Uses
What is tolcapone used for?
Tolcapone is commonly used to treat Parkinson’s disease, a condition that affects the part of your brain that controls your movements.
Tolcapone may also be used for other conditions as determined by your healthcare provider.
How does tolcapone work (mechanism of action)?
Tolcapone belongs to a group of medicines called catechol-O-methyltransferase (COMT) inhibitors. It is believed to slow down the breakdown of levodopa, another medicine used to treat Parkinson’s disease. This helps extend the effect of levodopa.
How is tolcapone supplied (dosage forms)?
Tolcapone is available as Tasmar and generic tolcapone in the following dosage form that is taken by mouth.
- 100 mg oral tablets
How should I store tolcapone?
Tolcapone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of tolcapone?
The most common side effects of tolcapone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Uncontrollable, involuntary movements (see below)
- Nausea, vomiting
- Diarrhea (see below)
- Loss of appetite
- Sleep problems
- Changes in urine (pee) color
- Sleepiness (see below)
- Hallucinations (see below)
- Sweating
There may be other side effects of tolcapone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of tolcapone?
While less common, the most serious side effects of tolcapone are described below, along with what to do if they happen.
Severe Allergic Reactions. Tolcapone may cause allergic reactions, which can be serious. Stop taking tolcapone and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking tolcapone. Your health care provider may schedule lab tests and other appointments to check your liver. Keep all appointments to have your blood checked. Call your healthcare provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine (pee)
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Sleepiness. Tolcapone can make you sleepy, sometimes very suddenly and without warning signs. Do not drive or do other activities that require alertness or coordination until you know how tolcapone affects you.
Low Blood Pressure Upon Standing (Orthostatic Hypotension). Tolcapone may cause a sudden drop in blood pressure when standing up from a seated or lying position. This may also cause fainting. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your healthcare provider right away if you have any of the following symptoms of orthostatic hypotension.
- Dizziness, feeling lightheaded, or fainting upon standing
- Blurred vision
- Confusion
- Feeling weak
Diarrhea. Diarrhea is common with tolcapone. You may get diarrhea within a few weeks of starting tolcapone or many months later. Call your healthcare provider right away if you have any of the following.
- Severe diarrhea
- Diarrhea that does not go away
- Diarrhea with weakness, dizziness, or fever
Hallucinations or Psychotic-like Behaviors. Tolcapone may cause hallucinations or psychotic-like behaviors. Tell your healthcare provider right away if you experience any of the following (either you have noticed on your own or you have been told by others).
- Hearing, seeing, smelling, tasting, or otherwise perceiving things that have turned out to be false
- Delusional thoughts (such as false belief that you are being controlled)
- Disorganized thoughts (such as jumping between topics or having a hard time focusing)
- Sudden decline in self-care (such as personal hygiene or academic/work performances)
- Aggressive behavior
Uncontrollable, Involuntary Movements (Dyskinesia). Tolcapone may cause or worsen involuntary movement problems, including shakiness, stiffness, or jerkiness. Call your healthcare provider right away if you develop or have worsening or more frequent unusual/uncontrolled movements.
Unusual or Compulsive Behaviors. Tolcapone can cause some people to have strong unusual and uncontrolled urges (compulsions), including gambling, sex, shopping, or eating. Talk to your healthcare provider right away if you or someone you know notices that you have new or worsening strong urges or behaviors.
Muscle Problems. Tolcapone may cause muscle breakdown (rhabdomyolysis), which can be serious and rarely lead to kidney damage and death. Get emergency help right away if you have any of the following symptoms of rhabdomyolysis.
- Unexplained muscle pain, weakness, or tenderness
- Dark-colored urine (pee)
- Fever
- Muscle cramps
- Stomach pain
- Nausea or vomiting
Warnings & Precautions
Who should not use tolcapone?
Allergies to Ingredients. People who are allergic to any of the following should not take tolcapone.
- Tolcapone
- Tasmar
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific tolcapone products they stock.
Liver Problems. Tolcapone should not be used if you have ever experienced liver injury from taking tolcapone that made you stop the medicine. Tolcapone should also not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.
Medicine-Related Muscle Damage. Tolcapone should not be used if you have ever experienced muscle damage (rhabdomyolysis) that is possibly related to a medicine use.
Medicine-Related Fever and Confusion. Tolcapone should not be used if you have ever experienced any fever and confusion that are possibly related to a medicine use.
What should I know about tolcapone before using it?
Do not take tolcapone unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share tolcapone with other people, even if they have the same condition as you. It may harm them.
Keep tolcapone out of the reach of children.
Tell your health care provider if you do not see improvements in your symptoms within 3 weeks of taking tolcapone.
Do not stop taking tolcapone without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.
- High fever
- Muscle stiffness or rigidity, where it is hard to move
- Changes in your breathing or heart rate
- Increased sweating
- Confusion
Tolcapone may cause you to feel sleepy, especially if you already have conditions or take medicines that can make you drowsy. You may feel sudden drowsiness in the middle of an activity without warning signs. Tolcapone may also cause dizziness, especially when you stand up quickly after lying or sitting down. Do not drive or do other activities that require alertness or coordination until you know how tolcapone affects you.
What should I tell my healthcare provider before using tolcapone?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if tolcapone is right for you.
In particular, make sure that you discuss any of the following.
Psychotic Disorder. Tell your healthcare provider if you have any psychotic disorder such as schizophrenia or delusional disorder. Tolcapone may increase the risk of psychosis.
Sleepiness. Tell your healthcare provider if you have any conditions such as obstructive sleep apnea or narcolepsy that make you more sleepy than usual or if you feel that you are prone to feeling drowsy during the day. Tolcapone may increase the risk of sudden daytime drowsiness.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Low blood pressure
- Uncontrollable, involuntary movements (dyskinesia)
- Unusual urges such as gambling, binge eating, compulsive shopping, or increased sex drive
- Liver problems
- Kidney problems
Other Medicines and Supplements. Tolcapone may interact with other medicines and supplements. Before taking tolcapone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how tolcapone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take tolcapone while you are pregnant or trying to get pregnant.
Breastfeeding. It is not known if tolcapone passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take tolcapone while breastfeeding.
Interactions
Does tolcapone interact with foods or drinks?
There are no known interactions between tolcapone and foods or drinks.
It is unknown if drinking alcohol will affect tolcapone. The risk of drowsiness or sleepiness may be increased if you drink alcohol while taking tolcapone.
Does tolcapone interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking tolcapone.
- A nonselective monoamine oxidase inhibitor (MAOI), such as phenelzine (Nardil), tranylcypromine (Parnate), or isocarboxazid (Marplan), which is a medicine usually used for depression
- Methyldopa, which is a medicine used to reduce blood pressure
- Dobutamine, which is a medicine usually used for severely reduced heart function
- Apomorphine (Apokyn), which is a medicine used to treat Parkinson’s disease
- Isoproterenol, which is a medicine used for slow heart rate or heart block
- Warfarin (Coumadin, Jantoven), which is a blood thinner
- Desipramine (Norpramin), which is a medicine commonly used to treat depression
- Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
- Tolcapone may alter the blood levels of some other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with tolcapone. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much tolcapone?
If you or someone else has used too much tolcapone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of tolcapone?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Tolcapone (Tasmar)?
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