We know that living with Parkinson's disease can be challenging at times. It's not easy to get through the day with things like tremors and slow walking . So doctors prescribe various medications to control these symptoms. Today we're going to talk about one such special medication, Tolcapone. This is not a medication that is usually given alone. It is given with levodopa- carbidopa , which is the main medication for Parkinson's disease. Simply put, it's like a "helper" that helps the main medication.
What is Tolcapone?
Okay, let's put this simply. Parkinson's disease occurs when the production of a chemical called dopamine in our brain decreases. The medicine you are given, called levodopa-carbidopa, works by getting into the brain and converting it into dopamine. But sometimes the effectiveness of this medicine can gradually decrease.
This is where tolcapone comes in. Tolcapone is a drug in a class of drugs called COMT inhibitors. It works by stopping the body from breaking down levodopa before it reaches the brain. This means that it allows more of your main medication to reach the brain, making it more effective and lasting longer . The brand name for this drug is Tasmar.
Things you should tell your doctor before taking this medicine
Before you start taking this medication, it is very important to inform your doctor about your complete health condition. This medication may interact with some medical conditions. If you have any of the following conditions, be sure to tell your doctor.
| Health condition/fact | Why do you need to tell the doctor? |
|---|---|
| Liver disease | This medicine can affect the liver, so it is important to know if there is any liver weakness. |
| Kidney disease | Medicines are removed from the body by the kidneys. Therefore, the doctor should be aware of the functioning of the kidneys. |
| Mental illness | Sometimes these medications can affect mental status, so it's important to be aware of this in advance. |
| Sleep apnea or narcolepsy | This medication can cause some people to suddenly fall asleep, so it is important to report any such conditions. |
| If you are trying to get pregnant, are pregnant, or are a breastfeeding mother | Be sure to mention this, as you need to be especially careful about using medication in these situations. |
| Allergies to other medications, foods, or dyes | Tell your doctor about any allergies you have. |
How exactly do you use this medicine?
The method of using this medicine is very simple.
- Swallow the pill with a glass of water.
- Take the prescribed dose at the prescribed time, as prescribed by the doctor. You can take it before or after meals.
- Never take more than the doctor tells you to.
- Do not stop taking the medication suddenly without medical advice. Doing so may cause a severe reaction.
- If you are giving this medicine to children, talk to a pediatrician about it.
What to do if you miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once.
What if I take too much medicine?
If you think you have taken more medicine than you think, call the National Poisons Information Centre at the Colombo National Hospital immediately. Or go to the Emergency Department (ETU) of the nearest hospital. Treat this as an emergency.
Remember, this medicine has been prescribed for you only. Do not give it to anyone else, even if they have the same symptoms as you.
Other medications that may interact with this medicine
It is very important to tell your doctor about all the medications you are taking, including vitamins and herbal products, because some medications can interact with tolcapone.
| What can cause problems? | Description |
|---|---|
| Do not take these with anything. | |
| MAOI type medications | Medications for depression like Marplan, Nardil, and Parnate. |
| Inform your doctor if you are taking these together. | |
| Alcohol | Alcohol can alter the effects of medication and increase drowsiness. |
| Medication for sleep or anxiety | Drowsiness and decreased attention may increase. |
| Apomorphine, dobutamine, dopamine, epinephrine, isoproterenol, norepinephrine | These are medications given for conditions such as heart disease and high blood pressure. |
| Warfarin | A medicine given to prevent blood clots. |
| Other | Desipramine, linezolid, methyldopa, narcotic painkillers. |
What things should you be careful about when taking medication?
It is very important to pay attention to changes in your body while taking this medicine.
- Dizziness and balance : YouYou may feel dizzy or lightheaded. Therefore , do not drive or operate machinery until you know how this medicine affects you. Be careful when getting up from a sitting position, especially if you are elderly.
- Sudden sleep onset: This is a bit more serious. Some people can suddenly fall asleep without any sleepiness, while talking, eating, or even driving. If you experience this, tell your doctor immediately.
- Uncontrollable urges: Some people may experience uncontrollable urges to gamble, have sex, spend money unnecessarily, or binge eat while taking this medication. This is nothing to be ashamed of, and it can be a side effect of the medication. If you experience any of these, tell your doctor right away.
- Skin care: While taking this medicine, always check your skin for changes in your existing moles or new moles. If you notice any changes, tell your doctor .
- Dry mouth : If your mouth is dry, chewing sugar-free gum, sucking on unsweetened candy, and drinking plenty of water can help.
What side effects might I experience?
Like any medicine, tolcapone can have side effects. Some are serious, some are common.
| Symptoms of liver damage | Dark yellow or brown urine, yellowing of the eyes or skin, pain in the upper right part of the stomach, nausea, loss of appetite. |
| Symptoms of muscle damage | Dark urine, difficulty urinating, unusual weakness, muscle pain. |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Other serious symptoms | Severe diarrhea, hallucinations, sudden sleepiness, loss of consciousness and falling, uncontrollable shaking of limbs such as arms, legs, face, and neck. |
| Diarrhea | Dizziness |
| Headache | Loss of appetite |
| Nausea | Trouble sleeping |
Where do you keep the medicine?
- Keep out of reach of children .
- Store at room temperature (between 20-25 degrees Celsius).
- Keep the bottle cap tightly closed.
- Throw away any medicine left after the expiration date.
Take-Home Message
- Tolcapone is a companion drug that increases the effectiveness of your main Parkinson's medication.
- Before starting this medication, tell your doctor about all medical conditions you have and all medications you are taking.
- Do not stop taking the medication suddenly without medical advice.
- Be on the lookout for sudden sleepiness, uncontrollable cravings, and signs of liver damage. If you notice any of these, tell your doctor immediately.
- If you suspect an overdose, immediately go to the National Poisons Information Center or the nearest hospital Emergency Department (ETU).
- Talk openly with your doctor about any questions or concerns you may have.
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