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Compare Entacapone vs. Zelapar

Head-to-head comparisons of medication uses, side effects, warnings, and more.

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.

  • Entacapone (Comtan)
    Selegiline
  • Entacapone (Comtan)
    Selegiline

  • Summary of Entacapone vs. Zelapar

    Summary for COMT inhibitor
    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.

    Summary for MAO-B inhibitor
    Prescription only

    Selegiline helps relieve symptoms of Parkinson's disease in people who have "off" episodes as their carbidopa/levodopa medication starts to wear off. Selegiline is a type of monoamine oxidase inhibitor (MAOI), which is a drug class that has many drug interactions. Generic selegiline tablets and capsules are taken twice per day; the brand name for the pills, Eldepryl, is no longer available. Selegiline also comes as orally disintegrating tablets (ODTs) under the brand name Zelapar that are dissolved on the tongue once per day. Side effects include changes in blood pressure, nausea, and dizziness.

  • Indications of Entacapone vs. Zelapar

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

  • Pros and Cons of Entacapone vs. Zelapar

    Pros and Const for COMT inhibitor
    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
    Pros and Const for MAO-B inhibitor
    Pros
    •Extends the actions of carbidopa/levodopa to relieve PD symptoms
    •Comes as tablets, capsules, and ODTs
    •Taken once or twice a day, depending on the form of the medication
    Cons
    •Doesn't work well when you take it by itself; must take in addition to a carbidopa/levodopa medication
    •Commonly causes nausea and dizziness

  • Common Side Effects of Entacapone vs. Zelapar

    Common Side Effects for
    •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%)
    Common Side Effects for

    Selegiline tablets and capsules:

    •Nausea (20%)
    •Dizziness (14%)
    •Stomach pain (8%)
    •Confusion (6%)
    •Hallucinations (6%)
    •Dry mouth (6%)

    Zelapar (selegiline) ODTs:

    •Nausea (11%)
    •Dizziness (11%)
    •General body pain (8%)
    •Headache (7%)
    •Trouble sleeping (7%)
    •Runny nose (7%)
    •Involuntary movements (dyskinesia; 6%)
    •Skin irritation (6%)
    •Back pain (5%)
    •Indigestion (5%)
    •Inflamed or sore mouth (5%)
    •Other irritation in the mouth (e.g., pain when swallowing, pain in mouth, mouth sores)

  • Warnings of Entacapone vs. Zelapar

    Common Side Effects for
    •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
    Common Side Effects for
    •High blood pressure
    •Serotonin syndrome
    •Extreme sleepiness and falling asleep during activities
    •Low blood pressure and risk of falls
    •Difficulty controlling body movements
    •Hallucinations and behavior changes
    •Intense urges
    •Caution in people with phenylketonuria (PKU) - Zelapar ODTs only

  • Prices with our coupons for Entacapone vs. Zelapar

    Learn more about Entacapone
    Learn more about Selegiline

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