sinemet (carbidopa / levodopa):

Pros and Cons for Carbidopa

Pros

Helps levodopa relieve your Parkinson's symptoms
Might allow some people to take a lower dose of levodopa, which can ease side effects like nausea and vomiting
Can split the tablet in half as needed
Available in a lower-cost generic form