Introduction
Comtan 200 mg is a prescription medicine used in the treatment of Parkinson's disease. This medicine helps to treat excessive shaking by slowing down the body movements. It works by increasing the amount of dopamine, a chemical messenger that is needed to control the abnormal movements.
Comtan 200 mg has no antiparkinsonian effect on its own. It is used in combination with carbidopa/levodopa. It helps to treat wearing-off symptoms of Parkinson's disease, such as stiffness, tremors, muscle spasms, and poor muscle control. It may be taken with or without food, preferably at bedtime. However, take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor.
If you have missed a dose, take it as soon as you remember it. It is important that this medication is not stopped suddenly without talking to the doctor as it may worsen your condition. Your doctor may advise for periodic skin examination as it can cause melanoma.
Some common side effects of this medicine include nausea, vomiting, fatigue, confusion, constipation, insomnia(difficulty sleeping), nightmares, and increased sweating. It may also cause dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. It is common to have diarrhea with this medicine, so drink plenty of fluids and watch for weight loss. Inform your doctor if you develop any unusual changes in mood, an abnormally high sex drive, and hallucinations. It may cause your urine to change in a brownish-orange color but it is not harmful and usually resolves once treatment is completed. Please consult your doctor if these side effects worry you or do not go away.
Side effects of Comtan 200 mg
Common
- Nausea
- Vomiting
- Fatigue
- Confusion
- Constipation
- Insomnia (difficulty in sleeping)
- Nightmare
- Hallucination
- Increased sweating
- Fall
- Urine discoloration
- Dizziness
- Diarrhea
- Muscle coordination impaired
- Ischemic heart disease
- Heart attack
- Abdominal pain
- Dryness in mouth
How to use Comtan 200 mg
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Comtan 200 mg may be taken with or without food, but it is better to take it at a fixed time.
How Comtan 200 mg works
Comtan 200 mg is a selective reversible inhibitor which is given in combination with levodopa. It works by inhibiting a chemical messenger [catechol-O-methyl transferase (COMT)] which in turn helps in increasing the amount of dopamine (chemical messenger) in the brain. Thus, an adequate amount of dopamine in the brain helps to coordinate body movements. This is how it works to control symptoms of Parkinson's disease.
What if you forget to take Comtan 200 mg?
If you miss a dose of Comtan 200 mg, skip it and continue with your normal schedule. Do not double the dose.
Indication
Parkinson's disease
Administration
May be taken with or without food.
Adult Dose
Oral
Adjunct to levodopa treatment in Parkinson's disease
Adult: 200 mg w/ each levodopa/dopa decarboxylase inhibitor dose. Max: 200 mg 10 times daily (2,000 mg daily).
Hepatic Impairment
Safety and efficacy not established
Renal Dose
Renal Impairment
Dose adjustment not necessary
Contraindication
History of neuroleptic malignant syndrome and nontraumatic rhabdomyolysis. Phaeochromocytoma. Hepatic impairment.
Mode of Action
Entacapone is a selective, reversible, peripheral inhibitor of COMT, an enzyme involved in the metabolism of dopamine and levodopa. It is used in patients with Parkinson's disease and "end-of-dose" motor fluctuations that cannot be stabilised on levodopa combinations alone.
Precaution
Levodopa-induced orthostatic hypotension may be aggravated. Abrupt withdrawal. Concomitant use with a selective MAO-A and MAO-B inhibitor, or concomitant use with a selective MAO-A plus a selective MAO-B inhibitor. Biliary obstruction. Impairs ability to drive and operate machinery. Pregnancy and lactation. Children and elderly.
Lactation: excretion in milk unknown; use with caution
Side Effect
>10%
Dyskinesia (25%),Nausea (14%),Diarrhea (10%),Hyperkinesia (10%),Urine discoloration (10%)
1-10%
Hypokinesia (9%),Dizziness (8%),Abdominal pain (8%),Fatigue (6%),Constipation (6%),Back pain (4%),Vomiting (4%),Dry mouth (3%),Dyspnea (3%),Increased sweating (2%),Back pain (2%),Anxiety (2%),Somnolence (2%),Dyspepsia (2%),Flatulence (2%),Purpura (2%),Asthenia (2%),Hallucinations (1-4%),Taste perversion (1%),Agitation (1%),Gastritis (1%),Bacterial infection (1%)
Frequency Not Defined
Insomnia,Postural hypotension,Confusion,Dopaminergic side affects due to increased dopamine levels
Rare: rhabdomyolysis, retroperitoneal fibrosis
Pregnancy Category Note
Pregnancy Category: C
Lactation: excretion in milk unknown; use with caution
Interaction
Drugs metabolised by COMT e.g. adrenaline, apomorphine, dobutamine, dopamine, isoprenaline, methyldopa, noradrenaline and remiterol. Iron preparations and levodopa. Avoid ethanol.