Key takeaways
Entacapone (Comtan) and selegiline (Emsam, Zelapar) are both medications used to help manage symptoms of Parkinson's disease, particularly when carbidopa / levodopa starts to wear off. However, they belong to different medication classes. Entacapone is a catechol-O-methyltransferase (COMT) inhibitor, while selegiline is a monoamine oxidase type B (MAO-B) inhibitor. Entacapone is taken orally with each dose of carbidopa / levodopa, up to a maximum of 1,600 mg per day, and is available in both brand and generic forms. Selegiline, on the other hand, is available as tablets, capsules, and orally disintegrating tablets (ODTs), with dosing typically at 5 mg twice daily or 1.25 mg once daily for the ODT form. It also comes in patches. Selegiline is available as a lower-cost generic. Common side effects of entacapone include involuntary movements and nausea, while selegiline can cause nausea, dizziness, and changes in blood pressure. Entacapone has a few potential drug interactions, while selegiline has many interactions, including with antidepressants and certain foods. Both medications can cause sleepiness and impulsive behaviors, so it's important to be cautious with activities like driving.
