Disease Information for Tolcapone (Tasmar) Administration/Toxicity

Associated Diseases & Rule outs
Associated Disease & Complications
Drug induced Hepatic toxicity
Neuroleptic malignant syndrome
Toxic hepatitis
Disease Mechanism & Classification
DRUG/Anti-parkinsons medication (examples)
DRUG/Catechol-o-methyltransferase (COMT) inhibitor
DRUG/Parkinsonism adjunctive medication
DRUG/Potentiates levodopa/prevents shut down effect
DRUG/Prevent levodopa metabolism
PROCESS/Medication/Drug (CONFIRM dose/before treatment)
Tolcapone (Tasmar) admin, Brand name/Tasmar (Tolcapone)
Drug Dosage
DRUG/.$$$$ Very Expensive
DRUG/.$$$$$ Most Expensive
DRUG/1999 Approx. New drug (RX)
DRUG/Dose 100 mgm (Unit/Pill/Capsule size)
DRUG/Dose 200 mgms (Unit/Pill/Capsule size)
DRUG/Dose TID Medication
DRUG/Oral medication (ex)

Anti-parkinsonism drug;COMT inhibitor class used in combination suppresses symptom fluctuations;lower levodopa dose;oral preparation---------------------------------------------------

COMT inhibitors

Catecholamine-O-methyltransferase inhibitors reduce the metabolism of levodopa to 3-O-methyldopa and thereby alter the plasma pharmacokinetics of levodopa, leading to more sustained plasma levels and more constant dopaminergic stimulation of the brain. Two such agents, tolcapone and entacapone, are currently available and may be used as an adjunct to levodopa-carbidopa in patients with response fluctuations or an otherwise inadequate response and who either have failed with other adjunctive therapies or are not candidates for such therapies. Treatment results in reduced response fluctuations, with a greater period of responsiveness to administered levodopa. Tolcapone is given in a dosage of 100 mg or 200 mg three times daily, and entacapone is given as 200 mg with each dose of Sinemet (levodopa-carbidopa). With either preparation, the dose of Sinemet taken concurrently may have to be reduced by up to one-third to avoid side effects such as dyskinesias, confusion, hypotension, and syncope. Diarrhea is sometimes troublesome. Because rare cases of fulminant hepatic failure have followed its use, tolcapone should be avoided in patients with preexisting liver disease. Serial liver function tests should be performed at 2-week intervals for the first year and at longer intervals thereafter in patients receiving the drug—as recommended by the manufacturer. Hepatotoxicity has not been reported with entacapone, which is therefore the preferred agent, and serial liver function tests are not required.

[currentdxrx 2005 accessmedicine.coim]


External Links Related to Tolcapone (Tasmar) Administration/Toxicity
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)