Tolcapone
Tolcapone is a medication that acts as a catechol-O-methyltransferase (COMT) inhibitor used as an adjunct to levodopa therapy in Parkinson's disease to reduce motor fluctuations and extend the effect of levodopa. It crosses the blood-brain barrier, providing central and peripheral inhibition of COMT, in contrast to entacapone which acts peripherally only.
By inhibiting peripheral metabolism of levodopa to 3-O-methyldopa, tolcapone increases levodopa bioavailability in the brain and
Tolcapone is given orally in divided doses with carbidopa-levodopa. The total daily dose commonly ranges up
Tolcapone carries a risk of serious hepatotoxicity and requires liver function monitoring before starting and regularly
Common adverse effects include nausea, orthostatic hypotension, dyskinesias, confusion, and sleep disturbances. Caution with concomitant MAO