Entacapone

Entacapone is a catechol-O-methyl transferase inhibitor which is licensed for treatment of Parkinson's disease as an adjunct to L-dopa.

Entacapone is effective in reducing "on-off" fluctuations and may improve dyskinesias by permitting a reduction in the dose of L-dopa.

• wearing-off is one of the most frequent problems encountered by levodopa-treated patients
• entacapone, a peripheral inhibitor of catechol-O-methyltransferase (COMT), reduces this motor complication by prolonging the effect of levodopa.

Unwanted effects include:

• dyskinesias, which usually resolve when the L-dopa dose is reduced (often by 10-30%)
• diarrhoea which is often temporary
• discolouration of urine

Reference:

• Brooks DJ, Sagar H (2003) Entacapone is beneficial in both fluctuating and non-fluctuating patients with Parkinson's disease: a randomised, placebo controlled, double blind, six month study. J Neurol Neurosurg Psychiatry 74: 1071-1079.
• MeReC Bulletin (1999), 10 (10), 37-40.