Tolcapone (Tasmar) is an oral add-on medication for Parkinson's disease (PD). It's usually used when carbidopa/levodopa isn't controlling PD symptoms well enough.
Parkinson's disease (PD); as add-on treatment to carbidopa/levodopa
Tolcapone (Tasmar) is a catechol-O-methyltransferase (COMT) inhibitor. It blocks the activity of the protein, COMT, which results in more stable levels of levodopa.
When it's taken together with carbidopa/levodopa, tolcapone (Tasmar) causes levodopa to reach and stay at higher levels in the brain. Your body converts levodopa to dopamine, and higher levels of dopamine in the brain help relieve PD symptoms.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Abdominal pain
dizziness
dizziness or lightheadedness when getting up from a lying or sitting position
drowsiness
fainting
hallucinations (seeing, hearing, or feeling things that are not there)
headache
nasal congestion (stuffy nose)
trouble in sleeping
twitching, twisting, or other unusual body movements
vomiting
Less common
Absence of or decrease in body movement
blood in urine
chills
confusion
falling
general feeling of discomfort or illness
hyperactivity
loss of balance control
troubled breathing
Rare
Agitation
bloody or cloudy urine
burning of feet
burning, prickling, or tingling sensations
chest discomfort
difficult or painful urination
difficulty in thinking or concentrating
frequent urge to urinate
irritability
joint pain, redness, or swelling
muscle cramps
neck pain
stiffness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Can help relieve PD symptoms that occur between levodopa doses; sometimes called the "wearing-off" effect
For the brand medication (Tasmar), the manufacturer offers a copay savings card for those with private insurance.
Can cause liver failure; not a good option for people with liver problems
Has a lot of side effects
Cannot be taken alone; only used as an add-on medication
Can be expensive
Take tolcapone (Tasmar) only as prescribed. Your dose might change when you're first starting out. Make sure you let your provider know of any side effects and PD symptoms while you're taking the medication so they can adjust your dose correctly.
Tolcapone (Tasmar) can cause serious liver damage. You'll need to get labs drawn regularly, so your provider can monitor your liver.
Tolcapone (Tasmar) should only be used in combination with a levodopa-containing medication. Keeping track of your medications can be hard if they're constantly changing. Contact your provider if you're ever not sure how you're supposed to take your Parkinson's medications.
Side effects include dizziness, confusion, and randomly falling asleep. Don't drive or do activities that require a lot of focus until you know how the medication affects you.
You might notice a drop in blood pressure when you stand up or get up from bed. This change in blood pressure can cause dizziness and fainting. Getting up slowly can help prevent a dangerous fall.
Tolcapone (Tasmar) 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.
Risk factors: Liver problems | History of liver damage from tolcapone (Tasmar)
Tolcapone (Tasmar) can cause serious liver damage, which can be life-threatening. Potentially dangerous medications like this should only be used if benefits outweigh the risk. Tolcapone (Tasmar) should never be used if you have liver problems or a history of liver damage from tolcapone (Tasmar). Your provider will monitor your labs closely to check on your liver. Contact your provider right away if you have yellowing of the skin or eyes, pale colored stools, tiredness, and low appetite. These can be signs of liver problems. If you don't see any results within 3 weeks of starting tolcapone (Tasmar), let your provider know as they might have you stop taking the medication.
Risk factors: History of drowsiness | History of sleep problems | Taking sedatives or medications that make you drowsy
Medications, like tolcapone (Tasmar), that raise the levels of levodopa and dopamine in your body can cause you to suddenly fall asleep, even if you don't feel sleepy. Avoid driving or doing things that require you to focus until you know how this medication affects you. Take extra care if you have a history of sleepiness or falling asleep suddenly in the past. Let your provider know if you feel very sleepy during the daytime or if you fall asleep during activities where you need to concentrate.
Sometimes, people taking tolcapone (Tasmar) have a sudden drop of blood pressure when they sit or stand up from a lying down position. This can lead to serious falls or fainting. If this already happens to you, it might get worse when you start the medication. Let your provider know if you have a fall, faint, or experience dizziness when changing positions. It can help if you rise slowly and steady yourself on a firm object, like a sturdy nightstand, whenever you're getting up.
Risk factors: History of certain mental health conditions
Tolcapone (Tasmar) and medications that raise your dopamine levels can cause hallucinations and changes in behavior and thinking. There have been reports of paranoia, delusions, confusion, aggressive behavior, uneasiness, trouble sleeping, lots of dreaming, and less awareness of your surroundings. Usually, these symptoms occur shortly after you start taking these medications or after your dose is raised. Let your provider know if this happens to you; they might lower your dose, which can help.
There have been reports of people having lower impulse control while taking PD medications such as tolcapone (Tasmar). This can include strong sexual or gambling urges, urges to spend a lot of money, and binge eating. Talk to your provider if these urges start to have a negative impact on your life. Lowering your dose or stopping the medication can help.
Some people taking tolcapone (Tasmar) have reported severe muscle damage that can lead to kidney damage. Let your provider know right away if you experience muscle aches, soreness, or cramping, or if you have dark-colored urine, because these can be signs of serious muscle damage.
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 100mg | 90 tablets | $1039.65 | $11.55 |
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Liver problems
History of liver damage, muscle damage, high fever, or confusion with tolcapone (Tasmar)
Parkinson's disease (PD); as add-on treatment to carbidopa/levodopa
Relief of "off" episodes in people with Parkinson's disease (PD) who are taking a carbidopa/levodopa medication
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