(Brand names in India: Syncapone, Entacom plus)
How do Entacapone & Tolcapone act?
Entcapone is a friend of levodopa.
It prevents the breakdown of levodopa by inhibiting an enzyme called COMT. The name of the enzyme is not important, what is important is that entacapone protects levodopa.
Therefore, it makes the levodopa stay longer in the blood. As a a result the effect of levodopa is increased, and more importantly – the effect of levodopa lasts for a longer time.
- It directly increases the effect of levodopa. In some patients, when Parkinson’s disease progresses, the effect of levodopa lasts for a shorter and shorter time. These patients may often say something like the following: Well, I agree that levodopa helps me. It perks me up, makes me want to walk, in fact, I can walk very, very well for the first 2 hours after taking levodopa. But, 2 hours later the effect goes away! And I am back to the stage where I was before taking levodopa. This roller-coaster ride continues throughout the day. – This is called “Predictable wearing OFF”. Entacapone is extremely helpful in this situation.
- Rarely, it may cause mild liver side effects. This is not very common.
- The stronger brother – Tolcapone – is not available in India. Tolcapone is more effective than entacapone. But Tolcapone can result in serious liver injury, and therefore it’s use needs to be very closely monitored.
Who doesn’t need friends? Entacapone helps its buddy levodopa to keep acting longer.
Doctors don’t use Entacapone much, because of the risk of liver injury.
Dr. Siddharth Kharkar
Dr. Kharkar is a Neurologist, Epilepsy specialist & Parkinson’s disease specialist in Mumbai, Maharashtra, India. He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.