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Comtan Review Article

 

Entacapone, known as Comtan, is an inhibitor of of catechol-O-methyltransferase (COMT), used to treat the idiopathic Parkinson disease as an adjunct to other therapies. It works by blocking the COMT enzyme which breaks down the levodopa in the body this effect allows levodopa to last longer in the body and the effect lasts until the next dosage. This medication should be taken by mouth usually in combination with the prescribed dose of levodopa or cardiopa and up to 8 times a day. Your doctor will prescribe you this medication based on your general medical condition, response to therapy and liver function.

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Comtan, also known as entacapone, is widely used for treating idiopathic Parkinson’s disease together with levodopa/carbidopa therapy. Entacapone inhibits catechol-O-methyltransferase (COMT) and is a nitrocatechol-structured compound.

Comtan is available in tablet form of 200 mg each. Microcrystalline cellulose, mannitol, croscarmellose sodium, hydrogenated vegetable oil, polysorbate 80, glycerol 85%, hydroxypropyl methylcellulose, sucrose, yellow iron oxide, red oxide, magnesium stearate, and titanium dioxide are the main active compositions of the drug. It is indicated to patients experience end-of-dose “wearing off” symptoms in Parkinson’s disease.


Dosage

The recommended daily dose of Comtan is 1600 mg. One Comtan tablet of 200 mg should be taken along with one dose of levodopa/carbidopa dose, not more than eight times a day. It is recommended that this drug be always administered along with levodopa/carbidopa, as it does not have any effect on parkinsonian when taken alone.

This drug can be consumed with or without food and in combination with immediate as well as sustained-release formulations of levodopa/carbidopa.

Although there are no severe outcomes in case of Comtan overdose, but a big overdose may result in complete inhibition of the COMT enzyme in the body that will disable the metabolism of endogenous and exogenous catechols. Abdominal pain and loose stools are some common adverse effects of overdose. One should consult a doctor immediately in case of overdose.


Contraindications

Comtan (entacapone) tablets should not be indicated to patients with hepatic impairment, as it may double the AUC and Cmax in patients with liver diseases.

One should never reduce the dosage of Comtan abruptly, as it may result in appearance of Parkinson’s disease symptoms, Hyperpyrexia and Confusion. Adjustments in the dopaminergic treatments are needed for discontinuing Comtan treatment.
People allergic to entacapone or someone who has taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within last 14 days, should not take Comtan.

If you have low blood pressure or liver problems, then consult your doctor before taking Comtan as you might require dose adjustment or some tests. Patients might experience enhanced sexual urges, atypical urges to gamble, or other strong urges during Comtan treatment.

It is yet to be established if Comtan passes into breast milk or is harmful for nursing baby, therefore it is not recommended for nursing mothers. Pregnant women and nursing mothers should consult their doctors before starting this medication.
Patients with Parkinson’s disease are at higher risk of developing skin cancer or melanoma than other people, therefore you should speak to your doctor about the possible risks and regular skin examination is recommended.


Side Effects

Comtan may result in certain allergic reactions like hives, difficulty breathing, and swelling of face, lips, tongue, or throat, in some patients.

Some of the serious side effects of Comtan are dyskinesia/hyperkinesias, aggravation of Parkinson's Disease symptoms, fever, confusion, stiff muscles, sweating, hallucinations, tremors, tight feeling in your chest, breathing problem, muscle pain, tenderness, weakness with fever or flu symptoms and urine discolouration.

Besides, you might experience mild nausea, vomiting, stomach pain, diarrhoea or constipation, loss of appetite, dry mouth, unusual skin changes, dizziness, agitation, anxiety and drowsiness.
The colour change of urine like orange, brown, red or black is not harmful. Consult your doctor in case of any of these or other side effects.


 

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