entacapone

• Risk factors: Already feeling drowsy | History of sleep problems | Taking sedatives or medications that make you drowsy

Entacapone (Comtan) and carbidopa/levodopa medications can make you fall asleep out of nowhere, even if you don't feel sleepy. This can happen at any time of day and can lead to accidental injuries. Because of this risk, be careful driving or doing things that require you to focus while you're taking entacapone (Comtan). Make sure you know how this medication affects you first before doing these activities. If you normally feel sleepy or if you've fallen asleep suddenly in the past, it might be safer if you avoid driving while you're taking entacapone (Comtan). Let your provider know if you feel very sleepy during the daytime or if you fall asleep during activities where you need to concentrate while you're taking entacapone (Comtan).

• Risk factors: History of low blood pressure

Entacapone (Comtan) can boost the effects of carbidopa/levodopa medications. This can raise your risk of low blood pressure. Taking entacapone (Comtan) can cause your blood pressure to drop when you stand from a sitting or lying down position. This can lead to fainting. To lower your risk of falling, get up slowly when you stand from a sitting or lying down position. Let your provider know if your blood pressure is lower than it usually is or if you feel dizzy while you're taking entacapone (Comtan).

• Risk factors: History of certain mental health conditions

Some people taking entacapone (Comtan) and medications that raise dopamine levels have had hallucinations. They've also reported changes in behavior and thinking, such as paranoia, delusions, confusion, aggressive behavior, uneasiness, and less awareness of their surroundings. Generally, these symptoms can occur shortly after you start taking these medications or after your dose is raised. Because of this risk, you shouldn't take entacapone (Comtan) if you have certain mental health conditions. In addition, some medications used for mental health conditions, such as haloperidol (Haldol) or perphenazine, can worsen your Parkinson's disease and might affect how well entacapone (Comtan) works. Let your provider know if you experience any changes in behavior or thinking during entacapone (Comtan) treatment.

Entacapone (Comtan) and other medications for Parkinson's disease can cause impulsive behavior. These changes in behavior include strong sexual or gambling urges, urges to spend a lot of money, and other urges. These medications can also make it hard to control these urges. If these urges start to have a negative impact on your life, let your provider know. You might not be aware that you have these urges while taking entacapone (Comtan), so your provider might ask you if you've recently had these behaviors at your next visit. If these urges occur, your provider might consider lowering your dose or stopping treatment.

Entacapone (Comtan) can cause diarrhea. In studies, most cases of diarrhea were mild or moderate, but a few were severe. Usually, this side effect happens within the first few months after starting entacapone (Comtan). But, it can start as early as the first week or as late as several months after starting. Diarrhea can also be a sign of inflammation in your colon (colitis). If your colon is inflamed, you can have moderate-to-severe diarrhea with watery, non-bloody stool. Diarrhea can lead to weight loss, dehydration, and low potassium levels. Make sure to drink plenty of fluids to avoid getting dehydrated while you're taking entacapone (Comtan). If you have any symptoms of diarrhea, colitis, or dehydration while you're taking entacapone (Comtan), let your provider know. Typically, these symptoms get better or go away after you stop the medication.

Some people taking entacapone (Comtan) have reported severe muscle damage (rhabdomyolysis). Sometimes, this can lead to kidney damage. It's not clear whether entacapone (Comtan) affects the risk of this muscle damage. But, it might be related to the involuntary movements (dyskinesia) you might experience with treatment. Let your provider know right away if you have muscle aches, soreness, or cramping, dark-colored urine, or feel weak. These can be signs and symptoms of serious muscle damage.

Although rare, some people taking medications for Parkinson's disease can develop a serious condition called neuroleptic malignant syndrome (NMS). Symptoms include very high fevers, irregular pulse, muscle stiffness, and confusion. Most times, symptoms happen when the medication is stopped or when the dose is lowered suddenly.

It's not clear whether entacapone (Comtan) plays a role in causing NMS. There also haven't been any reports of people taking entacapone (Comtan) who developed this condition in studies. But it's important to be aware of these symptoms so you can get treated as soon as you notice them. Don't stop taking entacapone (Comtan) or lower your dose without talking to your provider so they can tell you how to do so safely.

Entacapone (Comtan) works by blocking the COMT protein. But, this protein normally helps break down other medications, such as apomorphine (Apokyn) and epinephrine (Epipen). When entacapone (Comtan) is taken with these medications, they can stay in the body longer and raise your risk of side effects like faster heart rate, irregular heart rhythm, and changes in blood pressure.

In addition, it's generally not recommended to take entacapone (Comtan) with non-selective monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil). Non-selective MAOIs can also block the breakdown of important hormones and medications like those listed above. It's important to note that some medications for Parkinson's disease, like rasagiline (Azilect) and selegiline, are selective MAO-B inhibitors. These medications can be taken together with entacapone (Comtan).