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Tasmar Review Article

 

Tasmar (tolcapone), indicated as an adjunct to levodopa and cardiopa, is used to treat the signs and symptoms of idiopathic Parkinson in patients who can not take or have not responded to other medications. It is a catechol-O-methyltransferase inhibitor, which works by prolonging the anti-Parkinson effect of levodopa. You should take this medication by mouth with or without food, usually three times a day as directed by your doctor. You may start on a low dose, which may be increased after three weeks if your doctor thinks that you will benefit from a higher dose. You should not use this drug if you are allergic to any of it's components, if you have a liver disease or two abnormal liver function tests, if you have a history of certain muscle problems or fever or confusion that may have been caused by Tasmar or if you are taking a non selective monoamine oxidase inhibitor. You should keep in mind that some other medications can interact with this drug and you must inform your doctor about any other drugs you are taking. The most common side effects are involuntary movements, nausea, sleep disorders, diarrhoea, excessive dreaming, muscle cramps, dizziness, hallucinations and confusion.

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Tasmar (tolcapone) is a medication used to treat Parkinsonís disease. The brain cells of Parkinsonís patients progressively lose their ability to produce dopamine, a chemical that is essential in control of body movement. It is thought that Tasmar, as a COMT inhibitor, slows the breakdown of the dopamine that is produced, which gives the patient more muscle control and coordination.
Some patients being treated for Parkinsonís disease experience ďwearing-off phenomenaĒ characterized by reappearance of symptoms before the next scheduled medication dose. Tasmar is indicated for these patients.

Tasmar is always used in combination with carbidopa/levodopa to treat Parkinsonís disease, specifically those patients who experience symptoms of the disease between doses of carbidopa/levodopa. Due to the possibility of severe liver problems, any patient who does not experience a benefit from this medication after three weeks of treatment should stop taking the medication.

The usual dose of Tasmar is 100mg three times daily. The first dose is taken with the first daily dose of carbidopa/levodopa while the other doses are taken at equal intervals throughout the day. Tasmar can be taken with or without food. For best effect, the patientís dose of levodopa should be decreased, possibly as much as 30%. If Tasmar is stopped suddenly, the patient may experience more symptoms of Parkinsonís disease or confusion and a high fever. Patients who abruptly stop taking Tasmar should be monitored closely.

Tasmar has the potential to cause liver injury. Patients should watch for signs of liver injury, including jaundice (yellowing of eyes and skin), loss of appetite, fatigue and clay-colored stools while taking Tasmar. Patients who have lab results suggesting liver disease should not be started on this medication. If a patient develops liver problems while taking Tasmar and the drug is stopped, the patient should not be restarted on the medication. Liver enzyme tests are recommended but may not prevent liver injury. However, if liver injury is detected early and the medication is stopped, there is a better chance of recovery.

Other side effects of Tasmar include nausea, excessive dreaming, loss of appetite, muscle cramps, vomiting and diarrhea, dizziness and headache. Patients may experience low blood pressure when sitting or lying down and so should be careful when rising to a standing position in case of dizziness or syncope. Tasmar may produce drowsiness and hallucinations. Patients should be cautioned to not drive or operate machinery until they are familiar with how the medication affects them.

Tolcapone is rated pregnancy category C. It is not shown to have detrimental affects to a developing fetus. However, other medications used in combination with Tasmar can result in injury to a fetus so the health care professional should always be informed of pregnancy. Tasmar may be excreted into breast milk and health care providers should be aware of this situation also.


 

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