Ongentys
Ongentys (opicapone) is a newly approved, add-on medication used for treating Parkinson’s disease (PD). It's taken once per day at bedtime, but can cause involuntary movements.
What is Ongentys (opicapone)?
What is Ongentys (opicapone) used for?
How Ongentys (opicapone) works
Ongentys (opicapone) is a catechol-O-methyltransferase (COMT) inhibitor. COMT is a protein in your body that breaks down a commonly used Parkinson's medication called levodopa. This causes levodopa to be less effective at relieving symptoms of Parkinson's disease, which occur due to low dopamine levels in the brain.
By blocking COMT, Ongentys (opicapone) allows levodopa to reach and stay at higher levels in the body. This means more levodopa can be converted into dopamine in the brain to relieve PD symptoms.
Drug Facts
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What are the side effects of Ongentys (opicapone)?
Common Side Effects
- Involuntary movements (20%)
- Constipation (6%)
- Weight loss (4%)
Other Side Effects
- Dizziness
- Dry mouth
- Trouble sleeping
- High blood pressure
- Hallucination (seeing things that aren't real)
Serious Side Effects
- Excessive sleepiness
- Low blood pressure: dizziness, tiredness, feeling faint
- Symptoms after stopping the medication suddenly: fever, stiff or rigid muscles, confusion
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Falling asleep during daily activities
- Hallucinations
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Mood swings, irritability, hostility
- New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
- Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Constipation
- Dizziness
- Dry mouth
- Trouble sleeping
Pros and cons of Ongentys (opicapone)
Cons
Must be used together with carbidopa/levodopa medications (e.g., Sinemet, Rytary)
Not a good option for people with severe liver problems
Brand name only, which can be expensive
Pharmacist tips for Ongentys (opicapone)
Medications like Ongentys (opicapone) can cause you to suddenly fall asleep. It's recommended that you don't drive while taking this medication. Also avoid doing things that require your attention until you know how Ongentys (opicapone) affects you.
Make sure your provider knows about all your medical conditions and the medications you're taking, especially if you're taking a monoamine oxidase inhibitor (MAOI) (e.g., selegiline, phenelzine (Nardil)), antipsychotics (e.g., haloperidol, perphenazine), or other certain medications. These medications can interact with Ongentys (opicapone) and cause serious side effects. Don't start any new medications without talking to your provider or pharmacist first. They can make sure all your medications are safe for you to take.
Frequently asked questions about Ongentys (opicapone)
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What are the risks and warnings for Ongentys (opicapone)?
Ongentys (opicapone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suddenly falling asleep
Risk factors: History of sleep problems | Also take other medications that make you sleepy | Drinking alcohol
Ongentys (opicapone) can make you suddenly fall asleep in the middle of your daily activities, such as driving. Your risk is higher if you have a history of sleep problems, if you're taking medications that can make you sleepy (e.g., opioids, benzodiazepines, sleep medications), or if you drink alcohol. Because of this risk, it's best to avoid driving. Also avoid doing things that require you to focus until you know how this medication affects you. Let your provider know if you feel very sleepy during the daytime or if you fall asleep during activities requiring concentration.
Low blood pressure and fainting
Ongentys (opicapone) can lower your blood pressure, especially when you stand from sitting or lying down. This can cause you to fall or faint. To lower this risk, make sure to get up slowly when you stand from a sitting or lying down position, and try to hold onto something. Contact your provider if you feel symptoms of low blood pressure (like feeling faint, lightheaded, or dizzy). If you fall and hit your head, get medical help right away.
Involuntary movements
Ongentys (opicapone) can cause or worsen involuntary and erratic movements (dyskinesia). It's thought to be due to elevated levels of levodopa and changing dopamine levels in the body. In clinical studies, dyskinesia was the most common side effect of Ongentys (opicapone). Contact your provider if you experience movements that you can't control. Your provider might lower the dose of your carbidopa/levodopa medication or your other medications that raise dopamine, if you're taking any.
Hallucinations and changes in behavior or thoughts
Risk factors: History of mental health problems
Although rare, Ongentys (opicapone) can cause hallucinations (hearing or seeing things that aren't real) or changes in your behavior or thinking (e.g., delusions, irritation, aggressive behaviors). Because this medication can worsen mental health problems in certain people, let your provider know if you have a history of such problems so they can find a different option for you. In addition, some mental health medications can lower the effects of dopamine in your brain. This can worsen your PD symptoms and make Ongentys (opicapone) not work as well for you. If you or your loved ones notice you have these unusual behaviors, contact your provider, because you might need to stop taking Ongentys (opicapone).
Difficulty controlling impulsive behavior
Impulse control problems are possible with medications like Ongentys (opicapone), because they work in your brain to raise dopamine levels. Dopamine is a natural chemical involved in the reward system in your brain. Some examples of impulse control problems include intense urges to gamble, engage in sexual activity, spend money, and binge eating. Once these problems start to happen, they might be hard to control, because you might not recognize them as abnormal behaviors. If you or your loved ones recognize these urges and they start to have a negative impact on your life, contact your provider right away.
Ongentys (opicapone) dosage forms
Typical dosing for Ongentys (opicapone)
The typical dose is 50 mg by mouth once per day at bedtime.
For people with moderate liver problems, the typical dose is 25 mg by mouth once per day.
How much does Ongentys (opicapone) cost?
Ongentys (opicapone) contraindications
Take Ongentys (opicapone) with an MAOI
Medical conditions that can cause high dopamine levels (e.g., pheochromocytoma)
What are alternatives to Ongentys (opicapone)?
Ongentys (opicapone) images
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